Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
Tandem measurement of D-dimer and myeloperoxidase or C-reactive protein to effectively screen for pulmonary embolism in the emergency department.
The hypothesis was that the tandem measurement of D-dimer and myeloperoxidase (MPO) or C-reactive protein (CRP) could significantly decrease unnecessary pulmonary vascular imaging in emergency department (ED) patients evaluated for pulmonary embolism (PE) compared to D-dimer alone. ⋯ The tandem measurement of D-dimer and MPO would have significantly decreased negative pulmonary vascular imaging compared with D-dimer alone and should be validated prospectively.
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Multicenter Study
Interobserver agreement in assessment of clinical variables in children with blunt head trauma.
To be useful in development of clinical decision rules, clinical variables must demonstrate acceptable agreement when assessed by different observers. The objective was to determine the interobserver agreement in the assessment of historical and physical examination findings of children undergoing emergency department (ED) evaluation for blunt head trauma. ⋯ Both subjective and objective clinical variables in children with blunt head trauma can be assessed by different observers with acceptable agreement, making these variables suitable candidates for clinical decision rules.
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Multicenter Study
Availability and quality of computed tomography and magnetic resonance imaging equipment in U.S. emergency departments.
The objective was to determine the availability and quality of computed tomography (CT) and magnetic resonance imaging (MRI) equipment in U.S. emergency departments (EDs). The authors hypothesized that smaller, rural EDs have less availability and lower-quality equipment. ⋯ Although access to CT imaging was high (>90%), CT resolution and access to MRI were variable. Based on observed differences, the availability and quality of imaging equipment may vary by ED size and location.
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Multicenter Study
Relapse after emergency department discharge for acute asthma.
The objectives were to determine patient and treatment-response factors associated with relapse after emergency department (ED) treatment for acute asthma. ⋯ Ethnicity (white), female gender, prior ED visits and admissions for asthma, and recent treatments (especially oral CS) were associated with asthma relapse, which remains relatively common. Future research is required to target this high-risk group.
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The authors aimed to determine whether certain emergency department (ED) triage "presenting complaint" descriptions are associated with shorter or longer waiting times, when compared with matched controls. ⋯ Waiting times for patients with certain presenting complaints are significantly associated with triage presenting complaint descriptions. It is likely that these descriptions allow EPs to selectively seek or avoid patients with liked or disliked complaints, respectively. The impact of this for patients and ED flow needs investigation.