Practical Summaries in Acute Care Archives – May 1, 2004
May 1, 2004
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Abdominal CT in Blunt Trauma: Hold the Contrast?
A number of studies have questioned the dogma of oral contrast administration. Only one, however, was prospective: Staffords study published in 1999 cast doubt on whether oral contrast added any significant data to the evaluation of stable patients. Now, a prospective, non-randomized, cohort study from Salt Lake City with 500 consecutive Trauma I (their highest designation) patients has omitted oral contrast from the routine trauma abdominal CT scan. -
Is Procalcitonin the Key to Discriminating Bacterial from Viral Lower Respiratory Infections?
Procalcitonin concentrations have been shown to be elevated in severe bacterial infections, but remain low in viral infections and non-specific inflammatory diseases. The objective of this study was to assess the capability of a new, rapid, and sensitive procalcitonin assay to identify bacterial lower respiratory tract infections needing antimicrobial treatment. -
Diagnosing Pulmonary Embolism in the ED: What’s Tops in the Toolbox?
The authors analyzed 965 consecutive patients presenting to any of three European emergency departments between October 2000 and June 2002 with complaints suggestive of pulmonary embolism (PE)sudden or worsening dyspnea, chest pain without another etiology, or syncope. -
Special Feature: Electrocardiographic Electrode Misconnection
The adage the best chest x-ray is an old chest x-ray can be extended to the world of electrocardiography. With the myriad and subtle changes that may occur on the 12-lead surface electrocardiogram, at times the emergency physicians best ally is an old tracing for comparison. -
ECG Review: Best Obtainable Tracing
The tracing in the Figure was obtained from a 59-year-old woman with a long history of smoking. She presented with acute dyspnea and atypical chest pain. Because of moderate respiratory difficulty, this was the best quality tracing obtainable. In full acknowledgment of its suboptimal technical quality, how would you interpret this ECG? What findings may be of potential concern?