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| 1 | Clinical and historical features of emergency department patients with pericardial effusions显示文摘BACKGROUND: Diagnosing pericardial effusion is critical for optimal patient care. Typically, clinicians use physical examination ? ndings and historical features suggesting pericardial effusion to determine which patients require echocardiography. The diagnostic characteristics of these tools are not well described. The objective of this study is to determine the prevalence of historical features and sensitivity of clinical signs to inform clinicians when to proceed with echocardiogram.METHODS: A retrospective review of point-of-care echocardiograms performed over a two and a half year period in two emergency departments were reviewed for the presence of a pericardial effusion. Patient charts were reviewed and abstracted for presenting symptoms, historical features and clinical findings. The prevalence of presenting symptoms and historical features and the sensitivity of classic physical examination ? ndings associated with pericardial effusion and tamponade were determined.RESULTS: One hundred and fifty-three patients with pericardial effusion were identified. Of these patients, the most common presenting complaint was chest pain and shortness of breath. Patients had no historical features that would suggest pericardial effusion in 37.5% of cases. None of the patients with pericardial effusion or pericardial tamponade had all of the elements of Beck's triad. The sensitivity of Beck's triad was found to be 0(0%–19.4%). The sensitivity for one ? nding of Beck's triad to diagnose pericardial tamponade was 50%(28.0%–72.0%).CONCLUSION: History and physical examination findings perform poorly as tests for the diagnosis of pericardial effusion or pericardial tamponade. Clinicians must liberally evaluate patients suspected of having a pericardial effusion with echocardiography. | Lori Stolz Josephine Valenzuela Elaine Situ-LaCasse Uwe Stolz Nicolas Hawbaker Matthew Thompson Srikar Adhikari | 2017 | World Journal of Emergency Medicine2017，8，1： | 4 |
| 2 | What is the ideal approach for emergent pericardiocentesis using point-of-care ultrasound guidance?显示文摘BACKGROUND:Traditionally performed using a subxiphoid approach,the increasing use of point-of-care ultrasound in the emergency department has made other approaches(parasternal and apical)for pericardiocentesis viable.The aim of this study is to identify the ideal approach for emergency-physician-performed ultrasound-guided pericardiocentesis as determined by ultrasound image quality,distance from surface to pericardial fl uid,and likely obstructions or complications.METHODS:A retrospective review of point-of-care cardiac ultrasound examinations was performed in two urban academic emergency departments for the presence of pericardial eff usions.The images were reviewed for technical quality,distance of eff usion from skin surface,and predicted complications.RESULTS:A total of 166 pericardial effusions were identified during the study period.The mean skin-to-pericardial fl uid distance was 5.6 cm(95%confi dence interval[95%CI]5.2-6.0 cm)for the subxiphoid views,which was signifi cantly greater than that for the parasternal(2.7 cm[95%CI 2.5-2.8 cm],P<0.001)and apical(2.5 cm[95%CI 2.3-2.7 cm],P<0.001)views.The subxiphoid view had the highest predicted complication rate at 79.7%(95%CI 71.5%-86.4%),which was signifi cantly greater than the apical(31.9%;95%CI 21.4%-44.0%,P<0.001)and parasternal(20.2%;95%CI 12.8%-29.5%,P<0.001)views.CONCLUSIONS:Our results suggest that complication rates with pericardiocentesis will be lower via the parasternal or apical approach compared to the subxiphoid approach.The distance from skin to fl uid collection is the least in both of these views. | Lori Stolz Elaine Situ-LaCasse Josie Acuña Matthew Thompson Nicolaus Hawbaker Josephine Valenzuela Uwe Stolz Srikar Adhikari | 2021 | World Journal of Emergency Medicine2021，12，3： | 2 |
| 3 | Effects of roads,topography,and land use on forest cover dynamics in the BrazilianAtlantic Forest显示文摘 | FREITAS S R HAWBAKER T J METZGER J P | 2010 | Forest Ecology and Management2010，259，3： | 1 |
| 4 | Road density and landscape pattern in relation to housing density, and ownership, land cover, and soil显示文摘 | Hawbaker T J Radeloff V C Hammer R B et at | 2004 | Landscape Ecology2004，20，： | 1 |
| 5 | Ultrathin whitetopping-state-of-the-practice for thin concrete overlays of asphalt显示文摘 | Hawbaker L D Cole L W | 1998 | Concrete in Construction1998，，： | 1 |
| 6 | Road Density And Landscape Pattern in Relation to Hhousing Density, Land Ownership, Land Cover and Soils 显示文摘 | Hawbaker T J Radeloff V C Hammer R B | 2004 | Landscape Ecology2004，20，5： | 1 |
| 7 | Road density and landscape pattern in relation to housing density, land ownership, land cover, and soils 显示文摘 | Hawbaker T J Radeloff V C Hmmer R B | 2004 | Landscape Ecology2004，20，5： | 1 |
| 8 | Road Density and Landscape Pattern in Relation to Housing Density, and Ownership, Land Cover, and Soils显示文摘 | Todd J. Hawbaker Volker C. Radeloff Roger B. Hammer Murray K. Clayton | 2005 | Landscape Ecology2005，，5： | 1 |
| 9 | Road Density and Landscape Pattern in Relation to Housing Density,and Ownership,Land Cover,and Soils显示文摘 | Hawbaker T J Radeloff V C Hammer R B | | 0，，05： | 1 |
| 10 | Road density and landscape pattern in relation to housing density, and ownership, land cover, and soils显示文摘 | Hawbaker T J Radeloff V C Hammer R B | 2005 | Landscape Ecology2005，20，5： | 1 |
| 11 | Road den- sity andlandscape pattern in relation to housing density, land ownership,land cover, and soils显示文摘 | Hawbaker T J Radelof V C Hmmer R B | 2004 | Landscape Ecolo- gy2004，20，： | 1 |
| 12 | Characterizing recent and projecting future potential patterns of mountain pine beetle outbreaks in the southern rocky mountains 显示文摘 | Liang L Hawbaker T J Chen Y L | 2014 | Applied Geogra- phy2014，55，： | 1 |
| 13 | Housing growth inand near United States protected areas limits their conservation val- ue显示文摘 | Radeloff V C S I Stewart T J Hawbaker | 2010 | Proceedings of National Academy of Sciences of USA2010，107，1： | 1 |
| 14 | Road density and landscape pattern in relation to housing density, land ownership, land cover, and soils显示文摘 | Hawbaker T J Radeloff V C Hmmer R B | 2004 | Landscape Ecology2004，20，： | 1 |
| 15 | Roads and landscape pattern in northern wisconsin based on a comparison of four road data sources显示文摘 | T J Hawbaker V C Radeloff | 2004 | Conservation Biology2004，18，5： | 1 |
| 16 | Road density and landscape pattern in relation to housing density, land ownership, land cover, and soils 显示文摘 | HAWBAKER T J RADELOFF V C HMMER R B | 2004 | Landscape Ecology2004，20，5： | 1 |
| 17 | Mapping mountain pine beetle mortality through growth trend analysis of time-series Landsat data显示文摘 | Liang L Chen Y L Hawbaker T J | 2014 | Remote Sens-Basel2014，6，6： | 1 |
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