Can J Emerg Med
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Review Meta Analysis
Incidence of postintubation hemodynamic instability associated with emergent intubations performed outside the operating room: a systematic review.
Hemodynamic instability following emergent endotracheal intubation (EETI) is a potentially life-threatening adverse event. The objectives of this systematic literature review were to document the incidence of postintubation hemodynamic instability (PIHI), to determine the definitions for PIHI used in the available literature, and to examine factors associated with PIHI in adult patients who require EETI. ⋯ PIHI was found to occur in 110 cases per 1,000 in-hospital, emergent intubations. However, heterogeneity among the included studies limits the reliability of this summary estimate. Further investigation is warranted.
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Controlled Clinical Trial
Ineffectiveness of cognitive forcing strategies to reduce biases in diagnostic reasoning: a controlled trial.
Cognitive forcing strategies (CFS) may reduce error arising from cognitive biases. This is the first experimental test to determine the effect of CFS training in medical students. ⋯ The educational interventions suggested by experts in clinical reasoning and employed in our study to teach CFS failed to show any reduction in diagnostic error by novices.
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Comparative Study
Outcomes of non-acute coronary syndrome patients discharged from the emergency department with troponin positivity.
Cardiac troponin elevation portends a worse prognosis in diverse patient populations. The significance of troponin elevation in patients discharged from emergency departments (EDs) without inpatient admission is not well known. ⋯ A positive troponin assay during ED stay in discharged patients is an independent marker for risk of subsequent admission. Our findings suggest that the prognostic power of an abnormal troponin extends to patients discharged from the ED.