Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The incidence of posterior vessel wall puncture (PVWP) during central line placement with possible subsequent injury to structures lying behind the vein is unknown. At times the internal jugular vein lies immediately anterior to the carotid artery rather than lateral to it, leading to potential arterial puncture should the needle pass through the vein completely. The objective of this study is to evaluate the incidence of PVWP during simulated ultrasound (US)-guided vessel cannulation. ⋯ This study found a high incidence of inadvertent PVWP during simulated US-guided vessel cannulation in this model.
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The authors present a case of a 71-year-old female who presented to the emergency department with slurred speech, left sided facial droop, and right arm and leg weakness. During her ED stay, she developed left sided chest pain and right arm numbness in the setting of EKG changes. The patient's clinical course is outlined and a discussion of the potential etiologies as well as the clinical management is provided.
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The objective was to critically appraise and highlight methodologically superior medical education research specific to emergency medicine (EM) published in 2009. ⋯ Thirty-six medical education publications published in 2009 focusing on EM were identified. This critical appraisal reviews and highlights seven studies that met a priori quality indicators. Current trends are noted.