Articles: emergency-department.
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Eur J Trauma Emerg S · Jun 2013
Serum cleaved tau protein and traumatic mild head injury: a preliminary study in the Thai population.
To determine the correlation between serum cleaved tau protein and traumatic mild head injury (MHI) (GCS 13-15). ⋯ As it was uncorrelated with traumatic MHI, serum cleaved tau protein proved to be an unreliable biomarker to use in the early detection of and decision-making for traumatic MHI patients at the emergency department.
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A case is presented in which topical tranexamic acid was used to stop local bleeding from a nipple following piercing in a young man with haemophilia. This case, with a review of the relevant literature, highlights the use of topical tranexamic acid as part of a methodical approach to stop localised, non-massive bleeding, particularly in patients with inherited or acquired coagulopathies.
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Curr Emerg Hosp Med Rep · Jun 2013
Airway Management & Assessment of Dyspnea in Emergency Department Patients with Acute Heart Failure.
Shortness of breath is the most common symptom in patients with acute heart failure (AHF). Ensuring adequate oxygenation and ventilation as well as symptomatic relief are key goals of early emergency department management. In this focused review, we describe how to assess dyspnea in clinical practice and how to treat AHF patients to relieve dyspnea, with initial discussion on Airway and Breathing management for patients who present in extremis.
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Emergency Departments (ED) in the UK have seen increasing attendance rates in recent years. Departments are now seeking strategies to reduce their attendances. A review of all ambulance attendances to the ED at Ninewells Hospital was conducted to identify if patients presenting by ambulance could be seen and treated more appropriately in other parts of the health service. ⋯ The ambulance services present one-third of the patients to the ED at Ninewells Hospital. 30%-32% were found to be attending inappropriately and 74%-80% of these could have been managed in primary care. Reducing inappropriate ambulance attendances could reduce the departmental patient load by 11%.
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Nephrol. Dial. Transplant. · May 2013
Randomized Controlled Trial Comparative StudyUrinalysis is more specific and urinary neutrophil gelatinase-associated lipocalin is more sensitive for early detection of acute kidney injury.
Neutrophil gelatinase-associated lipocalin (NGAL) protein is a promising biomarker to detect acute kidney injury (AKI). Earlier detection of AKI could facilitate evaluation of novel therapeutic strategies. ⋯ NGAL can be reliably measured in clinical urine samples, although pyuria is an important potential confounder. In our cohort, increased urinary NGAL was associated with AKI by the AKIN criteria; however, the sensitivity and specificity were only fair, in part because patients with pre-renal causes are not excluded by AKIN criteria. Conversely, findings on microscopic urinalysis are very specific for AKI.