Can J Emerg Med
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We sought to identify emergency department interventions that lead to improvement in door-to-electrocardiogram (ECG) times for adults presenting with symptoms suggestive of acute coronary syndrome. ⋯ There are multiple interventions that show potential for reducing emergency department door-to-ECG times. Effective bundled interventions include having a dedicated ECG technician, triage education, and better triage disposition. These changes can help institutions attain best practice guidelines. Emergency departments must first understand their local context before adopting any single or group of interventions.
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A 19-year-old female, university student with a long-standing history of migraine headaches presented to the emergency department (ED) with a 36-hour history of gradual onset of left-sided headache, preceded by visual aura. She stated that her headache was worse than usual and now associated with nausea, vomiting, and photophobia, despite use of oral ibuprofen. ⋯ Her neurological examination was normal and her neck was supple with full range of motion. She was a non-smoker, infrequent cannabis user, and her last menstrual period was normal.
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Randomized Controlled Trial
Point-of-care ultrasound before attempting clean-catch urine collection in infants: a randomized controlled trial.
A new non-invasive bladder stimulation technique has been described to obtain clean-catch urine specimens in infants. This study aimed to evaluate if point-of-care ultrasound (POCUS) guided feeding protocol to measure bladder volume prior to stimulation techniques improves clean-catch urine collection success. ⋯ NCT02751671.