The American journal of emergency medicine
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The objective of this prospective, analytic study was to identify predictors and describe the demographic and clinical correlates of head computed tomography (CT) evaluation in patients with poisoning or drug overdose and altered mental status. Forty-three patients that were evaluated by head CT and 109 that were not evaluated by head CT were entered into the study at a poison control center. None of the 43 scanned patients had any acute findings on head CT. ⋯ When the use of head CT was added to the second model, it also emerged as an independent explanatory predictor of admission (OR 4.8; CI 95% 1.2-20.4) in addition to GCS (OR 10.1; 95% CI 2.2-45.4). In this pilot study, patients presenting to the emergency department (ED) with suspected poisoning or drug overdose were found to have a low likelihood of abnormal findings on head CT scan. Those among whom CT scans were obtained were more likely to be admitted to the hospital from the ED, despite negative findings.
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This study was performed to determine the impact of electrocardiogram (ECG) interpretation on urgent patient care decisions by internal medicine (IM) and emergency medicine (EM) resident physicians. Six clinical scenarios and ECGs were given to 31 IM residents and 31 EM residents at a university medical center. Based on the ECG interpretation, the residents were asked to select the best patient management from a list of choices. ⋯ Compared with EM residents, IM residents were less likely to choose the correct management of posterior wall MI and unstable SVT. Both IM and EM residents were prone to misinterpreting LVH and BER as acute myocardial ischemia. Resident education in both specialties should focus on ECG interpretation skills to improve patient management decisions.
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The purpose of this study was to describe the relative frequency, pattern, and mechanism of surfing injuries. Descriptive data of surfing injuries was collected by using a Web site-based interactive multiple choice survey. Data was collected from May 1998 to August 1999. ⋯ Sixty-seven percent of acute surfing injuries are caused by board contact. Older surfers, more expert surfers, and those surfing large waves have a higher relative risk for significant injury. Equipment modifications are suggested that may decrease the risk for injury.
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This study examined research training characteristics among pediatric emergency medicine (PEM) fellows. A 45-question survey was mailed to all registrants of the 1998 National PEM Fellows' Conference. Descriptions of curricular design and administrative support components, perceived barriers, and subjective stress related to research were obtained. ⋯ The most commonly cited barriers to more active participation in research were inadequate experience, inadequate time, and lack of administrative help. Stress in relationship to research was high (5.1 on a 1-7 Likert scale). PEM fellows report increasing levels of didactic exposure and administrative support for conducting research, however, PEM fellows still report experiencing significant amounts of stress and a number of perceived barriers.