The American journal of emergency medicine
-
The objective of this survey was to determine the percentage of unfunded studies published in the four major emergency medicine journals and to examine the sources in funded studies. This study was a retrospective survey of all issues of the four general emergency medicine journals in 1994. Funding was categorized as public national, private, international, institutional, or unfunded. ⋯ Overall, significantly more of the emergency medicine articles in the four journals were unfunded (63% unfunded [95% CI = 56.7-69.1]; 37% funded [95% CI = 30.9-43.3]). The sources of funding for each of the journals varied, with most being private (45%). In conclusion unfunded research remains a major source of emergency medicine literature in the four main emergency medicine journals.
-
Cardiac rupture is a frequent cause of death following blunt trauma. Most of these patients die at the scene with only a few surviving to make it to the hospital. With improvements in prehospital care and rapid regional transport, more of these patients may arrive at the hospital with signs of life. ⋯ The differential appearance of upper body cyanosis frequently accompanies these injuries. Prompt recognition and expeditious surgical treatment may increase the number of survivors of this catastrophic injury. Presented here is an illustrative case report and review of the literature.
-
Non-life-threatening blunt chest trauma is a commonly occurring phenomenon. No clear guidelines exist in the literature regarding the appropriate investigation and treatment, and most clinicians' practice patterns are based on anecdote, individual experience, and the theoretical risk of complications. ⋯ No significant lung injury was detected in the study cohort of patients, on either an immediate or delayed basis. In the absence of compelling evidence of an underlying lung injury, the performance of chest or rib radiography is of no benefit, and considerable cost savings can potentially be realized.
-
Multicenter Study
Photograph documentation of motor vehicle damage by EMTs at the scene: a prospective multicenter study in the United States.
The purpose of this study was to determine if emergency medical service (EMS) personnel could take instant photographs of motor vehicle damage at crash scenes depicting the area and severity of damage of the crash under adverse weather conditions, in different lighting, and quickly enough so as not to interfere with patient care. This prospective multicenter trial involved 35 ambulances responding to motor vehicle crash scenes in rural, suburban, and urban areas in five centers in four states. Emergency medical technicians (EMTs) reported their experience implementing a protocol for use of an instant camera to photograph vehicle damage at crash scenes. ⋯ From one EMS agency in the study, 48 scene times during which photographs were taken were, on average, 1.5 minutes shorter than 48 scene times immediately before implementation of on-scene crash photography. Photographs were taken in different weather and lighting conditions. EMTs reported they were able to determine both area and severity of damage in 260 of 290 (92.5%) crash photographs, but they were unable to determine area and severity of damage in only 2 of 290 (0.7%) crash photographs.