Annals of emergency medicine
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Sexual assault nurse examiner (SANE) programs have improved the quality of care for sexual assault victims. An adverse effect of these programs is reduced resident clinical exposure to victims of sexual assault. The objectives of this project are to determine the baseline level of resident competence in knowledge and management of sexual assault and to demonstrate the effectiveness of training in developing resident competence. ⋯ Emergency medicine residents training in an urban center with an active SANE program had limited knowledge and skills in the treatment of victims of sexual assault. Our multimodal educational intervention increased residents' knowledge and evidence collection skills to levels equivalent to that of experienced providers in a SANE program.
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Emergency physicians frequently administer procedural sedation and analgesia to nonfasted patients; however, they currently have no specific guidelines to aid them in preprocedural risk stratification. We assembled a committee of leading emergency physician sedation researchers to develop a consensus-based clinical practice advisory for this purpose. ⋯ The advisory is not intended to assert a legal standard of practice or absolute requirement. It is expected that emergency physicians will at times appropriately deviate from it according to individualized judgment and unique clinical circumstances.
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The Simplified Motor Score was recently found to exhibit equal test performance to the Glasgow Coma Scale (GCS) when predicting 4 clinically important trauma outcomes. The present study tests the interrater reliability of the Simplified Motor Scale, the GCS and its components, and 2 other simplified neurologic scales when applied to patients presenting to the emergency department with altered levels of consciousness from any cause. ⋯ The Simplified Motor Scale has the best interrater reliability for the assessment of altered level of consciousness of traumatic and nontraumatic cause among the scales tested.
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Our objective is to determine whether a bedside ultrasonographic measurement of optic nerve sheath diameter can accurately predict the computed tomographic (CT) findings of elevated intracranial pressure in adult head injury patients in the emergency department (ED). ⋯ Bedside ED optic nerve sheath diameter ultrasonography has potential as a sensitive screening test for elevated intracranial pressure in adult head injury.