J Emerg Med
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The COVID-19 pandemic presents a significant challenge to the global health care system. Implementing timely, accurate, and cost-effective screening approaches is crucial in preventing infections and saving lives by guiding disease management. ⋯ This study developed and validated three machine learning prediction models for COVID-19 mortality based on accessible clinical features. The RF model showed the best performance among the three models. The nine variables identified in the models may warrant further investigation as potential prognostic indicators of severe COVID-19.
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Biatrial thrombus is a rare condition that is typically associated with a patent foramen ovale (PFO). ⋯ This is a case of a 75-year-old man with history of heavy alcohol use found down with altered sensorium. He was hypothermic and in atrial fibrillation with rapid ventricular rate and was subsequently found to have a biatrial thrombus with no evidence of PFO. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Biatrial thrombus presents the unique danger of progressing to both pulmonary embolus and acute embolic disease (including stroke); both are life-threatening diagnoses that can be prevented by means of identifying and treating this rare and dangerous condition.
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Pandemics with devastating morbidity and mortality have occurred repeatedly throughout recorded history. Each new scourge seems to surprise governments, medical experts, and the public. The SARS CoV-2 (COVID-19) pandemic, for example, arrived as an unwelcome surprise to an unprepared world. ⋯ Our proposed ethical norms should help future physicians make morally challenging choices during pandemics.
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The differential diagnosis for pediatric neck pain is broad and includes benign and life-threatening entities. The neck is a complex structure with many compartments. Rare disease processes exist that can mimic more serious conditions, such as meningitis. ⋯ We present a case of a teenager with several days of severe pain underneath her left jaw, limiting the motion of her neck. After laboratory and imaging evaluation, the patient was found to have an infected Thornwaldt cyst and was subsequently admitted for IV antibiotic treatment. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Including infected congenital cysts on the differential for pediatric neck pain can help ensure appropriate use of invasive procedures, such as lumbar puncture. Missed cases of infected congenital cysts could lead to patients returning to the emergency department with persistent or worsened symptoms.
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Randomized Controlled Trial
Pediatric Chest Compression Improvement Via Augmented Reality Cardiopulmonary Resuscitation Feedback in Community General Emergency Departments: A Mixed-Methods Simulation-Based Pilot Study.
Yearly, more than 20,000 children experience a cardiac arrest. High-quality pediatric cardiopulmonary resuscitation (CPR) is generally challenging for community hospital teams, where pediatric cardiac arrest is infrequent. Current feedback systems are insufficient. Therefore, we developed an augmented reality (AR) CPR feedback system for use in many settings. ⋯ The novel CPR feedback system, AR-CPR, significantly changed the CC performance in community hospital non-pediatric-specialized general EDs from 18-21% to 87-90% of CC epochs at goal. This study offers preliminary evidence suggesting AR-CPR improves CC quality in community hospital settings.