{"title":"Accuracy of FAST-ED for Assessment Large Vessel Occlusion of Acute Ischemic Stroke in Emergency Department.","authors":"Chatchanan Pornpanit, Punnaporn Loymai, Nattaphol Uransilp, Winchana Srivilaithon","doi":"10.2147/OAEM.S461177","DOIUrl":"10.2147/OAEM.S461177","url":null,"abstract":"<p><strong>Background: </strong>Acute large vessel occlusion stroke (LVOS) requires swift and precise assessment for effective treatment. The Field Assessment Stroke Triage for Emergency Destination (FAST-ED) protocol shows promise for rapid LVOS evaluation but lacks extensive validation. This study aims to assess the accuracy of FAST-ED in predicting LVOS and compare its predictive capability with the National Institute of Health Stroke Scale (NIHSS).</p><p><strong>Methods: </strong>This prospective cross-sectional study was conducted at Thammasat University Hospital. Participants included those aged 18 years or older who presented with symptoms of acute stroke syndrome within 24 hours of onset. The study focused on comparing FAST-ED assessments by emergency department physicians with NIHSS evaluations by neurologists, followed by vascular imaging, which included brain multiphase CT angiography, MRI with MRA, and transcranial Doppler ultrasound combined with carotid Doppler ultrasound. Statistical analyses included the use of AuROC to assess the effectiveness of FAST-ED and to compare FAST-ED with NIHSS.</p><p><strong>Results: </strong>130 patients were included in the analysis, with 47 diagnosed with LVOS. No significant differences were found in most baseline characteristics between LVOS and non-LVOS groups, except for a higher prevalence of atrial fibrillation and lower systolic blood pressure in the LVOS group. The FAST-ED scale demonstrated a fair ability to predict LVOS with an AuROC of 0.79 (95% confidence interval (CI); 0.70, 0.87). A FAST-ED cut point of ≥4 showed improved specificity and likelihood ratio. Comparing FAST-ED≥4 with NIHSS≥6 revealed similar AuROC (0.74, 95% CI; 0.65, 0.82 and 0.72, 95% CI; 0.64, 0.80, respectively), with no significant statistical difference (p=0.661).</p><p><strong>Conclusion: </strong>FAST-ED scale, especially with a cut-off point of ≥4, exhibits fair overall accuracy in predicting LVOS in patients who presented with suspected acute stroke within 24 hours at the ED. This predictive capability is closely comparable to that of the NIHSS at a cut-off point of ≥6.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"203-210"},"PeriodicalIF":1.5,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074230","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":"Prehospital Emergency Care: A Cross-Sectional Survey of First-Aid Preparedness Among Layperson First Responders in Northern Uganda.","authors":"Keneth Opiro, Derrick Amone, Margret Sikoti, Amos Wokorach, Jerom Okot, Felix Bongomin","doi":"10.2147/OAEM.S464793","DOIUrl":"https://doi.org/10.2147/OAEM.S464793","url":null,"abstract":"<p><strong>Background: </strong>Uganda has a high incidence of road traffic accidents and high mortality rates, yet lacks a mature prehospital emergency care system. Our study addresses this gap by assessing the experiences, training, and confidence in providing first aid (FA) among diverse layperson first responders in Northern Uganda, expanding beyond previous research, which was limited to Central Uganda and specific occupational groups.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey among layperson first responders of various occupations in Gulu City, Acholi sub-region, Uganda. Data on socio-demographics, training, experiences, knowledge, and confidence in FA were collected.</p><p><strong>Results: </strong>We included 396 participants, of whom 81.6% (n=323) were male, 47.0.6% (n=186) were aged 21-30 years, 59.3% (n=235) had obtained a secondary level of education, 23.7% (n=94) were commercial motorcyclists, and 45.7% (n=181) had work experience of >5 years. The majority (85.4%, n=338) had witnessed acute illness/trauma. Accidents/bleeding were the most commonly witnessed cases (68.6%, n=232), followed by burn injuries (10.1%, n=34). Most participants (52.3%, n=207) had attended FA training. Only 20.5% (n=81) had obtained an above-average score (≥70%). The majority (67.9%, n=269) were confident in providing FA. Lack of knowledge and skills (61.4%, n=78), fear of taking health risks (18.9%, n=24), and legal implications (7.1%, n=9) were the major reasons for not being willing to confidently give FA. Factors associated with above-average knowledge were tertiary education and being confident in providing FA, while training in FA and prior experience in giving FA were associated with confidence in giving FA.</p><p><strong>Conclusion: </strong>In this study, laypeople in Northern Uganda exhibited a high level of FA training. However, low confidence in providing FA is attributed to inadequate knowledge, fear of health risks, and legal concerns. Therefore, future efforts should focus on assessing FA practices in diverse regions and promoting formal FA training.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"191-202"},"PeriodicalIF":1.5,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761510","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":"Evaluating the Diagnostic Accuracy of the Alvarado Score and Abdominal Ultrasound for Acute Appendicitis: A Retrospective Single-Center Study.","authors":"Saleh Al-Wageeh, Qasem Abdulkarem Alyhari, Faisal Ahmed, Abdulfattah Altam, Gubran Alshehari, Mohamed Badheeb","doi":"10.2147/OAEM.S462013","DOIUrl":"10.2147/OAEM.S462013","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is a complex diagnosis that often requires both clinical and radiological evaluation. Significant variations in diagnostic approaches are evident among clinicians and healthcare institutions. While certain guidelines advocate for risk stratification based on clinical characteristics, others emphasize the importance of pre-operative imaging. This study seeks to explore the accuracy of the Alvarado Score and abdominal ultrasound (AUS) in diagnosing acute appendicitis.</p><p><strong>Methods: </strong>Suspected cases of appendicitis admitted to Al-Thora Hospital in Ibb, Yemen, from Jan 2021 to July 2022 were evaluated. The demographics, clinical, and laboratory data were collected and analyzed. This study assessed Alvarado scores (calculated based on clinical evaluation and laboratory data) and pre-operative AUS findings, correlating them with post-operative and histopathology findings. The Alvarado scores and AUS sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were assessed using the ROC curve.</p><p><strong>Results: </strong>Out of 1021 cases of acute abdomen, 171 patients were suspected of appendicitis. Using AUS along with the Alvarado score, appendicitis was presumed in 137 patients who underwent appendectomy. 130 (94.9%) patients had positive intraoperative and histopathology findings while 7 (5.1%) had negative findings. The Alvarado Score had a sensitivity and specificity of 94.62% and 87.80% at cutoffs of 6, respectively [Area under the curve (AUC): 0.985; 95% confidence interval (CI), 0.954 to 0.998; p < 0.0001]. Abdominal US showed a sensitivity of 98.46% and specificity of 82.93% (AUC:0.907; 95% CI, 0.853 to 0.946; p < 0.0001).</p><p><strong>Conclusion: </strong>Alvarado's score and AUS exhibited high sensitivity and specificity in diagnosing acute appendicitis. The substantial accuracy and efficacy of both the Alvarado score and AUS support their utilization as primary investigative tools in resource-limited settings. This approach can help avoid unnecessary appendectomies and minimize the financial burden on patients.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"159-166"},"PeriodicalIF":1.5,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591652","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":"The Relationship Between Acute Kidney Injury in Sepsis Patients and Coagulation Dysfunction and Prognosis.","authors":"Zhenyi Wang, Shimin Dong, Yanjun Qin","doi":"10.2147/OAEM.S453632","DOIUrl":"10.2147/OAEM.S453632","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the relationship between ARF and coagulopathy in patients with sepsis and to explore the prognostic value of these conditions.</p><p><strong>Patients and methods: </strong>The data of 271 patients with sepsis-associated coagulopathy admitted from June 2021 to June 2022 were reviewed. The patients were divided into a survival group and a nonsurviving group according to patient prognosis. Independent sample t tests were utilized to compare laboratory parameters within 24 hours of admission, as well as the APACHE II and SOFA scores, between the two patient groups. According to the sepsis-associated coagulation dysfunction (SAC) grading criteria for grading, Spearman correlation analysis was used to study the relationship between blood creatinine and SAC grading and assignment scores, and receiver operating characteristic (ROC) curves and Cox's proportional risk regression model were used to explore the factors affecting the prognosis of SAC patients.</p><p><strong>Results: </strong>Spearman correlation analysis revealed strong associations between serum creatinine (Scr) concentration, SAC classification, and SAC score, with coefficients above 0.7. SAC classification outcomes varied significantly with severity: mild severity had a 77.6% survival rate versus 22.4% mortality; moderate severity had 21.5% survival versus 78.5% mortality; and severe cases had a 0.7% survival rate versus 99.3% mortality (P<0.01 for all). Multivariate analysis revealed significant predictors of outcome, including multiple organ dysfunction syndrome (MODS), with an OR of 2.070 (P=0.019); the SOFA score (OR=1.200, P<0.01); the international normalized ratio (INR) (OR=0.72, P=0.013); and the Scr level (OR=0.995, P<0.01). The areas under the ROC curves for the SOFA score, APACHE II score, and SAC classification were >0.8, all P < 0.05.</p><p><strong>Conclusion: </strong>In patients with sepsis, SAC grade 3 or a SAC score of 4 or higher is associated with poorer prognosis, and the interaction of acute kidney injury exacerbates the degree of SAC, consequently affecting prognosis.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"145-157"},"PeriodicalIF":1.5,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11228537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560025","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}
Jaime A Quintero, Camilo A Medina, Federico Penagos, Jaime Andres Montesdeoca, Gildardo Antonio Orozco, Juan Saavedra-Castrillón, Julio Diez-Sepulveda
{"title":"Electrocardiographic Abnormalities in Patients with Hyperkalemia: A Retrospective Study in an Emergency Department in Colombia.","authors":"Jaime A Quintero, Camilo A Medina, Federico Penagos, Jaime Andres Montesdeoca, Gildardo Antonio Orozco, Juan Saavedra-Castrillón, Julio Diez-Sepulveda","doi":"10.2147/OAEM.S455159","DOIUrl":"10.2147/OAEM.S455159","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperkalemia is a prevalent electrolyte disorder related to elevated serum potassium levels, resulting in diverse abnormal electrocardiographic findings and associated clinical signs and symptoms, often necessitating specific treatment. However, in some patients, these abnormal findings may not be present on the electrocardiogram even in elevated serum potassium levels. This study aims to identify electrocardiographic abnormalities related to the severity of hyperkalemia and the clinical outcomes in an emergency department in southwestern Colombia.</p><p><strong>Methodology: </strong>This is a retrospective cross-sectional descriptive study. We described the electrocardiographic findings, clinical characteristics, treatment, and outcomes related to the degrees of hyperkalemia. The potential association between the severity of hyperkalemia and electrocardiographic findings was evaluated.</p><p><strong>Results: </strong>A total of 494 patients were included. The median of the potassium level was 6.6 mEq/L. Abnormal electrocardiographic findings were reported in 61.5% of the cases. Mild and severe hyperkalemia groups reported abnormalities in 59.9% and 61.2%, respectively. The most common electrocardiography abnormalities were the peaked T wave 36.2%, followed by wide QRS 83 (16.8%). Only 1.4% of patients had adverse outcomes. The abnormal findings were registered in 61.5%. Mortality was 11.9%. The peaked T wave was the most common finding across different levels of hyperkalemia severity.</p><p><strong>Conclusion: </strong>High serum potassium levels are related with abnormal ECG. However, patients with different degrees of hyperkalemia could not describe abnormal ECG findings. In a high proportion of patients with renal chronic disease and hyperkalemia, the abnormalities in the ECG could be minimal or absent.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"133-144"},"PeriodicalIF":1.5,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477644","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}
Sarah A Elliott, Sholeh Rahman, Shannon D Scott, Wiliam R Craig, Lisa Knisley, Kathleen Shearer, Lisa Hartling
{"title":"Seeking Care for Children with Intellectual and/or Developmental Disabilities in the Emergency Department: A Mixed Methods Systematic Review of Parents' Experiences and Information Needs.","authors":"Sarah A Elliott, Sholeh Rahman, Shannon D Scott, Wiliam R Craig, Lisa Knisley, Kathleen Shearer, Lisa Hartling","doi":"10.2147/OAEM.S450191","DOIUrl":"10.2147/OAEM.S450191","url":null,"abstract":"<p><p>The objective of this review was to explore parents' experiences and information needs regarding management of their child with an intellectual and/or developmental disability (IDD) in the emergency department (ED). We searched six electronic databases and grey literature to identify primary studies in English published since 2000. We synthesized quantitative and qualitative outcome data simultaneously using a convergent integrated approach and used a Mixed Methods Appraisal Tool (MMAT) to assess methodological quality of the included studies. Nine articles derived from seven studies were included (3 qualitative, 3 quantitative, 1 mixed method). Four main themes related to parents' self-reported experiences were identified: 1) appropriateness of the ED to manage and support their child; 2) acknowledgement/recognition of their child's IDD and incorporation of those considerations into overall care and management; 3) managing and navigating the ED environment; and 4) decision to disclose their child's condition when visiting the ED. Two articles provided data relevant to information needs, highlighting parents' desire to have resources supporting ED orientation and access to services within and outside of the ED setting. From the limited number of studies, it was evident that parents wanted better communication with healthcare providers and a greater understanding by ED staff around physical space settings needed to support their child. Resources supporting ED staff and parents to communicate effectively and work together can ensure that children with IDDs care needs are met. Further research into understanding parents' experiences and information needs related to managing a child with an IDD in the ED is needed to guide the development of effective resources.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"117-131"},"PeriodicalIF":1.5,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443495","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":"Obesity and Penetrating Trauma: Outcomes from a Level 1 Trauma Center in New York City.","authors":"Albert Yao, Jaiden I Busso, Nisha Lakhi","doi":"10.2147/OAEM.S453589","DOIUrl":"10.2147/OAEM.S453589","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with increased morbidity and mortality in trauma scenarios; however, there has been conflicting evidence on outcomes of obesity and penetrating injuries, specifically gunshot wounds and stab wounds. We hypothesized that obesity may be protective due to a \"cushioning effect\" attributed to increased adiposity.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients presenting to a Level 1 Trauma Center with a penetrating trauma (gunshot/stab) injury during 2008-2021. Patients with a BMI ≥ 30 were compared to those with a BMI < 30. The primary outcome was Injury Severity Score (ISS). Secondary outcomes included intensive care unit (ICU) length of stay, days on ventilation, length of hospital stay, service of admission (trauma surgery, general surgery, discharged home, general medical floor), the body region of injury(s), Abbreviated Injury Scale (AIS), OR requirement, type of surgery, and discharge status. Statistical analysis was performed using χ<sup>2</sup>-test or Fisher's exact tests for categorical data, and Student's <i>t</i>-test or Mann-Whitney <i>U</i>-test for continuous variables with <i>p</i> < 0.05 as statistically significant. Subgroup analysis was performed based on the mechanism of injury.</p><p><strong>Results: </strong>There were 721 patients that met inclusion criteria, of which 540 were classified in the non-obese group and 181 (25.1%) in the obese group. The primary outcome, mean ISS score, in obese patients (9.0, SD = 13.0) and non-obese patients (9.4, SD = 13.8) was similar between groups respectively. Secondary outcomes, which included rates of severe abdominal injury (AIS ≥ 3), rates of intra-abdominal organ injury, and rates of gastro-intestinal resection, were also similar between non-obese and obese patients.</p><p><strong>Conclusion: </strong>This study did not demonstrate the existence of a \"cushioning effect\" in the setting of penetrating traumatic injury. Patients with increased BMI had similar a ISS score and patterns of injury as their non-obese counterparts.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"107-115"},"PeriodicalIF":1.5,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200761","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}
Anna Artymowicz, Christina Douglas, Kimberly Cockerham
{"title":"The Role of Ophthalmology in Tele-Stroke Consults for Triaging Acute Vision Loss.","authors":"Anna Artymowicz, Christina Douglas, Kimberly Cockerham","doi":"10.2147/OAEM.S395588","DOIUrl":"https://doi.org/10.2147/OAEM.S395588","url":null,"abstract":"<p><p>Advances in telemedicine have allowed physicians to provide care in areas that were previously geographically or practically inaccessible. Roughly 70% of all US hospital have less than 200 bed capacity and nearly 50% have fewer than 100 beds. These smaller hospitals often do not have specialists available for bedside patient care, making them potential beneficiaries of telemedicine medical specialty services. In 2005, the American Stroke Association proposed implementing telemedicine services in effort to increase access to acute stroke care in neurologically underserved areas such as small hospitals. Tele-stroke services have since become established across the country and are now utilized by approximately 30% of US hospitals. By reducing the time between presentation and evaluation by a stroke specialist, tele-stroke programs have successfully increased patient access to life-saving treatment with tissue-plasminogen activator (t-PA) treatments. This change has been especially profound remote and underserved community hospitals. However in the evaluation of acute vision loss, an area where ophthalmology and stroke care overlap, increased reliance on tele-stroke services has contributed to some unique challenges. Acute vision has a complex differential and is commonly a result of conditions other than stroke. When tele-stroke services are engaged for the evaluation of acute vision loss, the neurologist is asked to make medical decisions without complete information about the eye. This situation can expose patients to costly or inappropriate testing, unnecessary hospitalizations, or lead to delayed diagnosis and treatment of non-neurologic conditions of the eye. The goal of this paper is to provide an overview of the overlap between stroke and vision loss, highlight the challenges inherent in using tele-stroke in evaluating acute vision loss and to offer our comments on how increased communication between emergency medicine, ophthalmology, and neurology services can ensure that patients with vision loss receive the highest standard of care in all hospitals.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"45-56"},"PeriodicalIF":1.5,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724421","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":"Chest Pain Risk Stratification in the Emergency Department: Current Perspectives.","authors":"Zeynep Yukselen, Vidit Majmundar, Mahati Dasari, Pramukh Arun Kumar, Yuvaraj Singh","doi":"10.2147/OAEM.S419657","DOIUrl":"https://doi.org/10.2147/OAEM.S419657","url":null,"abstract":"<p><p>Chest pain is the second leading cause of all emergency department (ED) visits in adults in the United States, with nearly 11 million encounters yearly. While identifying low-risk patients is crucial for early discharge, identifying high-risk patients in ED is vital in timely and appropriate acute coronary syndrome (ACS) management. Traditional methods such as physical examination, cardiac markers, or imaging tests cannot reliably confirm or rule out ACS; they cannot be singularly incorporated to risk stratify patients. Various clinical risk scores have been proposed to address this challenge for risk stratification in patients being evaluated for suspected ACS. The ideal risk score should demonstrate high sensitivity and specificity to accurately differentiate between patients with varying levels of risk, particularly in identifying those at high risk for major adverse cardiovascular events. Simultaneously, an ideal scoring system should also be able to compute information for other non-coronary etiologies of chest pain that require time-sensitive interventions and workups (eg, aortic dissection and pulmonary embolism). In this review, we have assembled major risk scores used for risk stratification in patients with acute chest pain in ED. We have abbreviated their salient features to assist readers in their clinical decision-making.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"29-43"},"PeriodicalIF":1.5,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10853047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724420","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}
Shuaishuai Yuan, Yuting Huang, Pailing Xie, Peijun Li
{"title":"A Case of Severe Rhabdomyolysis, Acute Myocardial Damage and Multi-Organ Dysfunction Syndrome in a Patient with Novel Coronavirus Pneumonia.","authors":"Shuaishuai Yuan, Yuting Huang, Pailing Xie, Peijun Li","doi":"10.2147/OAEM.S446994","DOIUrl":"10.2147/OAEM.S446994","url":null,"abstract":"<p><p>In recent years, healthcare systems worldwide have faced the challenge of the severe COVID-19 pandemic. However, cases of severe rhabdomyolysis, acute myocardial damage, and multiple organ dysfunction syndrome (MODS) caused by COVID-19 are currently rare. This report presents a case of severe rhabdomyolysis, acute myocardial damage, and MODS caused by COVID-19. The patient was treated at The University of Hong Kong-Shenzhen Hospital. The purpose of this report is to aid clinicians in quickly identifying and treating similar cases, ultimately improving patient outcomes.</p>","PeriodicalId":45096,"journal":{"name":"Open Access Emergency Medicine","volume":"16 ","pages":"19-28"},"PeriodicalIF":1.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10840558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693139","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}