Emergency medicine journal : EMJ
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Pleuritic chest pain, a symptom of pulmonary embolism, is a common presenting symptom in the emergency department. The aim of this study was to validate an algorithm for the diagnosis of pulmonary embolism in emergency department patients with pleuritic chest pain. ⋯ The MIOPED (Manchester Investigation Of Pulmonary Embolism Diagnosis) diagnostic protocol can safely exclude pulmonary embolism in outpatients with pleuritic chest pain.
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Many patients who have been discharged from the emergency department (ED) with a diagnosis of "non-specific chest pain" (NSCP) have anxiety disorder (AD), a commonly missed entity in acute care. The objective of this study was to delineate characteristic properties that could enhance recognition of AD in ED patients admitted with NSCP. ⋯ Physicians should always consider AD in patients presenting to the ED with chest pain after ruling out organic aetiology. Patients' definition of atypical pain, recurrent admissions to ED, and presence of associated symptoms such as dizziness, chills or hot flushes, and fear of dying could aid in considering AD.
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To answer concerns related to implementation of the National Institute for Clinical Excellence (NICE) guideline on the management of head injury by determining the impact on the workload of a district general hospital. Increased computed tomography (CT) was of particular concern (cost, radiation risk, and delivery constraints). ⋯ This department has seen an increase in CT head requests since the implementation of the NICE guideline. This costs an extra 15,000 pounds sterling per 100 head injuries annually for this department, with an estimated 51.7 million pounds sterling burden for England and Wales. Further evaluation is required as there were only nine brain injuries in this audit population.
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To describe the epidemiology, process of care, and outcomes at 4-6 weeks after injury among patients with whiplash associated disorder attending a UK emergency department. ⋯ This study identifies that there is significant disability associated with whiplash associated disorder. Clear prognostic information would be a useful development.