Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The objective was to compare the rates of antimicrobial susceptibility in strains of Escherichia coli isolated from uncomplicated cystitis cases presenting to the emergency department (ED) of a tertiary care center to those reported on that institution's hospital-wide antibiogram. The hypothesis was that cases of uncomplicated cystitis presenting to the ED will exhibit higher antimicrobial susceptibility than is reported by the hospital-wide antibiogram. ⋯ The greater susceptibility of E. coli to TMP-SMX, cefazolin, and ciprofloxacin observed in this population supports the hypothesis that antimicrobial susceptibility rates in uncomplicated cystitis presenting to the ED are greater than those reported in the hospital-wide antibiogram. This could affect treatment guidelines by confirming that antimicrobials currently recommended for use in uncomplicated cystitis are more effective in this setting than currently reported by the hospital-wide antibiogram.
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Asthma is a common chronic respiratory condition, and exacerbations may cause individuals to seek care in emergency departments (EDs). This study examines the monthly patterns of asthma presentations to EDs in Alberta, Canada. ⋯ Rates of ED presentations for asthma have been declining in this province during the past decade. The reasons for this decline warrant further exploration. The SARIMA models quantified the temporal patterns and may be helpful for planning research and health care service needs.
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Uncontrolled hemorrhagic shock is the leading cause of potentially preventable death in major trauma patients. Damage control resuscitation (DCR), a strategy combining the techniques of permissive hypotension, hemostatic resuscitation, and damage control surgery, has been highly recommended for trauma patients. This study investigated whether emergency department (ED) crowding was associated with poor performance of the DCR strategies in treating hemorrhagic shock trauma patients. ⋯ ED crowding was associated with poor performance of DCR for major trauma patients in the ED. New strategies should be implemented to ameliorate crowded conditions and potential adverse outcomes.
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Some subcutaneous foreign bodies (FBs) are not easily visualized during physical examination and may not be detected on radiographic evaluation. Ultrasound (US) is capable of visualizing FBs of varying compositions. Previous studies have examined the use of US to detect FBs in deceased animal or human tissue. This study used live anesthetized porcine tissue to more closely model clinical conditions. ⋯ Ultrasound was sensitive, specific, and accurate in identifying FBs in live anesthetized porcine tissue. Surrounding edema or hematoma 2 hours after placement was so infrequently observed that it was not possible to determine its influence on the test characteristics.