Emergency medicine journal : EMJ
-
Multicenter Study
Comparison of Glasgow Admission Prediction Score and Amb Score in predicting need for inpatient care.
We compared the abilities of two established clinical scores to predict emergency department (ED) disposition: the Glasgow Admission Prediction Score (GAPS) and the Ambulatory Score (Ambs). ⋯ The GAPS is a significantly better predictor of need for hospital admission than Ambs in an unselected ED population.
-
We describe ketamine procedural sedations and associated adverse events in low-acuity and high-acuity patients in a resource-limited ED. ⋯ In this series of ketamine sedations in an urban, resource-limited ED, there were no serious adverse events attributable to ketamine.
-
CLINICAL INTRODUCTION: A 44-year-old woman presents pain free to our ED after experiencing 45 min of tightening of the chest with radiation to her left arm, diaphoresis and nausea. Her vital signs are normal except for her high BP, which is 180/110. ⋯ She visited a general practitioner who prescribed pain medication and treated her new-onset hypertension. Besides the recently found hypertension, heavy smoking is her only other traditional risk factor for cardiovascular disease.
-
A shortcut review was carried out to establish whether the use of intravenous vitamin C can reduce mortality or morbidity in patients diagnosed in the early phases of severe sepsis. Three directly relevant papers were found using the reported search strategy. ⋯ It is concluded that there is insufficient high-quality research to justify the routine use of vitamin C in severe sepsis. Further multicentre, double-blinded randomised controlled trials are required in order to establish the role of vitamin C in sepsis.
-
Review
Bet 1: Can induced hypertension improve outcome following acute traumatic spinal cord injury?
A shortcut review was carried out to establish whether augmentation of blood pressure to a high mean arterial pressure (MAP) target in the early phase of traumatic spinal cord injury (SCI) could lead to improvements in morbidity or mortality. 23 directly relevant papers were found using the reported search strategy. Of these, two systematic reviews collated the best evidence to answer the clinical question. ⋯ It is concluded that data from observational cohort studies support high MAP targets and avoidance of hypotension in the early stages of traumatic SCI, but there are insufficient trial data to support routine use as best practice. Given the intervention carries risk, induced hypertension requires careful consideration on a case-by-case basis.