European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The objective of this study was to investigate the accuracy of renal point of care ultrasound (POCUS) for the detection of hydronephrosis in children with a urinary tract infection (UTI). We prospectively included all patients with a final diagnosis of UTI who visited our pediatric emergency department between November 2009 and April 2011. Emergency physicians were encouraged to perform a renal POCUS during these visits, and a follow-up renal ultrasonography was performed by a radiologist who was blinded to the results of POCUS. ⋯ The sensitivity and the specificity were 76.5% (95% confidence interval: 58.1-94.6%) and 97.2% (95.2-99.2%), respectively. The positive and the negative predictive values were 59.1% (36.4-79.3%) and 98.8% (97.7-99.9%), respectively. Renal POCUS might be used to rule out hydronephrosis in pediatric UTI.
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Resuscitation of patients who sustain a cardiac arrest as a result of trauma (traumatic cardiac arrest) has previously been described as 'futile'. Several published series have since contradicted this claim and reported survival-to-discharge data ranging from 0 to 35%. ⋯ This minimizes de-novo decision-making under high-stress situations, promotes a rational approach and reduces the burden on an individual clinician. This narrative review sets out to highlight the differences in aetiology of traumatic cardiac arrest as compared with medical cardiac arrest and the consequent priorities in resuscitation.
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Randomized Controlled Trial Comparative Study
Virtual reality and live simulation: a comparison between two simulation tools for assessing mass casualty triage skills.
This study tested the hypothesis that virtual reality simulation is equivalent to live simulation for testing naive medical students' abilities to perform mass casualty triage using the Simple Triage and Rapid Treatment (START) algorithm in a simulated disaster scenario and to detect the improvement in these skills after a teaching session. ⋯ Virtual reality simulation proved to be a valuable tool, equivalent to live simulation, to test medical students' abilities to perform mass casualty triage and to detect improvement in such skills.
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Comparative Study
Evaluation of a hospital admission prediction model adding coded chief complaint data using neural network methodology.
Our objective was to apply neural network methodology to determine whether adding coded chief complaint (CCC) data to triage information would result in an improved hospital admission prediction model than one without CCC data. ⋯ Neural net methodology application resulted in the derivation and validation of a modestly stronger hospital admission prediction model after the addition of CCC data.