Pediatric Pain Assessment in the Emergency Department: Patient and Caregiver Agreement Using the Wong-Baker FACES and the Faces Pain Scale-Revised.

Objective: This study aimed to assess the agreement between patients presenting to the pediatric emergency department (ED) with acute pain and their caregivers when using the Wong-Baker FACES (WBF) and Faces Pain Scale-Revised (FPS-R).

Methods: This was a prospective, observational study examining patients 3 to 7.5 years old presenting to a pediatric ED with acute pain.

Qualitative Assessment of Face Validity and Cross-Cultural Acceptability of the Faces Pain Scale: "Revised" in Cameroon.

The Faces Pain Scale-Revised (FPS-R) is a self-report pain scale validated in numerous countries, but not in Cameroon. We postulated that while cultural factors influence pain perception and expression, the FPS-R should remain culturally acceptable for pediatric use. A convenience sample of 36 pediatric patients, aged 4 to 16 years, representing three primary language groups, was enrolled at Mbingo Baptist Hospital (MBH).

Multicenter, randomized trial of quantitative pretest probability to reduce unnecessary medical radiation exposure in emergency department patients with chest pain and dyspnea.

Background: Use of pretest probability can reduce unnecessary testing. We hypothesize that quantitative pretest probability, linked to evidence-based management strategies, can reduce unnecessary radiation exposure and cost in low-risk patients with symptoms suggestive of acute coronary syndrome and pulmonary embolism.

Methods And Results: This was a prospective, 4-center, randomized controlled trial of decision support effectiveness.

Rationale and methodology for a multicentre randomised trial of fibrinolysis for pulmonary embolism that includes quality of life outcomes.

Background: Submassive pulmonary embolism (PE) has a low mortality rate but can degrade functional capacity.

Objective: The present study aims to provide rationale, methodology, and initial findings of a multicentre, randomised trial of fibrinolysis for PE that used a composite end-point, including quality of life measures.

Methods: This investigator-initiated study was funded by a contract between a corporate partner and the investigator's hospital (the prime site).

Outcomes and radiation exposure of emergency department patients with chest pain and shortness of breath and ultralow pretest probability: a multicenter study.

Study Objective: Excessive radiation exposure remains a concern for patients with symptoms suggesting acute coronary syndrome and pulmonary embolism but must be judged in the perspective of pretest probability and outcomes. We quantify and qualify the pretest probability, outcomes, and radiation exposure of adults with both chest pain and dyspnea.

Methods: This was a prospective, 4-center, outcomes study.

Normalization of vital signs does not reduce the probability of acute pulmonary embolism in symptomatic emergency department patients.

Objectives: In a patient with symptoms of pulmonary embolism (PE), the presence of an elevated pulse, respiratory rate, shock index, or decreased pulse oximetry increases pretest probability of PE. 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.

Methods: This was a prospective, noninterventional, single-center study of diagnostic accuracy conducted on adults presenting to an academic emergency department (ED), with at least one predefined symptom or sign of PE and one risk factor for PE.

D-dimer and exhaled CO2/O2 to detect segmental pulmonary embolism in moderate-risk patients.

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

Objectives: To test if the etCO(2)/O(2) can produce clinically important changes in the probability of segmental or larger PE on computerized tomography multidetector-row pulmonary angiography (MDCTPA) in a moderate-risk population with a positive D-dimer.

Methods: Emergency department and hospitalized patients with one or more predefined symptoms or signs, one or more risk factors for PE, and 64-slice MDCTPA enrolled from four hospitals.

Impact of anaesthesia-surgery on D-dimer concentration and end-tidal CO2 and O2 in patients undergoing surgery associated with high risk for pulmonary embolism.

Background: The exhaled end-tidal CO2/O2 ratio and the D-dimer concentration are diagnostic markers of pulmonary embolism (PE).

Objective: To develop a non-invasive technique to monitor for PE in surgical patients. We examine the change imparted by anaesthesia-surgery on the end-tidal CO2/O2 compared with the D-dimer.