Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine the frequency of pulmonary embolism (PE) diagnosis when different alternative diagnoses were considered most likely before testing, because the relationship between specific alternative diagnoses and the diagnosis of PE has not been explored. ⋯ The frequency of PE is related to the most likely pretest alternative diagnosis. PE is diagnosed infrequently when anxiety, asthma or chronic obstructive pulmonary disease, musculoskeletal pain, or viral syndrome is the most likely alternative diagnosis.
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The reasons why some clinical decision rules (CDRs) become widely used and others do not are not well understood. The authors wanted to know the following: 1) To what extent is widespread use of a new, relatively complex CDR an attainable goal? 2) How do physician perceptions of the new CDR compare with those of a widely used rule? 3) To what extent do physician subgroups differ in likelihood to use a new rule? ⋯ Widespread use of a relatively complex rule is possible. Older and part-time physicians were less likely to have seen the Canadian C-Spine Rule but not less likely to use it once they had seen it. Targeting hard-to-reach subpopulations while stressing the safety and convenience of these rules is most likely to increase use of new CDRs.
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Randomized Controlled Trial
An emergency department intervention to increase booster seat use for lower socioeconomic families.
To evaluate the effectiveness of booster seat education within an emergency department (ED) setting for families residing in lower socioeconomic neighborhoods. ⋯ Education in a pediatric ED did not convince parents to purchase and use booster seats; however, the combination of education with installation significantly increased booster seat use in this population.
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Multicenter Study
How many attempts are required to accomplish out-of-hospital endotracheal intubation?
An important goal of emergency airway management is to complete endotracheal intubation (ETI) correctly, safely, and quickly, and repeated ETI attempts can increase patient morbidity and mortality. Clinical protocols limiting the number of ETI attempts may minimize harm, but this strategy also may reduce the frequency of successful ETI. ⋯ Out-of-hospital rescuers often require multiple attempts to accomplish ETI. A protocol limit of three attempts offers reasonable opportunity for accomplishing ETI within the constraints of the out-of-hospital environment.
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To investigate the association of seatbelt nonuse with injury patterns, injury severity, and in-patient hospital admission among adults presenting to emergency departments (EDs) in a statewide, population-based, sample of motor vehicle crashes. ⋯ Among patients presenting to an ED after a motor vehicle crash, unbelted occupants are more likely to require inpatient admission and to have sustained a severe injury to numerous body regions than are belted occupants.