J Emerg Med
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Videotaped recordings of simulation-based performance may allow learners the opportunity to review, evaluate, and reflect upon their own performance. ⋯ Residents' abilities to self-assess vary, and performance quality may influence self-assessment. Video review did not significantly increase self-assessment accuracy. Improving self-assessment skills may assist residents in identifying practice gaps, thereby allowing them to focus their energy toward filling that gap.
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To determine if the slope of Phase II and Phase III, and the alpha angle of the expiratory capnographic waveform, as measured via computer-recognizable algorithms, can reflect changes in bronchospasm in acute asthmatic non-intubated patients presenting to the emergency department (ED). ⋯ The study provides some preliminary data showing that capnographic waveform indices can indicate improvement in airway diameter in acute asthmatics in the ED. Capnographic waveform analysis presents several advantages in that it is effort-independent, and provides continuous monitoring of normal tidal respiration. With further refined studies, it may serve as a new method of monitoring non-intubated asthmatics in the ED.
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Violence is a leading cause of injury and death among adolescents. Reports indicate increasing incidence of violent injuries among adolescent females, but have not described characteristics of or charting completeness for these assault victims in the emergency department (ED). ⋯ Adolescent female victims of community violence presenting to an urban ED have different assault characteristics from males. Females' charts have less missing information. A high percentage of all charts have assault intentionality miscoded, suggesting that E-code-based violence surveillance in this population may not be accurate.
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Methadone has been used for many years in the clinical setting and has many well-described side effects. In recent years, the use of methadone and other opioids have been increasing throughout the United States (US), and presentations to US Emergency Departments (EDs) due to opioid use and abuse are increasing as well. ⋯ Although bilateral hearing loss is a rare toxic finding of opioid ingestion, given the prevalence of opioid use, this etiology should be considered in any patient presenting with this chief complaint.
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Initially described in 1926, spinal dural arteriovenous fistula remains diagnostically challenging. Presenting symptoms are often common complaints in general practice or the emergency department, such as leg weakness or numbness. One of the less recognized early features is that of sphincteric disturbance. ⋯ Atypical presentations of bladder dysfunction in addition to other neurologic complaints in the appropriate patient population should prompt spinal imaging to exclude a spinal dural fistula. Timely diagnosis and treatment can prevent the progression of spinal cord edema to infarction with paraparesis, and permanent bladder and bowel dysfunction.