Articles: emergency-services.
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Point-of-care ultrasound (PoCUS) is commonly used at the bedside in the emergency department (ED) as part of clinical examinations. Studies frequently investigate PoCUS diagnostic accuracy, although its contribution to the overall diagnostic approach is less often evaluated. The primary objective of this prospective, multicenter, cohort study was to assess the contribution of PoCUS to the overall diagnostic approach of patients with right upper quadrant abdominal pain. ⋯ Overall, 60 (97%) diagnostic approaches were comparable or better with PoCUS (χ2 = 15.9, p < 0.01). With PoCUS, the mean number of differential diagnoses significantly decreased by 2.3 (95% CI - 2.7 to - 1.5) (p < 0.01), proposed treatments by 1.3 (95% CI - 1.8 to - 0.9) (p < 0.01), and complementary diagnostic tests by 1.3 (95% CI - 1.7 to - 1.0) (p < 0.01). These findings show that PoCUS positively impacts the diagnostic approach and significantly decreases the mean number of differential diagnoses, treatments, and complementary tests.
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Pediatric emergency care · Apr 2024
Utility of Serum Amylase in Children With Abdominal Pain in the Pediatric Emergency Department.
Abdominal pain is among the most common chief complaints seen in pediatric emergency departments (PEDs). This study aims to evaluate the diagnostic utility of amylase and lipase in the evaluation of abdominal pain in the PED. ⋯ Although serum amylase and lipase testing may be suitable for abdominal pain screening, the concurrent use of both does not seem to add any clinically significant value to diagnosis.
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Emerg Med Australas · Apr 2024
Derivation of a clinical decision rule to exclude cerebral venous sinus thrombosis in emergency department patients: A retrospective cohort study.
To derive a clinical decision rule to exclude cerebral venous sinus thrombosis (CVST) in the ED. A secondary aim was to derive a rule that incorporated clinical parameters and the non-contrast CT brain. ⋯ A clinical decision rule was derived to rule out CVST. These results require validation before adoption into clinical practice.
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Emerg Med Australas · Apr 2024
Musculoskeletal chest pain prevalence in emergency department presentations: A retrospective case notes review.
Musculoskeletal (MSK) causes of chest pain are considered common in emergency care, yet management is limited, reported outcomes are poor and prevalence data in New Zealand are lacking. The present study aims to estimate the prevalence of MSK chest pain in New Zealand EDs and describe the characteristics of MSK chest pain cases. ⋯ These data provide a conservative estimate of MSK chest pain prevalence in EDs within the South Island of New Zealand. The findings highlight MSK chest pain as common in emergency care, providing a basis and justification for further research to improve management and outcomes for people with MSK chest pain.
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Pediatric emergency care · Apr 2024
Emergency Department Arrival Modes: Time for Mandatory Pediatric Readiness.
Because small children can be transported by private vehicles, many children seek emergency care outside of Emergency Medical Services (EMS). Such transports may access the closest emergency departments (EDs) without knowledge of their pediatric competence. This study quantifies this practice and the concept of mandatory pediatric readiness. ⋯ Pediatric patients seeking ED care overwhelmingly arrive through a private mode regardless of the severity of their problem or type of ED in which treated. Emergency Medical Services programs and state hospital regulatory agencies need to recognize this practice and assure the pediatric competence of every ED within their system.