Open Access Emergency Medicine最新文献

{"title":"Prognostic Impact of Therapeutic Agents for Septic-Associated Disseminated Intravascular Coagulation According to Different Sources of Infection.","authors":"Makoto Kobayashi, Kyohei Sakurai, Yoshimatsu Ehama","doi":"10.2147/OAEM.S484602","DOIUrl":"10.2147/OAEM.S484602","url":null,"abstract":"<p><strong>Purpose: </strong>Sepsis can be caused by various infectious sources; however, treatment strategies for secondary disseminated intravascular coagulation (DIC) differ between countries. The Japanese sepsis guidelines recommend the use of two drugs for DIC but do not specify which drugs should be used and under which conditions. No clear reports have compared the outcomes of DIC treatments based on the source of infection. This is the first study to clarify the difference in prognosis by the source of infection and compare the effect of the treatment of choice for DIC on prognosis.</p><p><strong>Patients and methods: </strong>This single-center, retrospective, nonrandomized cohort study included 411 patients with a confirmed diagnosis of sepsis-associated DIC who were initiated on DIC therapies. Recombinant thrombomodulin (rTM) preparation and antithrombin (AT) replacement therapy were the DIC therapies used. The patients were divided into five groups determined to be the primary source of infection for treatment: intestine-related, biliary tract, respiratory tract, urinary tract, and catheter-related bloodstream infections (CRBSIs). In addition to differences in DIC treatment, we evaluated the following three covariates that may influence mortality, considering the influence of background interactions at the infection source: serum albumin concentration, APACHE-II score, and blood antithrombin activity. A Cox proportional hazards model was used to assess the association between the covariates and compare their effect on 60-day survival.</p><p><strong>Results: </strong>Univariate analysis of the DIC drug choice results showed that survival was statistically significantly higher in the rTM arm for biliary tract infections (P = 0.002) and CRBSI (P = 0.021). However, multivariate analysis with other covariates showed that AT replacement therapy was statistically effective for respiratory tract infections (hazard ratio, 0.353; P = 0.027).</p><p><strong>Conclusion: </strong>Our study showed that the pathogenesis of severe sepsis with DIC differs depending on the source of infection which should be considered when developing treatment strategies. Particularly, the importance of anti-DIC drug selectivity based on the source of infection was confirmed.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"285-295"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Droperidol Plus Diphenhydramine for Symptom Improvement in Suspected Cannabinoid Hyperemesis Syndrome: A Prospective Cohort Study.","authors":"Quincy Chopra, Vincent Peyko, Jessica Annie Lee, Leo Puhalla, David J Gemmel, Todd Bolotin","doi":"10.2147/OAEM.S473627","DOIUrl":"https://doi.org/10.2147/OAEM.S473627","url":null,"abstract":"<p><strong>Background: </strong>Cannabinoid Hyperemesis Syndrome (CHS) is characterized by recurrent, paroxysmal episodes of nausea, vomiting, and abdominal discomfort in chronic cannabis users. Optimized CHS treatment data remain limited. Recent prospective evidence have demonstrated haloperidol superiority over ondansetron. Retrospective data suggest the utility of droperidol, a dopamine antagonist like haloperidol, for treating acute CHS.</p><p><strong>Objective: </strong>To prospectively assess the utility of droperidol plus diphenhydramine to mitigate common CHS symptoms.</p><p><strong>Methods: </strong>This was a multicenter, prospective interventional study in the emergency department (ED). Participants were administered a study regimen of droperidol and diphenhydramine to treat CHS after enrollment. The primary outcome measure was the change in VAS scores within the droperidol prospective cohort. Symptoms of nausea, vomiting, and abdominal pain were measured using a visual analogue scale (VAS) up to 120 minutes. Secondary measures assessed include repeat visits to the ED within seven days.</p><p><strong>Results: </strong>Amongst 47 droperidol participants, VAS for nausea and vomiting declined from baseline 8.3±2.0 to 3.1±3.3 at 30 minutes post treatment (p < 0.05), and 1.4±2.4 at 120 minutes (p < 0.05). For abdominal pain, VAS mean was 7.8±2.4 at baseline declining to 3.6±2.9 at 30 minutes (p < 0.05) and 1.7±2.9 at 120 minutes (p < 0.05). Return to the ED within 7 days following droperidol was 12.9% (n=47).</p><p><strong>Conclusion: </strong>This trial shows significant improvement in symptoms from baseline, 30 and 120 minutes post-treatment and return to the ED within a week post treatment with the study regimen.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"267-273"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Trends and Characteristics of Dermatological Conditions Presenting to a Saudi Major Emergency Department.","authors":"Nouf F Bin Rubaian, Reem S AlOmar, Ahmed S Alzahrani, Faleh M Alotaibi, Mohammed A Alharbi, Bader S Alanazi, Serene R Almuhaidib, Nawaf F Alsaadoon, Dunya Alfaraj, Nouf A AlShamlan","doi":"10.2147/OAEM.S468288","DOIUrl":"https://doi.org/10.2147/OAEM.S468288","url":null,"abstract":"<p><strong>Background: </strong>Numerous dermatological conditions present in the emergency department (ED). Some have subtle presentations, yet most provoke patient suffering. Such conditions need to be identified and managed properly. This study aims to epidemiologically describe the patterns and characteristics of dermatological conditions presenting to a secondary teaching hospital's ED.</p><p><strong>Methods: </strong>This retrospective chart review study analyses data on dermatological conditions that have presented to the ED between January 2021 and May 2023. The data gathered included sociodemographic variables, date and shift of visit, triage level, dermatological complaint characteristics, management, and discharge status. Comparative analysis was performed, and the level of significance was set at 0.05.</p><p><strong>Results: </strong>The total number of cases was 301. The median age was 12 years (IQR = 4-30 years), with similar distribution between males and females (50.17% and 49.83% respectively). Most cases had presented to the ED during the morning shift (49.83%). Triage levels IV and V made up 94.69%, and only 5.32% belonged to triage level III. Most presented during the winter season (32.89%). The median visit duration was 312 minutes, and of all cases treated, only 10 required a return visit to the ED. Also, 41.53% were discharged and 58.47% required further management. Maculopapular rashes were the most common finding (35.55%). Bullae/blisters and erythroderma accounted for those that most often required further management. The two most prescribed medications were topical steroids and antihistamines, followed by emollients (32.09% and 15.81%, respectively). Viral infections were the most reported complaint (22.26%) and only two patients complained of erythema multiforme (0.66%).</p><p><strong>Conclusion: </strong>This study found that the majority of cases could have been managed by family physicians at a primary care setting. Also, epidemiological seasonal variations were observed where the majority of patients requiring further management had presented during the autumn season.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"275-284"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features of Severe Deep Neck Space Infection: Five Clinical Cases and Our Experience in Their Management.","authors":"Ling Jin, Yongjun Chang, Yihua Zhao, Kai Fan, Jiawei Lu, Yang Wang, Shaoqing Yu","doi":"10.2147/OAEM.S476737","DOIUrl":"https://doi.org/10.2147/OAEM.S476737","url":null,"abstract":"<p><strong>Background: </strong>Deep neck space infection (DNSI) is an acute and severe condition, with severe cases being relatively rare but considerably more critical. Consequently, in clinical practice, there is a limited understanding and lack of comprehensive reviews on severe DNSI.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the diagnosis and treatment of five cases of severe DNSI admitted to our department.</p><p><strong>Results: </strong>All five patients were diagnosed via neck CT and surgical exploration. Bacterial cultures predominantly revealed mixed infections of Klebsiella and other gram-negative bacilli, along with anaerobic bacteria. Three patients had diabetes, two presented with diabetic ketoacidosis, and three had mediastinal involvement. Three patients underwent tracheotomy, while two required tracheal intubation. All patients were treated with neck incision, drainage, regular dressing changes, and targeted antibiotic therapy. They had an average hospital stay of 35.8 days, and all were discharged fully recovered.</p><p><strong>Conclusion: </strong>Severe DNSI tends to occur in patients with diabetes and other underlying systemic conditions. Infections involving multiple deep neck spaces, such as the parapharyngeal, pretracheal, and prevertebral spaces, leading to high-risk complications like airway obstruction, cervical necrotizing fasciitis, mediastinitis, and sepsis, are considered severe DNSI. Early diagnosis, timely surgical exploration, drainage to maintain airway patency, and targeted antibiotic therapy are crucial to effective management.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"257-266"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Challenges and Management Strategies for Superior Sagittal Sinus Thrombosis Induced by Snake Bite Envenomation: A Case Report from Somalia.","authors":"Abdullahi Ahmed Ahmed, Abdinasir Mohamed Elmi, Ismail Gedi Ibrahim, Mohamed Farah Yusuf Mohamud","doi":"10.2147/OAEM.S490920","DOIUrl":"https://doi.org/10.2147/OAEM.S490920","url":null,"abstract":"<p><strong>Introduction: </strong>Snakebite is a serious and potentially fatal public health concern, especially in tropical and subtropical regions, leading to severe complications. The World Health Organization (WHO) identified snakebite as a Neglected Tropical Disease (NTD) in 2017 and launched a global campaign in 2019 with the goal of halving the number of snakebite-related deaths and disability cases by half by the year 2030.</p><p><strong>Case presentation: </strong>A 26-year-old farmer male presented with a snake bite and soon developed neurological complications, including diplopia, seizures, and altered mental status with Glasgow coma scale(GCS) of 11 out of 15. Investigations revealed coagulation abnormalities and magnetic resonance venography showed acute thrombosis of the superior sagittal sinus. The patient was diagnosed with superior sagittal sinus thrombosis. He was admitted to the intensive care unit and treated with anticoagulants to manage the thrombus, prevent further clot formation, and administer seizure medications to control any potential seizures associated with the condition. Moreover, we closely monitored the patient's condition to ensure effective treatment and to address any complications that may arise. Throughout the next three days, the patient's health gradually improved due to supportive care. He was extubated and transferred to the general ward. He was discharged after 10 days, having made a full recovery.</p><p><strong>Conclusion: </strong>This case report from Somalia emphasizes the importance of recognizing and managing superior sagittal sinus thrombosis as a rare but life threatening consequence of snake bite envenomation, particularly in resource-limited settings where access to advanced diagnostic and treatment modalities may be limited. If a patient experiences headache, impaired vision or seizures, after a snake bite, it is important to be highly suspicious of cerebral vascular complications including venous sinus thrombosis. Moreover, we recommend that a national study be conducted to identify the prevalent snake species in the region and to determine their specific habitats.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"251-255"},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out of Hospital Bystander CPR Rates in Baltimore City, Maryland, 2020-2022, Compared to State and National Rates: A Preliminary Report.","authors":"Christian Angelo I Ventura, Benjamin J Lawner, Jennifer E Guyther, Jason Gullion","doi":"10.2147/OAEM.S491806","DOIUrl":"10.2147/OAEM.S491806","url":null,"abstract":"<p><p>This preliminary study was a rapid retrospective analysis of out-of-hospital cardiac arrest (OHCA) cases from Baltimore City between January 2020 and December 2022, using data from the Cardiac Arrest Registry to Enhance Survival. Of the 1,282 cases in 2022, 27.4% received bystander CPR compared to 40.7% in Maryland and 40.8% nationwide. These findings suggest individuals experiencing OHCA in Baltimore City are 45% less likely to receive bystander CPR. Despite community education initiatives and dispatch-assisted protocols, the low bystander CPR rate indicates significant barriers to intervention. Addressing these disparities may necessitate a health equity-focused investigation into public awareness, CPR training access, and sociocultural factors.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"247-250"},"PeriodicalIF":1.5,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Observational Study of Sexual Assaults in French Guiana During 2019-2020 [Letter].","authors":"Dian Eka Kusuma Wardani, Andi Melantik Rompegading, Megawati","doi":"10.2147/OAEM.S488186","DOIUrl":"10.2147/OAEM.S488186","url":null,"abstract":"","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"245-246"},"PeriodicalIF":1.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Emergency Department Length of Stay and Hospital Mortality in Patients Under Investigation for COVID-19.","authors":"Ar-Aishah Dadeh, Itsada Chaisuwaseth, Wainik Sookmee","doi":"10.2147/OAEM.S457942","DOIUrl":"10.2147/OAEM.S457942","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to determine the association between hospital mortality of patients under investigation (PUI) for COVID-19 and emergency department length of stay (EDLOS).</p><p><strong>Patients and methods: </strong>A retrospective study was conducted from April 3, 2020 to April 2, 2022. Adult PUI who presented with both clinical and epidemiological risk factors for COVID-19 disease and underwent sample collection with nasal swab for reverse transcription polymerase chain reaction were included in the study. The factors associated with EDLOS and hospital mortality were investigated using univariate logistic regression and multivariate logistic regression analyses.</p><p><strong>Results: </strong>A total of 961 PUI were enrolled that included 836 (87%) non-COVID-19 patients. The median (interquartile range [IQR]) EDLOS durations for 7-day and 30-day mortality of all PUI were 3.1 hours (2.1,4.3, P = 0.231) and 3.2 hours (2.1,4.3, P = 0.653). Multivariate logistic regression analysis revealed that the significant factors associated with EDLOS longer than 4 hours were consultation of three departments (adjusted odds ratio (aOR) 27.3, 95% CI 2.42-309.71, P = 0.007), emergency severity index (ESI) level 3 (aOR 2.31, 95% CI 1.37-3.9), investigations >2 (aOR 2.62, 95% CI 1.62-4.25), nebulization (aOR 2.34, 95% CI 1.39-3.96), administration of intravenous fluid (aOR 2.62, 95% CI 1.59-4.33), performing ≥1 procedure (aOR 3.35, 95% CI 1.51-7.43), and discharged patients (aOR 2.13, 95% CI 1.02-4.48).</p><p><strong>Conclusion: </strong>The significant factors associated with prolonged EDLOS in PUI included consultation of three departments, ESI level 3, investigations >2, ED treatment, ED procedures, and discharged patients. The median times of EDLOS and hospital LOS were 3.2 hours and 5.7 days. The EDLOS had no significant association with short-term mortality.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"231-243"},"PeriodicalIF":1.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Common Bile Duct Identification on Biliary Ultrasound in Emergency Department Patients.","authors":"Christopher Thom, Justin Yaworsky, Kevin Livingstone, David Han, Jakob Ottenhoff","doi":"10.2147/OAEM.S468678","DOIUrl":"10.2147/OAEM.S468678","url":null,"abstract":"<p><strong>Background: </strong>Biliary ultrasound is often utilized in the evaluation of abdominal pain in the Emergency Department (ED). Common bile duct (CBD) identification is traditionally a standard component of the biliary ultrasound examination but can be challenging to perform for the novice sonographer. Previous work has demonstrated that CBD dilatation is rare in cases of cholecystitis with normal liver function tests (LFTs). We sought to assess the frequency of CBD dilatation in the subset of ED patients undergoing hepatobiliary ultrasound who have normal LFTs and an absence of gallstones or biliary sludge on ultrasound. We also performed an assessment of changes in CBD diameter by age and cholecystectomy status.</p><p><strong>Methods: </strong>This was a retrospective chart review at a single academic ED. Patients were enrolled in the study if they underwent a radiology performed (RP) hepatobiliary ultrasound within the 2 year study period. Records were reviewed for the presence of gallstones or sludge, CBD diameter, age, clinical indication for the ultrasound, and LFTs. Descriptive analyses were performed, and interobserver agreement among data abstractors was assessed by <i>K</i> analysis for the presence of CBD dilatation. The Mann-Whitney test was utilized to assess statistical significance in the comparison of differences between CBD diameters amongst age groups.</p><p><strong>Results: </strong>Of 1929 RP hepatobiliary ultrasounds performed in the study period, 312 were excluded and 1617 met inclusion criteria. Amongst these, there were 506 patients who had normal LFTs and an ultrasound with no stones or sludge. Ten patients within this group had a dilated CBD > 7 mm (1.98%, 95% CI of 1.08% to 3.6%). We also noted a statistically significant increase in CBD size in the older age cohort and in those individuals with a history of cholecystectomy.</p><p><strong>Conclusion: </strong>CBD dilation in ED patients who present with normal LFTs and an absence of gallstones and biliary sludge is rare. Physicians should be reassured that the routine identification of the CBD on ultrasound in this setting is of low yield and need not be pursued.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"221-229"},"PeriodicalIF":1.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea-Protocol for A Randomized Controlled Trial.","authors":"Stig Holm Ovesen, Søren Helbo Skaarup, Rasmus Aagaard, Hans Kirkegaard, Bo Løfgren, Michael Dan Arvig, Bo Martin Bibby, Stefan Posth, Christian B Laursen, Jesper Weile","doi":"10.2147/OAEM.S454062","DOIUrl":"10.2147/OAEM.S454062","url":null,"abstract":"<p><strong>Purpose: </strong>Point-of-care ultrasound (POCUS) helps emergency department (ED) physicians make prompt and appropriate decisions, but the optimal diagnostic integration and potential clinical benefits remain unclear. We describe the protocol and statistical analysis plan for a randomized controlled trial. The objective is to determine the effect of a POCUS-driven diagnostic pathway in adult dyspneic ED patients on the proportion of patients having a hospital stay of less than 24 hours when compared to the standard diagnostic pathway.</p><p><strong>Patients and methods: </strong>This is a multicenter, randomized, investigator-initiated, open-labeled, pragmatic, controlled trial. Adult ED patients with chief complaint dyspnea are eligible. Patients are randomized (1:1) to the POCUS-driven diagnostic pathway or standard diagnostic pathway, with 337 patients in each group. The primary outcome is the proportion of patients having a hospital stay (from ED arrival to hospital discharge) of less than 24 hours. Key secondary outcomes include hospital length-of-stay, 72-hour revisits, and 30-day hospital-free days.</p><p><strong>Conclusion: </strong>Sparse evidence exists for any clinical benefit from a POCUS-integrated diagnostic pathway. The results from this trial will help clarify the promising signals for POCUS to influence patient care among ED patients with dyspnea.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"211-219"},"PeriodicalIF":1.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}