Annals of emergency medicine
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To determine emergency department patients' perceptions of their illness urgency, their attempts to get care elsewhere, and the proportion of patients referred to the ED. ⋯ In addition to their lack of access to other providers, patients' perceived need for immediate care and referrals by health professionals contribute to ED use for nonemergency conditions.
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To characterize the attendance at and presenters of conferences given to emergency medicine residents and to determine the ability of emergency medicine residents to attend conferences while working in the emergency department and on off-service rotations. ⋯ We found that a sizable proportion of programs may not have met the new Residency Review Committee requirements for lecture attendance at the time the guidelines were issued. The vast majority of programs met guidelines for relief of clinical duties, and a large proportion of programs exceeded the requirements for percentage of lectures given by emergency medicine faculty.
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Comparative Study
Abdominal compressions increase vital organ perfusion during CPR in dogs: relation with efficacy of thoracic compressions.
Abdominal compressions can be interposed between the thoracic compressions of standard CPR (SCPR). The resulting interposed abdominal compression CPR (IAC-CPR) may increase blood pressures and patient survival, particularly if applied as a primary technique after in-hospital cardiac arrest. We used a predominant cardiac compression canine model to study the effects of IAC-CPR on blood pressures and total and vital organ perfusion as a function of time after cardiac arrest and efficacy of SCPR. ⋯ Compared with predominant cardiac compressions alone (SCPR), the addition of interposed abdominal compressions (IAC-CPR) improves total and vital organ oxygen delivery through enhanced venous return and perfusion pressures.
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To assess current emergency medicine faculty scheduling practices, preferences, and recent changes. ⋯ Residency faculty prefer and have moved toward working shorter shifts. They are also working fewer night shifts per month and fewer night shifts in a row.
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Rupture of an abdominal aortic aneurysm into the inferior vena cava is uncommon. A classic syndrome of high-output heart failure, continuous abdominal bruit, and renal insufficiency has been described and permits a clinical diagnosis if an aortocaval fistula is considered in the differential diagnosis. ⋯ Physicians should consider abdominal ultrasonography and aortography in stable patients, followed by prompt surgical intervention. We report the case of a patient with an aortocaval fistula.