Emergency medicine journal : EMJ
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To examine the effect of fast track on emergency department (ED) length of stay (LOS). ⋯ ED fast track decreased ED LOS for non-admitted patients without compromising waiting times and ED LOS for other ED patients.
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Early warning scores (EWS) are used to identify physiological deterioration in patients. Studies to date have primarily focused on the correlation between trends in serially recorded EWS of inpatients and clinical outcomes. This study examined the predictive value of an EWS calculated immediately on presentation to hospital for acute medical patients. ⋯ Higher admission EWS correlate with increased risk of CCU/ICU admission, death and longer hospital stays independent of patient age. An improvement in serial EWS within 4 h of presentation to hospital predicts improved clinical outcomes. The EWS is a potential triage tool in the emergency department for acute medical patients.
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Randomized Controlled Trial
Cuffed oropharyngeal airway (COPA) placement is delayed by wearing antichemical protective gear.
Airway management, the first step in resuscitation, may entail special difficulties in mass casualty situations, even in experienced hands. Of the available airway devices, the cuffed oropharyngeal airway (COPA) appears the easiest one to insert, allowing a hands-free anaesthesiologist. A study was undertaken to evaluate the success of airway control with COPA when anaesthetists wore either surgical attire or antichemical protective gear. ⋯ Antichemical protective gear slowed proper placement of COPA and its fixation compared with surgical attire. COPA may be a temporarily useful device in non-conventional settings, but functional reassessment is required when injured patients reach medical facilities.
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An increasing number of studies have shown that ischaemia-modified albumin (IMA) levels rise in a number of acute ischaemic conditions such as cerebral infarct, myocardial infarct, pulmonary infarct and mesenteric infarct, suggesting that IMA may be useful as a diagnostic marker. A study was undertaken to investigate the effect on IMA levels of deep vein thrombosis (DVT), frequently encountered at the outset or during the course of diseases such as pulmonary embolism and cerebral infarct. ⋯ DVT is associated with raised serum IMA levels but IMA levels are not suitable as a diagnostic marker for DVT.
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To determine the prevalence and nature of chest radiographic abnormalities in patients presenting to the emergency department (ED) with suspected acute coronary syndrome but without signs or symptoms of other pathology. ⋯ In the patient group examined, chest radiography resulted in a low yield of unexpected chest pathology. Routine chest radiography for this group is questionable and needs further investigation.