Impedance threshold device (ResQGARD) increases systolic blood pressure in hypotensive patients in the emergency department

We assessed the effect of focused point of care ultrasound (POCUS) used for critical nontraumatic hypotensive patients presenting to the emergency department of our hospital on the clinical decisions of the physicians and whether it led to the modification of the treatment modality. This prospective clinical study was conducted at the Emergency Department of Antalya Training and Research Hospital. Nontraumatic patients aged 18 and older who presented to our emergency department and whose systolic blood pressure was <100 mmHg or shock index (heart rate/systolic blood pressure) was >1 were included in the study. While the most probable preliminary diagnosis established by the physician before POCUS was consistent with the definitive diagnosis in 60.6% (n=109) of 180 patients included in the study, it was consistent with the definitive diagnosis in 85.0% (n=153) of the patients after POCUS (p<0.001). POCUS performed for critical hypotensive patients presenting to the emergency department is an appropriate diagnostic tool that can be used to enable the physicians to make the accurate preliminary diagnosis and start the appropriate treatment in a short time.

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An Investigation of Risk Factors Affecting Short Term Mortality of Patients Referring to the Hospital Emergency Department

10.21203/rs.3.rs-108213/v1 ◽

2020 ◽

Author(s):

Elham Peyravi ◽

Hadid Hamrah ◽

Mohammad Sadegh Masoudi ◽

Milad Ahmadi Marzaleh ◽

Mahmoudreza Peyravi

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Emergency Department ◽

Systolic Blood Pressure ◽

Fars Province ◽

Hospital Emergency ◽

Short Term ◽

Factors Affecting ◽

Emergency Department Overcrowding ◽

Short Term Mortality

Abstract Background and Objective: One of the causes of short-term mortality in patients is the lower quality of services provided by hospital emergency departments. Given the particular importance of the hospital emergency system and the presence of numerous problems, as well as short term mortality rates in hospitals, this study aimed to investigate the risk factors affecting short term mortality of patients presenting to the Emergency Department at Nemazi Hospital in Shiraz, Fars province in 2019.Methods: This is a retrospective study with a case control-analytical design. The sample size was 768 subjects. In the present study, the emergency department overcrowding was measured by the NEDOCS (National Emergency Department Overcrowding Scale) criterion. The severity of the disease was also evaluated based on the level of the triage of patients through the Emergency Severity Index (ESI) system and vital signs.Results: With each year increase in age, the chance of short-term mortality increases by 0.8%. People with O2 sat% <90% are 7.3 times more likely to experience short term mortality in an emergency department compared to people with O2 sat%> 90%. A significant relationship was noted between short term mortality and SBP (systolic blood pressure) in the hospital's emergency department. It was also found out that as the triage score increases, short term mortality decreases significantly. As hospital stay increases, the chance of the patients' mortality decreases by 0.5%.Conclusion: The percentage of arterial blood oxygen saturation, systolic blood pressure, respiration rate per minute, triage score, the way the patient arrives at the hospital, working shifts, hospitalization duration, age, and comorbidities were regarded as the risk factors for short term mortality. Therefore, promoting professional knowledge and skills of nurses and physicians in the hospitals' emergency department and up-to-dating and reviewing emergency protocols as well as similar research can greatly help reduce short term mortality in the hospital's emergency department.

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Relationship between systolic blood pressure on arrival at Emergency Department and mortality after an episode of acute heart failure

Medicina Clínica (English Edition) ◽

10.1016/j.medcle.2018.08.007 ◽

2018 ◽

Vol 151 (8) ◽

pp. e43-e44

Author(s):

Òscar Miró ◽

Patricia Javaloyes ◽

Pere Llorens

Keyword(s):

Heart Failure ◽

Blood Pressure ◽

Emergency Department ◽

Systolic Blood Pressure ◽

Acute Heart Failure

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Effects of an inspiratory impedance threshold device on blood pressure and short term survival in spontaneously breathing hypovolemic pigs

Resuscitation ◽

10.1016/j.resuscitation.2005.07.015 ◽

2006 ◽

Vol 68 (3) ◽

pp. 399-404 ◽

Cited By ~ 27

Author(s):

Gardar Sigurdsson ◽

Demetris Yannopoulos ◽

Scott H. McKnite ◽

Jill L. Sondeen ◽

David G. Benditt ◽

...

Keyword(s):

Blood Pressure ◽

Short Term ◽

Term Survival ◽

Threshold Device ◽

Spontaneously Breathing ◽

Impedance Threshold Device ◽

Short Term Survival

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The comparison of modified early warning score and Glasgow coma scale-age-systolic blood pressure scores in the assessment of nontraumatic critical patients in Emergency Department

Nigerian Journal of Clinical Practice ◽

10.4103/1119-3077.178944 ◽

2016 ◽

Vol 19 (6) ◽

pp. 761 ◽

Cited By ~ 5

Author(s):

Ö Köksal ◽

G Torun ◽

E Ahun ◽

D Sığırlı ◽

SB Güney ◽

...

Keyword(s):

Blood Pressure ◽

Emergency Department ◽

Glasgow Coma Scale ◽

Systolic Blood Pressure ◽

Early Warning ◽

Early Warning Score ◽

Coma Scale ◽

Critical Patients

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Should Trauma Patients with a Glasgow Coma Scale Score of 3 Be Intubated Prior to Hospital Arrival?

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00008736 ◽

2010 ◽

Vol 25 (6) ◽

pp. 541-546 ◽

Cited By ~ 11

Author(s):

Charlene B. Irvin ◽

Susan Szpunar ◽

Lauren A. Cindrich ◽

Justin Walters ◽

Robert Sills

Keyword(s):

Blood Pressure ◽

Emergency Department ◽

Logistic Regression ◽

Glasgow Coma Scale ◽

Systolic Blood Pressure ◽

Endotracheal Intubation ◽

Body Region ◽

Trauma Patients ◽

Hospital Arrival ◽

Prehospital Endotracheal Intubation

AbstractIntroduction:Previous studies of heterogeneous populations (Glasgow Coma Scale (GCS) scores <9) suggest that endotracheal intubaton of trauma patients prior to hospital arrival (i.e., prehospital intubated) is associated with an increased mortality compared to those patients not intubated in the pre-hospital setting. Deeply comatose patients (GCS = 3) represent a unique population of severely traumatized patients and may benefit from intubation in the prehospital setting. The objective of this study was to compare mortality rates of severely comatose patients (scene GCS = 3) with prehospital endotracheal intubation to those intubated at the hospital.Methods:Using the National Trauma Data Bank (V. 6.2), the following variables were analyzed retrospectively: (1) age; (2) injury type (blunt or penetrating); (3) Injury Severity Score (ISS); (4) scene GCS = 3 (scored prior to intubation/without sedation); (5) emergency department GCS score; (6) arrival emergency department intubation status; (7) first systolic blood pressure in the emergency department (>0); (8) discharge status (alive or dead); (9) Abbreviated Injury Scale Score (AIS); and (10) AIS body region.Results:Of the 10,948 patients analyzed, 23% (2,491/10,948) were endotracheally intubated in a prehospital setting. Mortality rate for those hospital intubated was 35% vs. 62% for those with prehospital intubation (p <0.0001); mean ISS scores 24.2 ±16.0 vs. 31.6 ±16.2, respectively (p <0.0001). Using logistic regression, controlling for first systolic blood pressure, ISS, emergency department GCS, age, and type of trauma, those with prehospital intubation were more likely to die (OR = 1.9, 95% CI = 1.7−2.2). For patients with only head AIS scores (no other body region injury, n = 1,504), logistic regression (controlling for all other variables) indicated that those with prehospital intubation were still more likely to die (OR = 2.0. 95% CI = 1.4−2.9).Conclusions:Prehospital endotracheal intubation is associated with an increased mortality in completely comatose trauma patients (GCS = 3). Although the exact reasons for this remain unclear, these results support other studies and suggest the need for future research and re-appraisal of current policies for prehospital intubation in these severely traumatized patients.

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