Articles: emergency-department.
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Emergency radiology · Jul 2002
Reappraisal of use of X-rays in childhood ankle and midfoot injuries.
To determine whether the Ottawa ankle rules (OAR) can be applied in children and what the potential reduction in the use of X-ray studies might be. ⋯ The Ottawa ankle rules are very sensitive and can be applied in children, resulting in a reduction in the use of X-rays studies.
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Emergency radiology · Jul 2002
Utilization of CT-PA in an emergency department with readily available V/Q scintigraphy.
To describe the role of computed tomographic pulmonary angiography (CT-PA) in the emergency department of an institution which utilizes ventilation-perfusion (V/Q) scintigraphy as its primary imaging modality for the diagnosis of pulmonary embolism. ⋯ V/Q scintigraphy is the primary imaging modality for suspected pulmonary embolism in our emergency department. However, when utilized, CT-PA played an important role in patient management by confirming or excluding pulmonary embolism or providing an alternative diagnosis in the majority of patients suspected of having pulmonary embolism.
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Reducing the number of unnecessary antibiotic prescriptions given for common respiratory infections has been recommended as a way to limit bacterial resistance. This study assessed the validity of a clinical sore throat score in 2 community emergency departments (EDs) and its impact on antibiotic prescribing. We also attempted to improve on this approach by using a rapid streptococcal antigen test. ⋯ An explicit clinical score approach to the management of GAS pharyngitis is valid in a community ED setting and could improve the pattern of antibiotic prescribing. While the addition of a rapid streptococcal antigen test significantly decreased the sensitivity of detecting GAS infections, a combined approach consisting of the clinical score and throat culture for patients with negative results on the rapid test would decrease antibiotic prescribing and telephone follow-up without decreasing the sensitivity of detecting GAS infection.
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Paramedics often provide advance notice of patients with suspected acute myocardial infarction (AMI) so that emergency department (ED) staff can prepare for early aggressive management and expeditious thrombolysis, but the validity of this practice is unclear. Our objective was to determine the accuracy of prehospital AMI diagnosis by Paramedic Level III (ALS) attendants. ⋯ ALS paramedics can accurately identify patients likely to benefit from early aggressive AMI management. These data have implications with respect to prehospital triage of chest pain patients, "early notification" protocols and future prehospital thrombolytic strategies.