The American journal of emergency medicine
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An important step during spine immobilization is application of a cervical collar. Clothing or hair covering the neck may impinge on this process. The purpose of this study was to evaluate the effect of clothing and hair covering the neck on immobilization using a cervical collar. ⋯ In contrast, ROM with a cervical collar under the 4 conditions in all directions ranged from 10.80 degrees (5.10 degrees) to 18.81 degrees (7.37 degrees). We were unable to detect any significant differences in ROM between the 4 conditions. Our data suggest that long hair and clothing, which cover the neck, do not alter the effectiveness of cervical collar immobilization as measured by the cervical ROM device.
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The aim of this study was to determine the hemodynamic response and calculated shock index (SI=heart rate [HR]/systolic blood pressure [SBP]) in early acute blood loss. ⋯ A significant elevation in mean SI was observed in healthy volunteers after standing for 1 and 5 minutes. Although significant changes in HR and SBP were observed, these indices were still within "normal" limits. The SI may be more useful in early hemorrhage than either the HR or SBP alone.
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We compared 2 models of physician leadership for inhospital cardiac arrest teams (CATs): emergency medicine (EM) residents and staff hospitalist physicians. ⋯ Our findings validate the use of a 24-hour EM resident staffing model for CAT response to inhospital cardiac arrests.
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The aim of this study was to compare the performance of the Paediatric Canadian Triage and Acuity Scale (Paed CTAS) to a previous triage tool with respect to the percentage of admissions, the diagnostic and therapeutic interventions, and the mean pediatric risk of admission (PRISA) score in a pediatric tertiary center emergency department. Data were prospectively collected for 4 months before the Paed CTAS introduction (PRE group) and for 4 months after its implementation (Paed CTAS group). ⋯ The ability to predict admission was greater for the PRE tool as compared to the Paed CTAS tool (AUC: 0.82 vs 0.69, P=.001). The ability to predict requirements for interventions such as blood culture and intravenous fluid bolus was similar for both triage tools.
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To document the population-based incidence of sexual assault in Baltimore, Md, victims' alcohol/drug use, and pre-event circumstances. ⋯ This study revealed a high prevalence of physical/genital injury, supporting the call for an injury severity scale for sexual assault and for increased substance abuse counseling and educational/health resources to mitigate sexual assault and offer meaningful response when such crimes occur.