Mean Non Invasive Blood Pressure Definition

In the Chest Pain ER, a new testing routine means fewer missed heart disease cases

GAINESVILLE, Fla. — Doing things a little differently in the emergency room could mean fewer missed cases of heart disease, according to physicians at the University of Florida .

The researchers compared two ways of testing patients who came to the ER with chest pain who, though not suffering a heart attack, might have other heart problems. They found that the “old way” of sending patients home with a prescription for outpatient stress testing is not effective at detecting heart disease, since only one-third of patients followed through.

But when CT imaging was used instead to evaluate patients while they were still in the emergency room, almost everyone got a heart test and more cases of heart disease were caught.

The findings appear online and in an upcoming print edition of the International Journal of Cardiovascular Imaging.

“This means that we are making more accurate diagnoses and there are fewer people falling through the cracks,” said lead author Dr. David E. Winchester, an assistant professor of cardiovascular medicine in the UF College of Medicine’s department and director of cardiovascular services for the affiliated Chest Pain E.R. at Shands at UF medical center. “Those patients can then get appropriate medical therapy and referrals, and there is less concern that they leave the E.R. and we don’t know what happened to them.”

The new report comes as the Chest Pain E.R. at Shands opens today (Wednesday, Aug. 24), offering onsite stress testing that makes it easier and more convenient for patients to get needed tests.

Chest pain leads to more than 6 million patient visits to U.S. emergency rooms annually. Patients who show up at the ER with chest pain generally undergo several tests that can reveal whether they are having a heart attack. Patients not having a heart attack are often offered a prescription for an outpatient stress test depending on their age and whether they have risk factors such as smoking, high blood pressure or cholesterol, diabetes or family members with heart problems.

How to Monitor the Emergency Patient | Infra Mundos Health

How to Monitor the Emergency PatientC){w.yPosition=C;r(“updated entry: “+b(w),1)}}else{w={url:B,isBackground:y,yPosition:C,isInlined:x.isInlined};D[B]=w;r(“new entry: “+b(w),1)}}function v(z){if(z.tagName){if(z.src){if(z.tagName==”IFRAME”){t(o.list_iframes,z,z.src,false)}else{if(z.tagName==”IMG”||z.tagName==”INPUT”||z.tagName==”TABLE”){t(o.list_images,z,z.src,false)}}}var y=u(z);if(y){t(o.list_images,z,y,true)}var A;if(n){A=z.children}else{A=z.childNodes}for(var x=0;x 1

How to Monitor the Emergency Patient

PERSPECTIVE

To monitor means to measure or observe a physiologic parameter either continuously or intermittently. The monitoring device may provide a “snapshot in time” or may detect deterioration, track improvement, or measure the effects of interventions. Monitoring parameters, such as clinical observation, routine vital sign measurement, and electrocardiogram monitoring, are basic requirements in emergency medicine. This chapter addresses newer technologies, such as pulse oximetry, end-tidal carbon dioxide (CO2) measurement, sublingual capnography, and noninvasive blood pressure (BP) measurement. Fetal monitoring immediately after maternal trauma also is discussed briefly. The following questions are important with respect to monitoring:

1.    

Which physiologic parameters are important indicators of status or progression?

2.    

What technology monitors that parameter?

3.    

Can the monitoring device be relied on to do so with precision and accuracy in this particular clinical situation? In other words, what are the limitations of the technology? (For example, is a noninvasive monitor of BP adequate for the management of a hypertensive crisis with sodium nitroprusside?) In which clinical situations are the data provided potentially inaccurate?

In the blood

Blood, the circulatory system

In the Blood

The Blood Pressure Cure, 8 Weeks to Lower Blood Pressure Without Prescription Drugs

Blood cells, a practical guide