Emergency medicine journal : EMJ
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Comparative Study
Contribution of goal-directed ultrasonography to clinical decision-making for emergency physicians.
To determine the contribution of goal-directed right upper quadrant (RUQ) ultrasonography (US) on real-time decision-making of attending emergency physicians by evaluating their level of certainty for admission, surgery, medical treatment, additional laboratory and radiological investigations and discharge. ⋯ US performed by emergency department physicians affects the certainty of their decisions in patients presenting with RUQ pain. This effect is more evident on the decision to perform additional diagnostic studies and in patients about whom physicians are undecided.
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Letter Practice Guideline Guideline
Guidelines for difficult airway equipment in emergency departments.
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Multicenter Study
The health behaviour and clinical characteristics of ambulance users with acute asthma.
This study sought to determine if ambulance service users differ in their health behaviours to "walk-in" patients attending an emergency department (ED) with acute asthma. ⋯ Ambulance users with acute asthma are more likely to be older, married and less educated. There is no evidence that this group is less responsible in managing their health; however, fewer ambulance users attended their follow-up appointment and the implication for ongoing care requires further investigation.
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Comparative Study
Does prehospital thrombolysis increase the proportion of patients who have an aborted myocardial infarction?
An "aborted" myocardial infarction is defined as an acute coronary syndrome where there is rapid resolution of existing ST segment elevation associated with a rise in creatine kinase (CK) less than twice the upper limit of normal or a small troponin release compatible with minimal myocyte necrosis. Previous research has shown that earlier thrombolysis is associated with a higher rate of aborted infarction. It is also known that prehospital thrombolysis reduces the pain-to-needle time. ⋯ Although prehospital thrombolysis improved pain-to-needle time and a shorter pain-to-needle time increased the incidence of aborted infarction, prehospital thrombolysis was not associated with an increase in the proportion of aborted myocardial infarctions. Further work is required to understand this unexpected finding.