Here is a quick look at two articles published in the November issue of Annals of Emergency Medicine. Visit www.annemergmed.com to read the full text.

Safety of Assessment for Patients With Potential Ischemic Chest Pain in an Emergency Department Waiting Room: A Prospective Comparative Cohort Study

By F Scheuermeyer, et al.

Editor’s Capsule Summary

• What is already known on this topic: Crowding can lead to delays in the evaluation and management of patients.
• What question this study addressed: Can selected emergency department (ED) patients complaining of chest pain safely receive some or all of their care in the waiting room?
• What this study adds to our knowledge: There were no missed cases of acute coronary syndrome and no important complications in the 303 patients triaged to the waiting room.
• How this is relevant to clinical practice: This study suggests that with careful triage and prompt physician assessment, waiting room management might be an adequate, albeit not optimal, means of managing low-risk chest pain patients when there are no monitored beds available in the emergency department.
• Research we would like to see: Replication of this study with a larger number of subjects at multiple sites will be needed to establish exactly how safe this strategy is.

Infection and Natural History of Emergency Department–Placed Central Venous Catheters

By C LeMaster, et al.

Editor’s Capsule Summary

• What is already known on this topic: There is a perception that central lines placed while the patient is in the ED are more prone to infection, but little data exist.
• What question this study addressed: Billing and infection control data were used to estimate the infection rate of central lines placed in the ED at a busy urban teaching hospital over 2 years.
• What this study adds to our knowledge: The 656 lines placed in the ED were typically left in for 4-5 days. The infection rate was 1.9/1000, similar to that reported for central lines in other ICU case series.
• How this is relevant to clinical practice: These data do not support the practice of quickly changing central lines placed in the ED because of perceived infection risk.