Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study Comparative Study
Emergency-department diagnosis of acute myocardial infarction and ischemia: a cost analysis of two diagnostic protocols.
To assess the potential cost savings of the emergency-department (ED) diagnosis of acute myocardial infarction (AMI) and other myocardial ischemia using a nine- hour ED evaluation protocol. ⋯ At both centers, hospital charges related to the acute evaluation of chest pain were significantly lower with this ED diagnostic protocol for AMI and myocardial ischemia.
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To demonstrate that creatine kinase-MB fraction (CK-MB) elevations within three hours of presentation in the emergency department (ED) are associated with subsequent ischemic events in clinically stable chest pain patients. ⋯ An elevated CK-MB level within three hours of ED presentation is associated with a subsequent ischemic event in the clinically stable chest pain patient without ST-segment elevation. However, the ED CK-MB identifies only a minority or otherwise low-risk patients who develop ischemic events; other markers for diagnosing myocardial ischemia in the ED are needed.
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Randomized Controlled Trial Comparative Study Clinical Trial
In-vitro comparison of bag-valve-mask and the manually triggered oxygen-powered breathing device.
To determine whether tidal volume, intrapleural pressure, and gastric volume differ when the bag--valve-- mask (BVM) and the manually triggered oxygen powered breathing device (MTBD) are used in the settings of normal and decreased lung compliance. ⋯ In this model, tidal volumes and intrapleural pressures were similar for the two devices. When compliance was normal, no participant insufflated the stomach with the MTBD, while the gastric volume with BVM ventilation averaged 1.3 L. With decreased compliance, the MTBD again delivered significantly less gastric volume than the BVM (1.1 vs. 3.7 L, respectively). These findings favoring MTBD ventilation require corroboration in vivo.
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Multicenter Study
Emergency department CK-MB: a predictor of ischemic complications. National cooperative CK-MB project group.
To demonstrate that a positive CK-MB in the emergency department (ED) predicts an increased risk for complications of myocardial ischemia in patients admitted to the hospital for evaluation of chest pain. ⋯ Multicenter data support the hypothesis that CK-MB measurements can help risk-stratify ED chest pain patients whose initial ECGs are without diagnostic ST-segment elevation.