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Traumatic injury remains one of the most important and persistent causes for morbidity and mortality in the United States. The establishment of a trauma team that is available to evaluate and manage trauma quickly and efficiently during the very critical first minutes after the injured patient arrives at the hospital has significantly improved survival and dramatically reduced sequelae from these injuries. An important component of this expedited evaluation has been the recognition of the utility of ultrasound to augment the imaging and triage of the injured patient. In this well-researched monograph, the authors describe this rapidly growing modality and its many applications. All members of the trauma team should be familiar with the indications and limitations of this important trauma tool.
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High-sensitivity cardiac troponin (hs-cTn) assays have higher sensitivity for myocardial ischemic injury and necrosis than conventional assays, but with reduced specificity.
An hs-cTn level below the detectable limit is very accurate at excluding AMI in an ED patient with chest pain.
The precision of hs-cTn assays enables serial sampling of cardiac biomarkers to exclude AMI to be done over 1-2 hours as opposed to 3-9 hours for conventional cTn assays.
A normal coronary CT angiography (CCTA) (< 50% stenosis in any epicardial coronary artery) performed in an ED patient with chest pain is associated with a good 30-day outcome.
Use of CCTA in ED patients with chest pain is associated with reduced length of stay, admissions, and overall costs compared to typical care that often involves myocardial perfusion imaging.
CCTA is associated with a small but consistent increase in invasive coronary angiograms and reperfusion procedures compared to typical care that often involved myocardial perfusion imaging.
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More patients who received a preventive medicine intervention also had their physician receive the corresponding preventive intervention.
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Uncomplicated cellulitis, defined as cellulitis without abscess, is most often caused by streptococci.
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The ECG shown above was obtained from an acutely ill but alert and hemodynamically stable patient. How certain are you that the rhythm is ventricular tachycardia (VT)? Might there be another explanation if the patient in question was a young adult with renal disease and diabetes?
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The majority of patients with advanced cancer have decisional capacity at the time of their terminal hospitalization but lose that capacity before having an end-of-life discussion.
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Patients seen in emergency departments (ED) for acute chest pain who are deemed low risk for acute coronary syndrome (ACS) and relatively safe for discharge are often referred to their primary care physician (PCP) for follow-up.
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