Alan E Jones

..3 to 2.8). CONCLUSION: Nontraumatic hypotension was documented in 19% of a random sample of ED patients admitted to the hospital. Patients exposed to hypotension had a significantly increased risk of death during hospitalization...

..To determine the clinical effectiveness of implementing early goal-directed therapy (EGDT) as a routine protocol in the emergency department (ED)...

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..We examined the utility of the SOFA score for assessing outcome of patients with severe sepsis with evidence of hypoperfusion at the time of emergency department (ED) presentation...

..Once detected, aggressive and endpoint-directed resuscitation should be implemented to reverse the hypoperfusion and to prevent further deterioration, organ dysfunction, and death...

..Quantitative resuscitation consists of structured cardiovascular intervention targeting predefined hemodynamic end points. We sought to measure the treatment effect of quantitative resuscitation on mortality from sepsis...

..Guidelines recommend that sepsis be treated with an early resuscitation protocol such as early goal-directed therapy. Our objective was to assess the cost-effectiveness of implementing early goal-directed therapy as a routine protocol...

..The aim of the study was to test if the Mortality in Emergency Department Sepsis (MEDS) score accurately predicts death among emergency department (ED) patients with severe sepsis and septic shock...

..We seek to evaluate the diagnostic performance of the procalcitonin test for the diagnosis of bacteremia in the emergency department (ED) population...

..Therefore, it is critical for the clinician to understand the pathophysiology, recognition, and treatment of sepsis-induced hypoperfusion...

..The authors sought to determine the agreement and prognostic value of achieving ScvO(2) or LC goals in septic shock patients undergoing emergency department (ED)-based early resuscitation...

..We sought to determine the association between time to initial antibiotics and mortality of patients with septic shock treated with an emergency department-based early resuscitation protocol...

..We aimed to define the relationship between supranormal oxygen tension and outcome in postresuscitation patients...

..Our aim is to investigate the association of diabetes and initial glucose level with mortality in patients with suspected infection from the ED...

..We sought to determine one year outcomes associated with implementation of early goal directed therapy (EGDT) in the emergency department (ED) care of sepsis...

..Goal-directed resuscitation for severe sepsis and septic shock has been reported to reduce mortality when applied in the emergency department...

..Laboratory investigations suggest that exposure to hyperoxia after resuscitation from cardiac arrest may worsen anoxic brain injury; however, clinical data are lacking...

..quot; CONCLUSIONS: The unstructured clinical estimate of low pretest probability for PE compares favorably with the Canadian score and the Charlotte rule. Interobserver agreement for the unstructured estimate is moderate...

..No quantitative decision instrument has been derived specifically for patients with active cancer and PE...

..This study assessed the extent and mechanism of complement activation in community-acquired sepsis at presentation to the emergency department (ED) and following 24 hours of quantitative resuscitation...

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..0% of patients with a negative protocol would have an adverse outcome...

..We hypothesized that ED non-sustained hypotension increases risk of in-hospital mortality in patients with sepsis...

..We selected cardiopulmonary bypass (CPB) patients with expected and rapidly reversible hemodynamic instability to test the hypothesis that microcirculatory alterations can occur independent of mean arterial pressure (MAP)...

..We investigated the association between biomarkers of endothelial cell activation and sepsis severity, organ dysfunction sequential organ failure assessment (SOFA) score, and death...

..Future research should focus on ED clinical protocols to ensure appropriate resuscitation and investigation of etiology of out-of-hospital hypotension...

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..While contrast-induced nephropathy (CIN) is a known complication, this risk is not well defined in the ED or other ambulatory setting. The aim of this study was to define the risk of CIN following CTPA...

..Mitochondrial DNA levels were negatively associated with organ dysfunction, suggesting that plasma mtDNA does not significantly contribute to the pathophysiology of sepsis...

..4; CI, 0.8-2.3; P = 0.2) did not reach statistical significance. This study found a sepsis-specific activation of endothelium activation markers, particularly E-selectin and sFLT-1, in emergency department patients with hypotension...

..Abnormal (both low and high) central venous saturation (ScvO(2)) is associated with increased mortality in emergency department (ED) patients with suspected sepsis...

..No studies are identified using GIK in patients with septic shock or other forms of circulatory shock, providing an absence of evidence regarding the effect of GIK as a therapy in patients with shock...

..We tested the hypothesis that exposure to arterial hypotension after ROSC occurs commonly (>50%) and is an independent predictor of death...

..Given that regionalization of time-dependent high-acuity illness is an emerging paradigm, the aim of the present study was to develop and implement a regionalized approach to post-cardiac arrest care...

..Our aim was to identify the incidence of postintubation hypotension (PIH) after emergency intubation and to determine its association with inhospital mortality...

..The objective of this study was to evaluate if normalization of an initially abnormal vital sign can be used as evidence to lower the suspicion for PE...

..We sought to compare the outcomes of patients with cryptic versus overt shock treated with an emergency department (ED) based early sepsis resuscitation protocol...

..5 (95% CI 1.1-45). Among ED patients with non-traumatic undifferentiated symptomatic hypotension, the presence of hyperdynamic LVF on focused echo is highly specific for sepsis as the etiology of shock...

..Follow-up for diagnostic research studies might be facilitated if medical record review (MRR) could be used instead of telephone calls...

..Our aim was to describe the etiology of illness in patients identified and treated for severe sepsis in the emergency department...

..45-0.76). CONCLUSIONS: Using variables available in the emergency department, three previously validated intensive care unit scoring systems demonstrated moderate accuracy for predicting in-hospital mortality...

..Before implementing the EDGT protocol, the ED did not follow a written management protocol for septic patients...

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..Thus, this study sought to define the risk of these immediate complications with the overall aim of improving institutional guidelines and patient consent procedures...

..This study sought to evaluate the association between blood lactate concentrations along an incremental continuum up to a maximum value of 20 mmol/L and mortality...

..These data provide rationale for a clinical trial of lactate clearance as a distinct end point of early sepsis resuscitation...

..We hypothesize that the presentation of a quantitative pretest probability of acute coronary syndrome would safely reduce unnecessary resource use in low-risk emergency department (ED) chest pain patients...

..1; 95% CI 1.5-7.1). Mortality among patients who present to the ED with undifferentiated shock is high. The depth and duration of systolic blood pressure appears to have a dose-response relationship to adverse hospital outcome...

..The authors sought to determine the effect of in vitro time, temperature, and removable tourniquet use on changes in venous point-of-care lactate concentrations...

..We hypothesized that emergency department (ED) patients with severe sepsis who received EMS care had more rapid recognition and treatment compared to non-EMS patients...

..Pulmonary embolism (PE) decreases the exhaled end-tidal ratio of carbon dioxide to oxygen (etCO(2)/O(2))...

..Taken together, we submit that the present case report and prior case reports are sufficient to comprise a phase I study of the safety and efficacy of tenecteplase to treat acute pulmonary embolism...

..No prospective study has reported the incidence of contrast-induced nephropathy (CIN) or the associated morbidity and mortality after contrast-enhanced computed tomography (CECT) in the outpatient setting...

..We hypothesized that in patients with major pelvic injury (MPI) trauma ultrasound would perform with lower accuracy than has previously been reported...

..Our objective was to quantify the rate of thromboprophylaxis and incidence of in-hospital VTE, based upon risk of VTE, in a cohort of patients admitted through the emergency department (ED)...

..Our aim was to identify factors associated with postintubation hypotension after emergency intubation...

..The use of luminescent bacteria allowed for the development of a novel and powerful tool for assessing complement immunology for the purposes of mechanistic study and patient evaluation...

..Although these data add important new evidence to our understanding of arterial pressure management, there are still many unanswered questions upon which future investigations should focus...

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..This is a report of sonographic intraperitoneal fluid in the setting of major pelvic injury and hemodynamic instability found to be uroperitoneum and not hemoperitoneum...

..Experimental PE increased lung and systemic production of TxB(2). Inhibition at the COX-1/2 enzyme was equally as effective as inhibition of thromboxane synthase at reducing alveolar dead space and improving heart function after PE...

..To date, no standardized method for allocating scarce resources when the number of patients in need far exceeds capacity exists. We sought to derive and validate such a triage scheme...

..The objective was to assess productivity of previous recipients of Society for Academic Emergency Medicine (SAEM) grant awards...

..This will potentially result in saving thousands of lives per year and reduce the cost of care for septic patients. ..