The American journal of emergency medicine
-
The objective of this study was to develop a decision rule for ordering x-rays in knee injuries. Phase I was a retrospective chart review of 201 consecutive patients receiving knee radiographs in the emergency department in a 10-month period. Logistic regression was performed on 11 clinical indicators to develop a clinical decision rule. ⋯ The misclassification rate was 20%. Using this decision rule, the number of x-rays taken could have been reduced by 78%. A larger multicenter validation study of this knee radiograph decision rule is needed before widespread clinical usage.
-
Inhalation of volatile halogenated hydrocarbons may produce life-threatening cardiac and neurological toxicity. A 15-year-old boy developed ventricular fibrillation immediately after intentional inhalation of a fluorinated hydrocarbon from an automobile air conditioner recharge unit. ⋯ Aspiration pneumonitis and rhabdomyolysis complicated his hospital course before complete neurological recovery. The mechanism and treatment of cardiac arrhythmias after volatile fluorinated hydrocarbon inhalation are reviewed.