Articles: emergency-medicine.
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Multicenter Study
Discharge in Pandemic: Suspected Covid-19 patients returning to the Emergency Department within 72 hours for admission.
Coronavirus disease 2019 (Covid-19) has led to unprecedented healthcare demand. This study seeks to characterize Emergency Department (ED) discharges suspected of Covid-19 that are admitted within 72 h. ⋯ Several factors emerge as associated with 72-h ED return admission in subjects suspected of Covid-19. These should be considered when assessing discharge risk in clinical practice.
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The occurrence of head computed tomography (HCT) at emergency department (ED) visit for non-specific neurological symptoms has been associated with increased subsequent stroke risk and may be a marker of diagnostic error. We evaluate whether HCT occurrence among ED headache patients is associated with increased subsequent cerebrovascular disease risk. ⋯ Having a HCT performed at ED treat-and-release headache visit is associated with increased risk of subsequent cerebrovascular disease. Future work to improve cerebrovascular disease prevention strategies in this subset of headache patients is warranted.
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Randomized Controlled Trial Multicenter Study
Emergency physician performed ultrasound-assisted lumbar puncture in children: A randomized controlled trial.
Lumbar puncture (LP) is one of the most common procedures performed in pediatric emergency departments but first-attempt success rates remain low and traumatic LP remains frequent. The aim of this study was to determine if ultrasound performed by emergency physicians improves the probability of first-attempt success for lumbar puncture in children. ⋯ Our study does not support the routine use of ultrasound for performing lumbar puncture in children. Considering the minimal harm and ease of performance, ultrasound may be used as an adjunct and teaching tool in certain clinical situations.
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Multicenter Study
Acuity patterns of heart failure among emergency departments in a large health system.
The prognostic importance of Emergency Heart Failure Mortality Risk Grade (EHMRG) score in assessing short term mortality in Congestive Heart Failure (CHF) patients has been validated in the past, however, few studies have examined acuity patterns in the CHF population across healthcare settings. We aim to understand acuity patterns of CHF patients across a large health system for better resource utilization. ⋯ Academic hospitals had a higher number of Acute Heart Failure (AHF) patients, larger number of low acuity patients, higher admission rates, but less revisit rates to the ED as compared to community hospitals. We suggest acuity specific interventions will help decrease admission and revisit rates.
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Scand J Trauma Resus · Apr 2021
Multicenter StudyWhich symptoms pose the highest risk in patients calling for an ambulance? A population-based cohort study from Denmark.
Emergency medical service patients are a vulnerable population and the risk of mortality is considerable. In Denmark, healthcare professionals receive 112-emergency calls and assess the main reason for calling. The main aim was to investigate which of these reasons, i.e. which symptoms or mechanism of injury, contributed to short-term risk of death. Secondary aim was to study 1-30 day-mortality for each symptom/ injury. ⋯ In terms of risk of death on the same day and the day after the 112-call, "unconscious adult/possible cardiac arrest" was the most deadly symptom, about eight times more deadly than "breathing difficulties", 12 times more deadly than "unclear problem", 28 times more deadly than "possible stroke", and 52 times more deadly than "chest pain". "Breathing difficulties" and "unclear problem" as presented when calling 112 are among the top three contributing to short term deaths when calling 112, exceeding both stroke symptoms and chest pain.