European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study
Prediction of bacteremia in the emergency department: an external validation of a clinical decision rule.
The objective of this study was to validate a previously published clinical decision rule for predicting a positive blood culture in emergency department (ED) patients with suspected infection on the basis of major and minor criteria and a total score (Shapiro et al., J Emerg Med, 2008; 35:255-264). ⋯ The clinical decision rule performed well in our ED setting and is likely to be a useful supplement to clinical judgment.
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Comparative Study
Evaluation of nasogastric tubes to enable differentiation between upper and lower gastrointestinal bleeding in unselected patients with melena.
Gastrointestinal (GI) bleeding is a common surgical problem. The aim of this study was to evaluate how insertion of the nasogastric tube may enable differentiation between upper and lower GI bleeding in patients with melena. A retrospective study involving patients admitted to our surgery division with a melena was carried out between the years 2010 and 2012. ⋯ The sensitivity of examination of nasogastric aspirate to establish the upper GI as the source of bleeding was only 28% and the negative predictive value of a negative nasogastric aspirate was less than 1%. Most patients who initially presented with melena and were found to have upper GI bleeding had a negative nasogastric aspirate. Insertion of a nasogastric tube does not affect the clinical decision to perform upper endoscopy and should not be routinely carried out.
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Comparative Study Observational Study
Urgent carotid duplex and head computed tomography versus ABCD2 score for risk stratification of patients with transient ischemic attack.
The aim of the study was to prospectively compare the prognostic value of ABCD score, urgent carotid ultrasound (CUS), and unenhanced head computed tomography (UHCT) in patients presenting to the emergency department with transient ischemic attack (TIA). ⋯ Simple imaging tests showed added prognostic value to ABCD score in TIA patients. Urgent CUS together with UHCT should be performed in all TIA patients regardless of ABCD score.
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Observational Study
Analysis of a data-fusion system for continuous vital sign monitoring in an emergency department.
The aim of the study was to evaluate the ability of a data-fusion patient status index (PSI) to detect patient deterioration in the emergency department (ED) in comparison with track-and-trigger (T&T). ⋯ Electronic data capture offers opportunities for increased detection of deteriorating patients in a busy clinical environment compared with paper charts. Sample size in this study is insufficient to determine which electronic method (eT&T or PSI) offers superior detection of the need for escalation.