Annals of emergency medicine
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To determine the concordance of emergency physicians and radiologists in interpreting cranial computed tomography (CT) scans. The study also sought to determine the clinical significance of misinterpretations of cranial CT scans by emergency physicians. ⋯ The misinterpretation rate of cranial CT scans by emergency physicians is of potential clinical concern. However, clinical mismanagement is rare. We recommend that more formal education in CT interpretation be included in residency training and continuing medical education programs for emergency physicians.
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To determine the reasons patients with suspected acute myocardial infarction (AMI) delay seeking medical care or do not call 911. ⋯ Maximal benefit from thrombolytic therapy is not realized in a substantial proportion of patients with AMI because of delays in seeking medical care. Knowledge of the reasons patients delay or do not call 911 can help focus efforts on achieving more rapid treatment of patients with AMI.
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To determine whether nonemergency patients can be prospectively identified by triage nurses and safely triaged out of the emergency department without treatment. ⋯ A subset of patients with nonemergency problems can be prospectively identified and triaged out of the ED without significant adverse outcomes provided there is community support for follow-up care.
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We report the case of a 3-month-old girl with tetralogy of Fallot who was resuscitated from a near-fatal hypercyanotic episode (Tet spell). While tetralogy of Fallot is rare (1 in 10,000 live births), failures of diagnosis or management may result in catastrophic outcomes for an eminently survivable condition. An understanding of the pathophysiology of hypercyanotic spells will allow the emergency specialist to understand and apply a treatment option--compression of the abdominal aorta--not previously reported in the emergency medicine literature.