Emergency medicine journal : EMJ
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Observational Study
A new score for the diagnosis of acute coronary syndrome in acute chest pain with non-diagnostic ECG and normal troponin.
Acute coronary syndrome (ACS) represents a difficult diagnostic challenge in patients with undifferentiated chest pain. There is a need for a valid clinical score to improve diagnostic accuracy. ⋯ The ACSD score showed a good discrimination performance and an excellent negative predictive value which allows safely ruling out ACS in ED patients with undifferentiated chest pain. Our findings should be validated in a larger multicentre study.
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The characteristics of staphylococcal skin and soft tissue infections (SSTIs) are poorly understood in northern South America and the Caribbean. The objectives of this study were to determine the frequency of methicillin resistance among Staphylococcus aureus isolates in an emergency department (ED) in Guyana and to identify specific molecular characteristics of these methicillin-resistant Staphylococcus aureus (MRSA) strains. ⋯ Here, we demonstrate a clinically significant proportion of methicillin resistance in SSTI-associated staphylococcal isolates. Guyanese isolates were highly related to the most common community-associated strain seen in the USA, USA300. These results have important implications for empiric antibiotic therapy and infection control policies in Guyana and similar settings.
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The use of emergency services among adolescents and adults with autism spectrum disorder (ASD) transitioning into adult health services has not been well described. ⋯ Patients with ASD and their families are likely to engage with paramedics or police or visit the ED. Further education and support to families and emergency clinicians are needed to improve and, when possible, prevent such occurrences.
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The identification of serious injury is critical to the tasking of air ambulances. London's Air Ambulance (LAA) is dispatched by a flight paramedic based on mechanism of injury (MOI), paramedical interrogation of caller (INT) or land ambulance crew request (REQ).This study aimed to demonstrate which of the dispatch methods was most effective (in accuracy and time) in identifying patients with serious injury. ⋯ Telephone interrogation of the caller by a flight paramedic is as accurate as ground ambulance crew requests, and both are significantly better than MOI in identifying serious injury. Overtriage remains an issue with all methods.
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Social media has been viewed by some as a threat to traditional medical education. In emergency care, the underpinning educational principles of social media, while sometimes innovative in their delivery, are often no different than long-standing techniques and methods. This article aims to encourage discussion and debate that reduces the divide between these two communities of practice.