Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The presence of squamous epithelial cells (SECs) has been advocated to identify urinary contamination despite a paucity of evidence supporting this practice. We sought to determine the value of using quantitative SECs as a predictor of urinalysis contamination. ⋯ Squamous epithelial cells are a poor predictor of urine culture contamination, but may predict poor predictive performance of traditional urinalysis measures.
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Asthma is the most common chronic illness in children and accounts for > 600,000 emergency department (ED) visits each year. Reducing ED length of stay (LOS) for moderate to severe asthmatics improves ED throughput and patient care for this high-risk population. The objective of this study was to determine the impact of adding standardized, respiratory score-based admission criteria to an asthma pathway on ED LOS for admitted patients, time to bed request, overall percentage of admitted asthmatics, inpatient LOS, and percentage of pediatric intensive care unit (PICU) admissions. ⋯ Standardizing care for asthma patients to include objective admission criteria early in the ED course may optimize patient care and improve ED flow.
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Emergency departments (EDs) are an increasingly important site of care for older adults, but little is known about the priorities of emergency care in this population. We sought to describe and rank priorities of care among older adults receiving care in the ED. ⋯ Among a sample of cognitively intact older ED patients, the most common priorities were related to the accuracy and efficiency of the medical evaluation. These priorities should be considered by those attempting to improve the emergency care of older adults.
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Accurate diagnosis of acute subarachnoid hemorrhage (SAH) is critical in thunderclap headache patients due to high morbidity and mortality associated with missed aneurysmal bleeds. The objective of this study was to determine the utility of computed tomography angiography (CTA) in managing patients with acute, severe headaches and negative noncontrast CT and assess the cost-effectiveness of three different screening strategies-no follow up, CTA, and lumbar puncture (LP). ⋯ Although CTA is frequently used for evaluation of thunderclap headache patients, its utility is not clearly defined. LP follow-up is shown to be the most cost-effective strategy for evaluation of thunderclap headache patients in most clinical settings.