Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
Community-wide emergency department visits by patients suspected of drug-seeking behavior.
To measure community-wide ED use by patients at high risk for drug-seeking behavior. ⋯ Patients identified as being at high risk for drug-seeking behavior have high community-wide ED visit rates. Improving communication between and within hospitals may help identify patients who could benefit from more consistent community-wide care and appropriate treatment for addiction.
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Randomized Controlled Trial Clinical Trial
The efficacy of a standard training program for transillumination-guided endotracheal intubation.
To evaluate the success rate, intubation time, and complication rate of transillumination-guided intubation following two hours of instruction in the use of the Trachlight (TL) device. ⋯ A two-hour training session, including five successful light-guided intubations using the TL, was inadequate for producing acceptable success rates during manikin intubations by paramedic students. While TL intubation intervals were shorter when successful, the 2.2-second difference was not clinically meaningful. The incidence of trauma in our manikin model during TL intubations was significantly lower than that with DL.
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Comparative Study
The emergency department electrocardiogram and hospital complications in myocardial infarction patients.
To determine whether acute myocardial infarction (AMI) patients who have negative ECGs on presentation have significantly lower complication rates than do those AMI patients who have positive ECGs on presentation. ⋯ Negative- and positive-ECG AMI patients do not have moderate or large differences in the rates of in-hospital complications. Most negative-ECG patients who suffer complications evolve ECG changes prior to the event and such changes indicate the potential need for a higher level of care.
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Multicenter Study
Level I trauma certification and emergency medicine resident major trauma experience.
American College of Surgeons (ACS) and Residency Review Committee for Emergency Medicine (RRC-EM) guidelines conflict regarding the role of emergency physicians in directing major trauma resuscitations. This article describes the impact of ACS level I trauma certification on emergency medicine (EM) resident trauma experience. ⋯ EM residents direct a smaller percentage of major trauma resuscitations at ACS level I hospitals than they do at non-level I facilities. This finding is not offset by an increased trauma census at level I facilities and may be more pronounced in the Northeast and the Midwest.
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Comparative Study
Association of training level and short-term cosmetic appearance of repaired lacerations.
To determine the association between emergency practitioner level of training and cosmetic appearance of primarily closed wounds as evaluated at the time of suture removal. ⋯ Significant improvement in short-term cosmetic results following wound repair is associated with a training level beyond PGY1. These data reinforce the need for careful patient selection and close supervision of wound repair by trainees, especially of wound repair by medical students and interns.