Can J Emerg Med
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Multicenter Study Comparative Study
Survey of emergency physicians' requirements for a clinical decision rule for acute respiratory illnesses in three countries.
ABSTRACTObjective:There are currently no widely used guidelines to determine which older patients with acute respiratory conditions require hospital admission. This study assessed the need for clinical decision rules to help determine whether hospital admission is required for patients over 50 years for three common respiratory conditions: chronic obstructive pulmonary disease (COPD), heart failure (HF), and community-acquired pneumonia (CAP). ⋯ EPs are likely to adopt highly sensitive clinical decision rules to predict the need for hospital admission for patients over 50 years with COPD, HF, or CAP.
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Comparative Study
Evaluation of the incidence, risk factors, and impact on patient outcomes of postintubation hemodynamic instability.
Postintubation hemodynamic instability (PIHI) is a potentially life-threatening adverse event of emergent endotracheal intubation. The objectives of this study were to determine the incidence, risk factors, and impact on patient outcomes associated with PIHI in intubations performed in emergency medicine. ⋯ Based on our data, postintubation hypotension occurs in a significant proportion of ED patients requiring emergent airway control. Further investigation is needed to confirm the factors we found to be associated with PIHI and to determine if PIHI is associated with increased morbidity and mortality.
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Case Reports
Horseshoe abscess associated with acute carpal tunnel syndrome: somebody wake up the hand surgeon.
The horseshoe abscess is a rare variant of flexor tendon sheath infections. It involves the tendon sheaths of the first and fifth digits, which communicate through the deep potential space of the wrist. Neural compression is possible, leading to an acute carpal tunnel syndrome. The approach to such patients should include empirical antibiotic coverage and urgent consultation with a hand surgeon to facilitate operative management.
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Do specific elements of the history and physical examination predict the presence of pulmonary embolism in the emergency department? ⋯ To determine whether implicit clinical predictors previously untested predict the presence of pulmonary embolism in the emergency department.