Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a worldwide audience of academics and clinical practitioners. ⋯ In 2014, there were fewer total articles, but a slightly higher absolute number of articles screening in for formal scoring, when compared to the 2013 review. The number of EM development articles decreased, while the number of disaster and humanitarian response articles increased. As in prior years, the majority of articles focused on infectious diseases and trauma.
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The diagnosis of pulmonary embolism (PE) in the emergency department still poses difficulties because symptoms and signs are nonspecific. There is a need for more reliable noninvasive diagnostic tests to support clinical suspicion before the costly invasive procedures with complication risks still used in the diagnosis of PE. Signal peptide-CUB (complement C1r/C1s, Uegf, and Bmp1)-EGF (epidermal growth factor) domain-containing protein 1 (SCUBE1) is a novel, secreted cell surface protein expressed during early embryogenesis. The goal of this study was to compare the SCUBE1 levels between PE patients and healthy subjects and also investigate the value of SCUBE1 in the diagnosis of PE. ⋯ This preliminary study suggests that plasma SCUBE1 values have a good level of specificity for PE and may be of use in the diagnosis of PE. Further studies involving larger case series and also clinical studies are needed to corroborate these findings.
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Randomized Controlled Trial
The Inaccuracy of Using Landmark Techniques for Cricothyroid Membrane Identification: A Comparison of Three Techniques.
Successful cricothyrotomy is predicated on accurate identification of the cricothyroid membrane (CTM) by palpation of superficial anatomy. However, recent research has indicated that accuracy of the identification of the CTM can be as low as 30%, even in the hands of skilled providers. To date, there are very little data to suggest how to best identify this critical landmark. The objective was to compare three different methods of identifying the CTM. ⋯ All three methods performed poorly overall. All three techniques might potentially be even less accurate in instances where the superficial anatomy is not palpable due to body habitus. These findings should alert clinicians to the significant risk of a misplaced cricothyrotomy and highlight the critical need for future research.
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Randomized Controlled Trial Multicenter Study
National Cost Savings From Observation Unit Management of Syncope.
Syncope is a frequent emergency department (ED) presenting complaint and results in a disproportionate rate of hospitalization with variable management strategies. The objective was to estimate the annual national cost savings, reduction in inpatient hospitalizations, and reduction in hospital bed hours from implementation of protocolized care in an observation unit. ⋯ The potential national cost savings for managing selected patients with syncope in a dedicated observation unit is substantial. Syncope is one of many conditions suitable for care in an observation unit as an alternative to an inpatient setting. As pressure to decrease hospital length of stay and bill short-stay hospitalizations as observation increases, syncope illustrates the value of observation unit care.