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首页> 外文期刊>The Journal of Emergency Medicine >SCREENING ELECTROCARDIOGRAMS IN COCAINE-POSITIVE CHEST PAIN-FREE PSYCHIATRIC PATIENTS REQUIRING MEDICAL SCREENING
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SCREENING ELECTROCARDIOGRAMS IN COCAINE-POSITIVE CHEST PAIN-FREE PSYCHIATRIC PATIENTS REQUIRING MEDICAL SCREENING

机译：可卡因阳性胸部止痛性精神病患者的筛查心电图，需要医疗筛查

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Background: The current practice at a large urban academic emergency department (ED) is to obtain screening electrocardiograms (ECGs) as part of the medical screening on all psychiatric patients who test positive for cocaine. Objective: We sought to examine the impact of an ECG in the medical screening of chest pain-free psychiatric patients who test positive for cocaine. Methods: An institutional review board-approved retrospective chart review from January 2014 to December 2015 was performed on charts of adult ED patients requiring medical screening before transfer to a psychiatric facility. Patients who tested positive for cocaine on urine drug screens were included in this study. Patients with chest pain or those who did not have an ECG recorded were excluded. Outcomes evaluated included disposition and subsequent cardiac work-up. Results: One thousand nine hundred sixty-eight ED patients were identified who tested positive for cocaine on a urine toxicology screen, and 853 met the inclusion criteria. ECGs were normal in 812 patients (95% [95% confidence interval 93-96%]) and abnormal in 41 patients (5% [95% confidence interval 4-7%]). Of 41 patients with abnormal ECGs, 4 were admitted for cardiac work-up. Two patients had positive troponin values in the ED, 2 had cardiology consultations, and 3 had further cardiac stress testing, all of which were negative or nondiagnostic. No cardiac catheterizations were performed. Conclusions: Most ED patients with recent cocaine use but without chest pain have a normal ECG. Of the minority with an abnormal ECG, no cases of acute myocardial ischemia or infarction were identified. (C) 2019 Published by Elsevier Inc.
机译：背景：大型城市学术急诊部门（ED）的目前的实践是获得筛查心电图（ECG）作为医疗筛查的一部分，作为对可卡因阳性测试阳性的所有精神科患者。目的：我们试图检查ECG在胸部止痛性精神病患者的医学筛查中的影响，为可卡因测试阳性。方法：2014年1月至2015年1月至2015年12月的制度审查委员会批准的回顾图表审查是在转移到精神科工厂之前的成人ED患者的图表上进行。在本研究中包含对尿药物筛网进行阳性的可卡因阳性的患者。患有胸痛的患者或没有记录心电图的人。结果评估包括处理和随后的心脏次处理。结果：鉴定了一千九百六十八名ED患者，尿液毒理学筛网测试阳性，符合853符合纳入标准。 ECG在812名患者中正常（95％[95％置信区间93-96％]）和41名患者的异常（5％[95％[95％置信区间4-7％]）。 41例ECG异常，4例患者被录取为心脏锻炼。两名患者在ED中有肌肌钙蛋白值，2例有心脏病学咨询，3例有进一步的心脏压力测试，所有这些都是阴性或非诊断的。没有进行心脏导管。结论：最近可卡因的大多数ED患者使用但没有胸部疼痛都有正常的心电图。少数民族ECG异常，鉴定了急性心肌缺血或梗死的情况。 （c）2019由elsevier公司出版

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