European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Observational Study
What is the 30-day rate of adverse cardiac events in chest pain patients with ED troponin I assays≤99th centile using a contemporary sensitive assay? An exploratory analysis.
For nonhigh-risk patients who 'rule out' for acute coronary syndrome, Australasian guidelines recommend further testing to identify coronary artery disease. Testing is usually performed as an outpatient procedure. This recommendation has not changed with the advent of sensitive biomarker assays. We aimed to determine the 30-day rate of adverse cardiac events in emergency department (ED) chest pain patients without known coronary artery disease who had ED troponin I (TnI) assays≤99th centile using a contemporary troponin assay, stratified by the Heart Foundation (HF; Australia) risk group. ⋯ Among ED patients presenting with suspected acute coronary syndrome, adverse cardiac events at 30 days are rare in nonhigh-risk patients with contemporary TnI assays<99th centile.
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Does emergency ultrasound (EU) improve the speed of diagnosis of patients presenting to the emergency department (ED) with a ruptured abdominal aortic aneurysm (rAAA)? ⋯ There was a nonsignificant trend towards a faster time to diagnosis (51 min) in rAAA patients who underwent EU on presenting to the ED compared with those who did not undergo an ED EU (111 min). There was no improvement in survival or length of ICU unit stay.
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Out-of-hospital cardiac arrest (OHCA) is used to evaluate the performance of the emergency medical service (EMS) system. Our study examined the characteristics and outcomes of OHCA cases presenting to a tertiary care center in Beirut, Lebanon. ⋯ The OHCA survival rate in Beirut, Lebanon, is low. Bystander cardiopulmonary resuscitation and early defibrillation should be prioritized to achieve better outcomes.