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Effect of introducing the mucosal atomization device for fentanyl use in out-of-hospital pediatric trauma patients
device Emergency Medical Services fentanyl intranasal pain assessment pediatric trauma
2014/11/28
Background: Pain associated with pediatric trauma is often under-assessed and undertreated in the out-of-hospital setting. Administering an opioid such as fentanyl via the intranasal route is a safe a...
2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker
Pulmonary embolism outpatient risk-stratification Risk stratification malignancy prognosis decision rule treatment
2014/11/28
Objectives The purpose of this study was to determine whether a new accelerated diagnostic protocol (ADP) for possible cardiac chest pain could identify low-risk patients suitable for early discharge ...
Clinical Characteristics, Management, and Outcomes of Patients Diagnosed With Acute Pulmonary Embolism in the Emergency Department
fibrin fragment D venous thromboembolism medical decision making capnography tomography spiral computed
2014/11/28
Objectives In a large U.S. sample, this study measured the presentation features, testing, treatment strategies, and outcomes of patients diagnosed with pulmonary embolism (PE) in the emergency depart...
D-Dimer and Exhaled CO2/O2 to Detect Segmental Pulmonary Embolism in Moderate-Risk Patients
Fibrin fragment D venous thromboembolism medical decision making pulmonary embolism
2014/11/28
Rationale: Pulmonary embolism (PE) decreases the exhaled end-tidal ratio of carbon dioxide to oxygen (etCO2/O2). Objectives: To test if the etCO2/O2 can produce clinically important changes in the pro...
The Chest Pain Choice trial: a pilot randomized trial of a decision aid for patients with chest pain in the emergency department
emergency medicine chest pain acute coronary syndrome
2014/11/28
Background: Chest pain is a common presenting complaint in the emergency department (ED). Despite the frequency with which clinicians evaluate patients with chest pain, accurately determining the risk...
Effectiveness of the Chest Pain Choice decision aid in emergency department patients with low-risk chest pain: study protocol for a multicenter randomized trial
D-dimer pulmonary embolism venous thromboembolism testing
2014/11/28
Background: Chest pain is the second most common reason patients visit emergency departments (EDs) and often results in very low-risk patients being admitted for prolonged observation and advanced car...
Clinical features from the history and physical examination that predict the presence or absence of pulmonary embolism in symptomatic emergency department patients: results of a prospective, multi-center study
Prediction decision rules logistic regression D-dimer pulmonary embolism
2014/11/28
Study Objective—Prediction rules for pulmonary embolism (PE) employ variables explicitly shown to estimate the probability of PE. However, clinicians often use variables that have not been similarly v...
Association Between Timing of Antibiotic Administration and Mortality from Septic Shock in Patients Treated with a Quantitative Resuscitation Protocol
sepsis antibiotics septic shock emergency medicine
2014/11/28
Objective We sought to determine the association between time to initial antibiotics and mortality of septic shock patients treated with an emergency department (ED) based early resuscitation protocol...
Outcomes of Patients Undergoing Early Sepsis Resuscitation for Cryptic Shock Compared with Overt Shock
septic shock lactate resuscitation emergency medicine mortality
2014/11/28
Introduction We sought to compare the outcomes of patients with cryptic versus overt shock treated with an emergency department (ED) based early sepsis resuscitation protocol. Methods Pre-planned seco...
High Discordance of Chest X-ray and CT for Detection of Pulmonary Opacities in ED Patients: Implications for Diagnosing Pneumonia
chest x-ray computed tomography pneumonia emergency department diagnostic testing
2014/11/28
Objective To evaluate the diagnostic performance of chest x-ray (CXR) compared to computed tomography (CT) for detection of pulmonary opacities in adult emergency department (ED) patients. Methods We ...
Characteristics and Outcomes of Patients with Vasoplegic Versus Tissue Dysoxic Septic Shock
sepsis septic shock hyperlactatemia lactate mortality
2014/11/28
Background: The current consensus definition of septic shock requires hypotension after adequate fluid challenge or vasopressor requirement. Some patients with septic shock present with hypotension an...
Prospective Study of the Frequency and Outcomes of Patients with Suspected Pulmonary Embolism Administered Heparin Prior to Confirmatory Imaging
Pulmonary embolism empiric anticoagulation decision-making venous thromboembolism
2014/11/28
Objectives The administration of empiric systemic anticoagulation (ESA) before confirmatory radiographic testing in patients with suspected pulmonary embolism (PE) may improve outcomes, but no data ha...
Plasma Levels of Mitochondrial DNA in Patients Presenting to the Emergency Department with Sepsis
Sepsis SIRS mtDNA mitochondrial DNA inflammation
2014/11/28
Introduction Elevated levels of plasma mitochondrial DNA (mtDNA) have been reported in trauma patients, and may contribute to the systemic immune response. We sought to determine the plasma levels of ...
Whole blood lactate kinetics in patients undergoing quantitative resuscitation for septic shock
whole blood lactate kinetics septic shock emergency medicine
2014/11/28
Introduction We sought to compare the association of whole blood lactate kinetics with survival in patients with septic shock undergoing early quantitative resuscitation. Methods Preplanned analysis o...
The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation
sepsis severe sepsis scoring system Sequential Organ Failure Assessment mortality
2014/11/28
Objectives Organ failure worsens outcome in sepsis. The Sequential Organ Failure Assessment (SOFA) score numerically quantifies the number and severity of failed organs. We examined the utility of the...