Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To assess serum procalcitonin (PCT) and white blood cell (WBC) count in detecting bacteremia in elder emergency department (ED) patients. ⋯ In elder ED patients, a PCT level of 0.2 ng/mL is sensitive for bacteremia and, based on its negative likelihood ratio, is moderately helpful in ruling out the diagnosis. WBC count with or without left shift performed poorly in the diagnosis of bacteremia.
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Bronchiolitis is the most common disease of the lower respiratory tract in the first year of life. Treatment is controversial, with studies giving conflicting views on the benefits of bronchodilators and steroids. The objectives of this study were 1) to characterize the management of bronchiolitis in pediatric emergency departments (PEDs) in Canada, 2) to determine patient outcomes following emergency department (ED) visits, and 3) to provide descriptive data regarding bronchiolitis symptoms and family/personal medical history of these patients. ⋯ This study prospectively describes the treatment of bronchiolitis in the pediatric ED. The findings are consistent with the literature regarding the reported use of bronchodilators; however, use of steroids was found to be much lower than reported in other studies. Bronchodilator use in the ED and at discharge varied significantly by site. The results capture variation in treatment practices in Canadian PEDs, which may be the result of discordant randomized controlled trial evidence. Further research is needed to establish best practices.
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A massive nerve agent attack may rapidly deplete in-date supplies of atropine. The authors considered using atropine beyond its labeled shelf life. The objective was to determine the stability of premixed injectable atropine sulfate samples with different expiration dates. ⋯ Significant amounts of atropine were found in all study samples. All samples remained clear and colorless, and no substantial amount of tropine was found in any study sample. Further testing is needed to determine clinical effect.
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Comparative Study Clinical Trial
The validity of emergency department triage blood pressure measurements.
Automated blood pressure (ABP) devices are ubiquitous at emergency department (ED) triage. Previous studies failed to evaluate ABP devices against accepted reference standards or demonstrate triage readings as accurate reflections of blood pressure (BP). This study evaluated ED triage measurements made using an ABP device and assessed agreement between triage BP and BP taken under recommended conditions. ⋯ ABP triage measurements show significant discrepancies from a reference standard. Repeat measurements following AHA standards demonstrate significant decreases in the measured blood pressures.
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Clinical Trial Controlled Clinical Trial
Pain scores improve analgesic administration patterns for trauma patients in the emergency department.
To determine the efficacy of pain scores in improving pain management practices for trauma patients in the emergency department (ED). ⋯ Pain assessment using VPS increased the likelihood of analgesic administration to trauma patients with higher pain scores in the ED.