J Emerg Med
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Peritonsillar abscesses (PTAs) are encountered routinely in clinical practice. Ultrasound-guided aspiration has been proven both safe and effective in treating this condition. However, to date, there are no easily produced, low-cost models that enable the practice of point-of-care ultrasound-guided PTA aspiration and PTA diagnosis. ⋯ With minimal lead time and readily available equipment, we successfully created a low-cost ultrasound phantom for the purpose of PTA identification and drainage.
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Observational Study
The Effect of Human Supervision on an Electronic Implementation of the Canadian Triage Acuity Scale (CTAS).
Most electronic emergency department (ED) triage systems allow nurses to modify computer-generated triage scores. It is currently unclear how this affects triage validity. ⋯ Nursing supervision of the computer-automated CTAS triage system was associated with fewer hospital admissions, ICU consultations, and deaths in the triage score 4-5 categories, suggesting a safer triage process than the automated CTAS algorithm alone.
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Auscultation for an extended period of time using a wearable stethoscope enables objective computerized analysis and longitudinal assessment of lung sounds. However, this auscultation method differs from bedside auscultation in that clinicians are not present to optimize the quality of auscultation. No prior studies have compared these two auscultation methods. ⋯ Extending the duration of auscultation using a wearable stethoscope in a noisy clinical environment showed comparable performance to standard of care intermittent auscultation in identifying patients who have wheezes.
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Sepsis is a high mortality condition characterized by multi-organ dysfunction. Sepsis-induced cardiomyopathy (SIC) refers to cardiac dysfunction in sepsis. ⋯ SIC can be detected using FCU by emergency physicians in the ED and is associated with increased 90-day mortality.
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Cerebral fat embolism is a rare diagnosis that can occur after significant long bone trauma. Most patients have evidence of pulmonary involvement, but this case involved a patient with a pure neurologic manifestation of a fat embolism. ⋯ An 89-year-old woman presented to the emergency department as a transfer from an outside hospital with a diagnosis of air embolism after an episode of altered mental status and expressive aphasia. A secondary review of the patient's computed tomography angiography head imaging uncovered a cerebral fat embolism as the cause of the patient's acute neurologic event. The cerebral fat embolism was likely from a remote sacral fracture 6 weeks prior. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: When a patient presents with a concern for a stroke-like symptoms and a cerebral fat embolism is diagnosed, a thorough examination of the patient must be performed to identify the primary fracture site. Geriatric long bone fractures have well-known significant morbidity and mortality. An associated cerebral fat embolism can increase that mortality and morbidity and prompt diagnosis is important.