Annals of emergency medicine
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Multicenter Study Comparative Study Clinical Trial
Multicenter comparison of two clinical decision rules for the use of radiography in acute, high-risk knee injuries.
Two separate clinical decision rules, one developed in Ottawa and the other in Pittsburgh, for the use of radiography in acute knee injuries have been previously validated and published. In this study, the rules were prospectively validated and compared in a new set of patients. ⋯ Prospective validation and comparison found the Pittsburgh rule for knee radiographs to be more specific without loss of sensitivity compared with the Ottawa rule.
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Prior research has established the futility of continued resuscitation efforts for patients in cardiac arrest who fail to respond to out-of-hospital advanced cardiac life support. Determination of both medical and nonmedical factors resulting in the transport of patients in continuing cardiac arrest to the hospital may encourage the development of new systems or strategies to increase the appropriateness of these transports. ⋯ Factors other than medical ones often influence the decision to transport patients in continuing cardiac arrest. In our urban system, physician, medical examiner, and paramedic education and protocols were needed to aid decision-making in this situation.
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To describe the incidence and outcome of firearm-related injuries and to describe trends over time. ⋯ Firearm-related suicides among the young and assault-related shootings among all persons increased. The estimated proportion of shooting victims who survived did not change over time.
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Emergency medicine in Hong Kong is a relatively new specialty. Substantial progress toward recognition of emergency medicine in the territory has occurred during the past 2 years, and the Hong Kong College of Emergency Medicine is now formally recognized by the Royal College of Surgeons in the United Kingdom. With the transfer of the territory to chinese rule, the emergency medical system in Hong Kong may serve as a model for the development of emergency medicine in mainland China.