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1.
Aim
Airway management is a core aspect of emergency medicine. The technique of rapid sequence intubation (RSI) creates continuing debate between anaesthetists and emergency physicians in the UK, although similar complication rates for emergency department (ED) RSI have been shown for both specialties. This study examined prospectively collected data on every ED RSI performed in a university hospital in Glasgow over 5 years.Methods
Data were prospectively recorded for every attempted RSI in the ED on a dedicated form (as used in previous studies) between January 1999 and December 2003. Immediate complications were specifically sought in the questionnaire, as was the immediate destination on leaving the ED. The χ2 test was used for categorical data.Results
On average, 51 ED RSI were performed annually (range 42–60). Emergency physician RSI for trauma increased from 32% (7/22) in 1999 to 75% (21/28) in 2003 (χ2 = 9.32, df = 1, p = 0.002) and for non‐trauma from 62% (18/29) in 1999 to 79% (23/29) in 2003 (χ2 = 2.08, df = 1, p = 0.15). Complication rates for emergency physician RSI decreased from 43% (3/7) to 14% (3/21) for trauma (χ2 = 2.55, df = 1, p = 0.11) and from 28% (5/18) to 4% (1/23) for non‐trauma (χ2 = 4.44, df = 1, p = 0.035). This compares with mean complication rates for anaesthetists for trauma of 17% and for non‐trauma of 22%. Incidence of hypotension decreased in all groups; however, oxygen desaturation is now the most common complication. The rate of ED RSI prior to computed tomography (CT) scans increased in both the trauma (79% v 42%; χ2 = 7.42, df = 1, p = 0.0065) and non‐trauma (48% v 17%; χ2 = 5.85, df = 1, p = 0.016) groups.Conclusion
Emergency physician performed ED RSI is increasingly common but is not associated with overall higher numbers of RSIs being performed in the ED. Effective pre‐oxygenation should be emphasised during training. 相似文献2.
Demiryoguran NS Karcioglu O Topacoglu H Kiyan S Ozbay D Onur E Korkmaz T Demir OF 《Emergency medicine journal : EMJ》2006,23(2):99-102
Objectives
Many patients who have been discharged from the emergency department (ED) with a diagnosis of “non‐specific chest pain” (NSCP) have anxiety disorder (AD), a commonly missed entity in acute care. The objective of this study was to delineate characteristic properties that could enhance recognition of AD in ED patients admitted with NSCP.Methods
All patients between 18 and 65 years of age diagnosed with NSCP were enrolled. The Hospital Anxiety and Depression Scale (HADS) anxiety subscale was used as a screening test for AD. The patients with high HADS scores (⩾10) were evaluated by a psychiatrist for AD.Results
In total, 157 patients were enrolled in the study. HADS scores were found to be "high" (⩾10) in 49 patients (31.2%). Patients with high HADS scores had a higher frequency of associated symptoms (p = 0.004). Dizziness or lightheadedness, chills or hot flushes, and fear of dying were found to have been reported more frequently by patients with high anxiety scores. Of the group with high score, 33 patients (67.3%) were interviewed by a psychiatrist, and 23 (69.7%) of these patients were diagnosed with AD. Associated symptoms were described by 21 patients with AD (91.3%). Of those with AD, 18 (78.3%) had been previously admitted to the ED with chest pain. Atypical chest pain was described by 21 patients (91.3%).Conclusions
Physicians should always consider AD in patients presenting to the ED with chest pain after ruling out organic aetiology. Patients'' definition of atypical pain, recurrent admissions to ED, and presence of associated symptoms such as dizziness, chills or hot flushes, and fear of dying could aid in considering AD. 相似文献3.
Objectives
To establish the prevalence of previously undiagnosed dyslipidaemia in patients presenting to the emergency department (ED) with non‐traumatic chest pain and, more particularly, the prevalence in the subgroup which was discharged home from the ED, the group that traditionally would not have received a lipid test.Methods
Prospective, observational study of adult patients presenting to an ED with non‐traumatic chest pain as the presenting complaint.Results
A total of 185 eligible patients underwent lipid testing during their presentation: 96 in the ED and 89 in the wards. Overall 61% (n = 112) of patients had at least one abnormal lipid level. Of patients discharged from the ED, 62% had at least one abnormal lipid level.Conclusions
A moderate, but useful, increase in detection rates of dyslipidaemia is possible if lipid testing is offered to all patients presenting with chest pain, and not just to those who are admitted to wards for further investigation and management of suspected acute coronary syndromes. Testing of this group should be considered as a health promotion initiative in the ED, with appropriate follow up in the community. 相似文献4.
Markogiannakis H Sanidas E Messaris E Koutentakis D Alpantaki K Kafetzakis A Tsiftsis D 《Emergency medicine journal : EMJ》2006,23(1):27-31
Background
Vehicle accidents in Greece are among the leading causes of death and the primary one in young people. The mechanism of injury influences the patterns of injury in victims of vehicle accidents.Objective
Identification and analysis of injury profiles of motor‐vehicle trauma patients in a Greek level I trauma centre, by road‐user category.Patients and methods
The trauma registry data of Herakleion University Hospital of adult trauma patients admitted to the hospital after a vehicle accident between 1997 and 2000 were retrospectively examined. Patients were grouped based on the mechanism of injury into three road‐user categories: car occupants, motorcyclists, and pedestrians.Results
Of 730 consecutive patients, 444 were motorcyclists (60.8%), 209 were car occupants (28.7%), and 77 were pedestrians (10.5%). Young men constituted the majority of injured motorcyclists whereas older patients (p = 0.0001) and women (p = 0.0001) represented a substantial proportion of the injured pedestrians. With regard to the spectrum of injuries in the groups, craniocerebral injuries were significantly more frequent in motorcyclists and pedestrians (p = 0.0001); abdominal (p = 0.009) and spinal cord trauma (p = 0.007) in car occupants; and pelvic injuries (p = 0.0001) in pedestrians. Although the car occupants had the highest Injury Severity Score (ISS) (p = 0.04), the pedestrians had the poorest outcome with substantially higher mortality (p = 0.007) than the other two groups.Conclusions
The results reveal a clear association between different road‐user categories and age and sex incidence patterns, as well as outcomes and injury profiles. Recognition of these features would be useful in designing effective prevention strategies and in comprehensive prehospital and inhospital treatment of motor‐vehicle trauma patients. 相似文献5.
Objectives
To evaluate the effect of introducing an extended scope physiotherapy (ESP) service on patient satisfaction, and to measure the functional outcome of patients with soft tissue injuries attending an adult emergency department (ED), comparing management by ESPs, emergency nurse practitioners (ENPs), and all grades of ED doctor.Methods
The ESP service operated on four days out of every seven in a week in an urban adult ED. A satisfaction questionnaire was sent to all patients with a peripheral soft tissue injury and fractures (not related to the ankle) within one week of attending the ED. Patients with a unilateral soft tissue ankle injury were sent the acute Short Form 36 (SF‐36) functional outcome questionnaire, with additional visual analogue scales for pain, at 4 and 16 weeks after their ED attendance. Waiting times and time spent with individual practitioners was also measured.Results
The ESP service achieved patient satisfaction that was superior to either ENPs or doctors. Overall 55% of patients seen by the ESP service strongly agreed that they were satisfied with the treatment they received, compared with 39% for ENPs and 36% for doctors (p = 0.048). Assessment of long‐term outcome from ankle injury was undermined by poor questionnaire return rates. There was a trend towards improved outcomes at four weeks in those patients treated by an ESP, but this did not achieve statistical significance.Conclusion
Adding an ESP service to the interdisciplinary team achieves higher levels of patient satisfaction than for either doctors or ENPs. Further outcomes research, conducted in a wider range of emergency departments and integrated with an economic analysis, is recommended. 相似文献6.
Objectives
To assess the effect an ambulance pre‐alert call for patients with suspected acute myocardial infarction (AMI) would have on door to needle (DTN) times.Methods
We carried out back to back audits of DTN times following the initiation of the pre‐alert calls.Participants
All patients thrombolysed within the emergency department between July 2003 and April 2004 (inclusive).Statistical analysis
Mean DTN times and time to ECG pre‐change and post‐change were compared using the Two sample t test. The Fisher''s exact test was used to compare pre‐change and post‐change proportions of patients seen within guideline times.Results
In total, 73 patients were thrombolysed with 40 of these arriving by ambulance. Eighteen of these 40 were pre‐change and 22 were post‐change. Four patients were excluded. Fifty per cent of the pre‐change group had a DTN time of <30 minutes compared with 91% of the post‐change group (p = 0.005, Fisher''s exact test). The phase one mean DTN time was found to be significantly greater than that for phase two (Two sample t test, p = 0.016; 95% CI 1.6 to 14.6).Conclusions
There was a significant reduction in DTN times after the introduction of the pre‐alert call. 相似文献7.
Objective
The aim of this study was to compare the incidence of nausea and vomiting in patients with acute pain treated with morphine along with prophylactic metoclopramide or placebo.Method
A randomised controlled trial was carried out on patients requiring morphine for acute pain in the emergency department (ED) setting. Children under the age of 12, patients who had been vomiting or had already received prehospital analgesia, and those unable to give consent were excluded. All patients were given either metoclopramide (10 mg) or placebo (normal saline) followed by intravenous morphine. Pain scores (measured on a visual analogue scale) before and after morphine administration, all incidents of nausea or vomiting, the dose of morphine, and the patients'' demographic data were recorded. Fisher''s exact test was used for comparing the two groups of patients.Results
A total of 259 patients were recruited. There were 123 patients in the metoclopramide group (age range 15–94 years; median age 53) and 136 patients in the placebo group (age range 17–93 years; median age 52.5). The overall incidence of nausea and vomiting in the whole study population was 2.7%, (1.6% in the metoclopramide group and 3.7% in the placebo group). The difference between the two groups was not statistically significant (Fisher''s exact test = 0.451; p = 0.3; z‐test statistic = 1.02; 95% CI –6% to 2%).Conclusion
When intravenous morphine is administered for acute pain, the overall incidence of nausea and vomiting is low, regardless of whether these patients are given prophylactic metoclopramide or not. 相似文献8.
9.
Objective
To determine the efficacy of the Mortality in Emergency Department Sepsis (MEDS) score in the stratification of patients who presented to the emergency department (ED) with severe sepsis.Methods
Adults who presented to the ED with severe sepsis were retrospectively recruited and divided into group A (MEDS score <12) and group B (MEDS score ⩾12). Their outcomes were evaluated with 28 day hospital mortality rate, length of hospital stay, Kaplan‐Meier survival analysis, and receiver operating characteristic (ROC) analysis. Discriminatory power of the MEDS score in mortality prediction was further compared with the Acute Physiology and Chronic Health Evaluation (APACHE) II model.Results
In total, 276 patients (44.6% men and 55.4% women) were analysed, with 143 patients placed in group A and 133 patients in group B. Patients with MEDS score ⩾12 had a significantly higher mortality rate (48.9% v 17.5%, p<0.01) and higher median APACHE II score (25 v 20 points, p<0.01). Significant difference in mortality risk was also demonstrated with Kaplan‐Meier survival analysis (log rank test, p<0.01). No difference in the length of hospital stay was found between the groups. ROC analysis indicated a better performance in mortality prediction by the MEDS score compared with the APACHE II score (ROC 0.75 v 0.62, p<0.01).Conclusion
Our results showed that mortality risk stratification of severe sepsis patients in the ED with MEDS score is effective. The MEDS score also discriminated better than the APACHE II model in mortality prediction. 相似文献10.
Objective
To determine which of three commonly used methods for notifying medical staff of the arrival of an emergent case to the triage area of an emergency department (ED) is optimal.Methods
Prospective, randomised trial. Patients arriving with conditions rated as emergencies (triage category 2) were randomised to one of three notification arms: by microphone, by telephone, or by computer. The proportion of patients seen by a doctor within 10 minutes of arrival to the ED in each arm was compared.Results
A total of 1000 patients were enrolled. The proportion seen within 10 minutes for patients announced by microphone was significantly greater than those announced by telephone or computer (67.0% v 63.2% v 57.3%, respectively; χ2 6.30, p = 0.04). No method achieved the benchmark proportion of 80% of patients seen within 10 minutes of arrival.Conclusions
A microphone announcement heard by overhead speakers should be incorporated with other strategies to improve the timeliness of medical assessment of emergent cases. 相似文献11.
Objectives
To answer concerns related to implementation of the National Institute for Clinical Excellence (NICE) guideline on the management of head injury by determining the impact on the workload of a district general hospital. Increased computed tomography (CT) was of particular concern (cost, radiation risk, and delivery constraints).Method
Retrospective audit of all patients attending the hospital''s emergency department with a head injury over a three month period. Any reattendees for the same head injury episode were excluded but the need for CT was recorded. Case notes and electronic records were reviewed to determine whether the CT head or skull radiograph (SXR) was indicated in line with the NICE guideline. The workload was compared with an identical audit performed before the implementation of the NICE guideline.Results
Of 17 472 patients attending the ED in 2004, 472 had a head injury. CT scan was indicated in 36, a significant increase from 2003 (p<0.001). No SXR was indicated but two were performed, a significant decrease (p<0.001). The admission rate was unaltered. The positive predictive value of NICE was 17.1% compared with 25% (p = not significant) for the authors'' pre‐NICE departmental guideline.Conclusions
This department has seen an increase in CT head requests since the implementation of the NICE guideline. This costs an extra £15 000 per 100 head injuries annually for this department, with an estimated £51.7 million burden for England and Wales. Further evaluation is required as there were only nine brain injuries in this audit population. 相似文献12.
Haveman JW Karliczek A Verhoeven EL Tielliu IF de Vos R Zwaveling JH van den Dungen JJ Zeebregts CJ Nijsten MW 《Emergency medicine journal : EMJ》2006,23(10):807-810
Objective
To describe the triage of patients operated for non‐ruptured and ruptured abdominal aortic aneurysms (AAAs) before the endovascular era.Design
Retrospective single‐centre cohort study.Methods
All patients treated for an acute AAA between 1998 and 2001 and admitted to our hospital were evaluated in the emergency department for urgent AAA surgery. All time intervals, from the telephone call from the patient to the ambulance department, to the arrival of the patient in the operating theatre, were analysed. Intraoperative, hospital and 1‐year survival were determined.Results
160 patients with an acute AAA were transported to our hospital. Mean (SD) age was 71 (8) years, and 138 (86%) were men. 34 (21%) of these patients had symptomatic, non‐ruptured AAA (sAAA) and 126 patients had ruptured AAA (rAAA). All patients with sAAA and 98% of patients with rAAA were operated upon. For the patients with rAAA, median time from telephone call to arrival at the hospital was 43 min (interquartile range 33–53 min) and median time from arrival at the hospital to arrival at the operating room was 25 min (interquartile range 11–50 min). Intraoperative mortality was 0% for sAAA and 11% for rAAA (p = 0.042), and hospital mortality was 12% and 33%, respectively (p = 0.014).Conclusions
A multidisciplinary unified strategy resulted in a rapid throughput of patients with acute AAA. Rapid transport, diagnosis and surgery resulted in favourable hospital mortality. Despite the fact that nearly all the patients were operated upon, survival was favourable compared with published data.As untreated ruptured abdominal aortic aneurysm (AAA) has an almost 100% mortality, rapid diagnosis and treatment are essential goals. Nevertheless, several recent series report a hospital mortality >50% for patients with acute AAAs.1,2,3 These figures include only patients who arrive alive at the hospital. Therefore, total mortality for acute AAA may approximate 80–90%.4,5,6 Delay in treatment might significantly influence mortality; therefore, measures to reduce time to surgery can be valuable in decreasing mortality. Very few studies describe the delay to surgery.7,8,9,10 AbuRahma et al8 describe a mortality of 73% in patients operated after a delay of >2 h, whereas patients who were operated within 2 h had a mortality of 48% (p<0.05). Both transportation by ambulance and intrahospital management protocol have an influence on delays to surgery.This study aims to present the results of a strategy of direct ambulance transport to our tertiary referral centre when acute AAA was suspected, followed by minimal diagnostics and emergency surgery for nearly all patients. 相似文献13.
Introduction
Lactic acidosis portends a poor prognosis in trauma, sepsis, and other shock states and is useful for triaging and resuscitating emergency department (ED) patients. The authors sought to determine whether the AG is a reliable screen for lactic acidosis when applied specifically in the ED setting.Methods
The authors performed a retrospective cohort study over a seven month period. Subjects were all ED patients that had a serum lactate obtained. Sensitivity analyses of the AG for detecting presence of lactic acidosis were calculated for the traditional AG normal value (AG <12) and for the lower AG normal value when using newer ion selective electrode assays (AG <6).Results
Serum lactate levels were ordered in the ED on 440 occasions. 137 samples were excluded by protocol. Using an AG cutoff of 12, the sensitivity for detecting lactic acidosis was 58.2%, specificity was 81.0%, and the negative predictive value was 89.7%. Using the AG cutoff of 6, the sensitivity was 93.2%, the specificity was 17.3%, and the negative predictive value was 91.8%.Conclusions
The traditional definition of AG >12 was insensitive for the presence of lactic acidosis. Using the revised AG of >6 is more sensitive but non‐specific for lactic acidosis. The authors conclude that employing the AG as a screen for LA may be inappropriate in ED patients. Instead, they recommend ordering a serum lactate immediately upon suspicion of a shock state. A prospective study to confirm these findings is needed. 相似文献14.
Objective
To evaluate the performance of the Airway Scope for tracheal intubation by non‐anaesthetist physicians.Methods
Under supervision by staff anaesthetists, non‐anaesthesia residents performed tracheal intubation using either the Airway Scope (n = 100) or Macintosh laryngoscope (n = 100). The time required for airway instrumentation and the success rate at first attempt were investigated.Results
The time to secure the airway was shorter with the Airway Scope than with the Macintosh laryngoscope (p<0.001). The success rate at first attempt was higher with the Airway Scope than with the Macintosh laryngoscope (p<0.001).Conclusion
The Airway Scope may reduce the time to secure the airway and the incidence of failed tracheal intubation in novice laryngoscopists.Tracheal intubation is a lifesaving procedure used in many clinical situations. Failed tracheal intubation is sometimes serious, especially in emergencies. Direct laryngoscopy using the Macintosh laryngoscope is the most widely used technique for tracheal intubation. However, this technique is acknowledged to be a difficult skill for occasional users to master.1 Evidence from the literature indicates that the incidence of inaccurate intubation can be unacceptably high in such users.2,3 Thus, any device that could reduce the incidence of failed, inaccurate or erroneous intubation deserves attention.The Airway Scope (Pentax, Tokyo, Japan) is a new, rigid laryngoscope for tracheal intubation, providing a non‐line‐of sight view of the airway.4,5,6 It has a built‐in 2.4 inch monitor screen that displays an image from a charge‐coupled device attached to the tip of the scope. A single‐use blade protects the camera unit from oral contamination and accepts a tracheal tube with an outside diameter between 8.5–11 mm. Once the target signal shown on the monitor is aligned with the glottis opening, pushing the tracheal tube along with the tube guide allows it to pass through the vocal cords. We conducted a randomised study to compare the performance of the Airway Scope with that of the Macintosh laryngoscope when used by non‐anaesthetist physicians. 相似文献15.
Objectives
To review compliance with our emergency department (ED) guideline on the imaging of ingested non‐hazardous metallic foreign bodies in children, investigate adverse outcomes, and make suggestions for improving the guideline.Methods
Retrospective analysis of patients presenting in a 3 year period to a paediatric ED with a history of possible metallic foreign body (MFB) ingestion, who were managed according to an ED guideline.Results
We identified 430 episodes of possible MFB ingestion, of which 422 were eligible for inclusion in the study. Compliance with the guideline was 77.8% with no significant adverse events. The exclusion of symptoms as a criterion for x ray results in a reduction in the x ray rate of 56% in the symptomatic group with no increase in adverse events.Conclusion
A handheld metal detector (HMD) can be safely and reliably used in lieu of plain radiography to investigate children with a history of MFB ingestion, irrespective of symptoms and without incurring any significant adverse events. 相似文献16.
Objectives
To identify correlates of alcohol related assault injury in the city centre of a European capital city, with particular reference to emergency department (ED) and police interventions, and number and capacity of licensed premises.Methods
Assaults resulting in ED treatment were studied using a longitudinal controlled intervention, a three stage design during a three year period of rapid expansion in the night‐time economy, when ED initiated targeted police interventions were delivered. A controlled ED intervention targeted at high risk night‐clubs was carried out. Main outcome measure was ED treatment after assault in licensed premises and the street.Results
Targeted police intervention was associated with substantial reductions in assaults in licensed premises but unexpected increases in street assault were also observed (34% overall: 105% in the principal entertainment thoroughfare). Combined police/ED intervention was associated with a significantly greater reduction compared with police intervention alone (OR = 0.61, 95% CI 0.40 to 0.91). Street assault correlated significantly with numbers and capacity of premises. Risk of assault was 50% greater in and around licensed premises in the city centre compared with those in the suburbs, although dispersion of violence to more licensed premises was not observed.Conclusions
Marked decreases in licensed premises assaults resulting from targeted policing were enhanced by the intervention of ED and maxillofacial consultants. Capacity of licensed premises was a major predictor of assaults in the city centre street in which they are clustered. City centre assault injury prevention can be achieved through police/ED interventions targeted at high risk licensed premises, which should also target the streets around which these premises are clustered. 相似文献17.
Childhood falls: characteristics, outcome, and comparison of the Injury Severity Score and New Injury Severity Score 
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The aim of this study was to determine the general characteristics of childhood falls, factors affecting on mortality, and to compare the Injury Severity Score (ISS) and the New Injury Severity Score (NISS) as predictors of mortality and length of hospital stay in childhood falls.Methods
We retrospectively analysed over a period of 8 years children aged younger than14 years who had sustained falls and who were admitted to our emergency department. Data on the patients'' age, sex, type of fall, height fallen, arrival type, type of injuries, scoring systems, and outcome were investigated retrospectively. The ISS and NISS were calculated for each patient. Comparisons between ISS and NISS for prediction of mortality were made by receiver operating characteristic (ROC) curve and Hosmer‐Lemeshow (HL) goodness of fit statistics.Results
In total, there were 2061 paediatric trauma patients. Falls comprised 36 (n = 749) of these admissions. There were 479 male and 270 female patients. The mean (SD) age was 5.01 (3.48) years, and height fallen was 3.8 (3) metres. Over half (56.6%) of patients were referred by other centres. The most common type of fall was from balconies (38.5%), and head trauma was the most common injury (50%). The overall mortality rate was 3.6%. The cut off value for both the ISS and NISS in predicting mortality was 22 (sensitivity 90.5%, specificity 95.4% for ISS; sensitivity 100%, specificity 88.7% for NISS) (p>0.05). Significant factors affecting mortality in logistic regression analysis were Glasgow Coma Scale (GCS) <9, ISS >22, and NISS >22. There were no significant differences in ROC between three scoring systems. The HL statistic showed poorer calibration (p = 0.02 v p = 0.37, respectively) of the NISS compared with the ISS.Conclusions
In our series, the head was the most frequent site of injury, and the most common type of fall was from balconies. Scores on the GCS, NISS, and ISS are significantly associated with mortality. The performance of the NISS and ISS in predicting mortality in childhood falls was similar. 相似文献18.
Markakis C Dalezios M Chatzicostas C Chalkiadaki A Politi K Agouridakis PJ 《Emergency medicine journal : EMJ》2006,23(4):313-317
Background
Interhospital transfer imposes essential risk for critically ill patients. The Risk Score for Transport Patients (RSTP) scale can be used as a triage tool for patient severity.Methods
In total, 128 transfers of critically ill patients were classified in two groups of severity according to the RSTP. Statistical analysis was performed using the receiver operating characteristic (ROC) curve and goodness of fit statistics.Results
In total, 66 patients (51.5%) were classified as group I and 62 (48.4%) as group II. Major en route complications were more common in group II patients (19.3% v 3%, p<0.001). Haemodynamic instability was the most common complication. There were significant differences in the mean risk scores between group I and II patients (mean (SD) 4.48 (1.01) v 11.04 (3.47), p<0.001). Discrimination power of RSTP was acceptable (area under the ROC curve 0.743; cutoff value ⩾8). Goodness of fit was adequate (p = 0.390).Conclusion
The RSTP had acceptable discrimination and adequate goodness of fit and could be considered as a triage tool. Haemodynamic instability is the most common problem encountered during transfer. 相似文献19.
Aims
To identify the proportion of patients testing positive for deep vein thrombosis (DVT) who are injecting drug users (IDUs), and examine differences in the investigation and management of this group compared with non‐IDUs.Methods
Analysis of data collected from emergency department records and a review of patient notes.Results
All patients in this study who were known to inject recreational drugs tested positive for DVT on Doppler ultrasound scan.Conclusions
IDUs should be considered at high risk of developing DVT and should be investigated accordingly.To identify the proportion of patients testing positive for deep vein thrombosis (DVT) who are injecting drug users (IDUs).To establish if the IDUs are managed as inpatients more or less often than their non‐IDU counterparts.To highlight any differences in the medical management of patients with confirmed DVT in each group (IDUs and non‐IDUs). 相似文献20.