Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Residential carbon monoxide (CO) poisoning represents a significant cause of unintentional morbidity and mortality in the United States. Screening by fire departments and utility companies is usually limited to instances in which there are symptoms of CO poisoning or there is activation of a home CO detector. ⋯ Emergency medical services personnel can perform routine CO screening and detect occult elevations in CO levels during 911 responses. Public knowledge of CO poisoning is limited and the use of home CO detectors is rare in this study population.
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To describe a novel endotracheal intubation technique, magnetically guided intubation (MGI), and its rate of success in inexperienced medical students and interns using an airway mannequin model. ⋯ A novel method of orotracheal intubation using magnetic guidance is described as achieving a high rate of successful intubations when performed by inexperienced intubators.
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Case Reports
Ethics seminars: Consent and refusal in an urban American emergency department: two case studies.
Patients in the emergency department frequently voice refusals of care or are unable or unwilling to consent to care. While general principles surrounding consent and refusal can be articulated in theory, it is often far more complicated in the real setting. Further, it is impossible to contemplate in advance every possible situation that might arise. ⋯ Emergency physicians face such complex decisions on a routine basis. Ethical reasoning skills are obviously a core competence in emergency medicine, even if easy answers are elusive. Two cases are presented that illustrate this complexity, and routes to resolution are discussed.
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Comparative Study
The effects of octylcyanoacrylate on scarring after burns.
To compare the effects of octylcyanoacrylate (OCA), silver sulfadiazine (SSD), polyurethane film (PU), and dry gauze (G) on scarring three months after partial-thickness burns. ⋯ The effects of OCA spray, SSD, PU, and dry gauze on scarring three months after burns in pigs are similar.
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To implement a new five-level emergency department (ED) triage algorithm, the Emergency Severity Index (ESI), into nursing practice, and validate the instrument with a population-based cohort using hospitalization and ED length of stay as outcome measures. ⋯ Triage nurses at these two hospitals successfully implemented the ESI algorithm and provided useful feedback for further refinement of the instrument. Emergency Severity Index triage reproducibly stratifies patients into five groups with distinct clinical outcomes.