J Emerg Med
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The purpose of this study was to examine non-fatal strangulation by an intimate partner as a risk factor for major assault, or attempted or completed homicide of women. A case control design was used to describe non-fatal strangulation among complete homicides and attempted homicides (n = 506) and abused controls (n = 427). Interviews of proxy respondents and survivors of attempted homicides were compared with data from abused controls. ⋯ Non-fatal strangulation was reported in 10% of abused controls, 45% of attempted homicides, and 43% of homicides. Prior non-fatal strangulation was associated with greater than six-fold odds (odds ratio [OR] 6.70, 95% confidence interval [CI] 3.91-11.49) of becoming an attempted homicide, and over seven-fold odds (OR 7.48, 95% CI 4.53-12.35) of becoming a completed homicide. These results show non-fatal strangulation as an important risk factor for homicide of women, underscoring the need to screen for non-fatal strangulation when assessing abused women in emergency department settings.
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A medical student interested in Emergency Medicine (EM) will find acceptance into residency to be competitive and possibly difficult. An applicant should become aware of the qualities valued by EM residency directors. In the pre-clinical years, an applicant should do well in the basic sciences, perform well on the United States Medical Licensing Examination (USMLE) Step 1, and find an appropriate EM mentor. ⋯ The student must then acquire strong letters of recommendations from supervisors and a Dean's letter that accurately reflects the student's academic record. Preparation for a residency interview involves an understanding of both opportunities and challenges in the specialty. Coupled with a strong academic record, this gives the best chance for a favorable match.
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The study objective was to determine if Emergency Department (ED) patients experience fewer breaches of privacy and confidentiality in a larger, renovated ED compared to a similar patient population before renovation. We surveyed a convenience sample of patients regarding their privacy and confidentiality at the conclusion of their ED stay. ⋯ This was likely a result of both an increase in the department size (564 square feet per treatment space post-renovation vs. 375 square feet per treatment space pre-renovation) and the elimination of rooms separated only by curtains. Issues of privacy and confidentiality should be taken into consideration in the design of new departments and those to be renovated.
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The objective of this study was to evaluate the outcomes and associated factors for short-term success and long-term survival rates of resuscitated non-traumatic out-of-hospital cardiac arrest (OHCAs) in Denizli, Turkey. All non-traumatic OHCA patients from the Emergency Departments of the Pamukkale University and City Hospitals between the dates of January 1, 2004 and March 1, 2005 were included in this study. A successful outcome was defined as the return of spontaneous circulation or breathing, or evidence of a palpable pulse or a measurable blood pressure. ⋯ The predicted mean arrest time was 11.7 min (95% confidence interval 10.27-13.2). Type of transportation to the Emergency Department (ambulance, 32.1% vs. private vehicle, 44.5%; p = 0.057), place of arrest (home, 32.6% vs. other, 44.0%; p = 0.08), first rhythm at the scene (asystole, 22.9% vs. ventricular fibrillation-pulseless ventricular tachycardia, 48.0%, vs. pulseless electrical activity, 12.5%; p = 0.056), and advanced cardiac life support starting time (the first 8 min, 46.8% vs. later than 8 min, 32.0%; p = 0.025) had an effect on outcome. Intensive public education for diagnosis and appropriate reporting of OHCA, the importance of bystander cardiopulmonary resuscitation, and the use of automated external defibrillators have an impact on the potential to increase the number of survivors.
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Routine emergency department care for uncomplicated peritonsillar abscess involves needle aspiration or incision and drainage. Standard technique involves use of a tongue blade and auxiliary light source. We describe the novel use of a disassembled disposable vaginal speculum with fiberoptic light, a device becoming commonplace in many emergency departments. This novel approach to managing peritonsillar abscess greatly enhances visualization and facilitates peritonsillar abscess drainage.