J Emerg Med
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The World Health Organization (WHO) recommends using age-specific respiratory rates for diagnosing pneumonia in children. Past studies have evaluated the WHO criteria with mixed results. ⋯ Oxygen saturation was the best clinical predictor for pediatric pneumonia and should be further studied in a prospective sample of children with respiratory symptoms in a resource-limited setting.
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Review Case Reports
Management of Subcutaneous Emphysema with "Gills": Case Report and Review of the Literature.
Subcutaneous emphysema is often a symptom of a serious pathologic condition but rarely requires direct treatment. Subcutaneous emphysema itself occasionally may interfere with effective cardiopulmonary resuscitation and require direct intervention. ⋯ Subcutaneous emphysema and pneumomediastinum can cause tension physiology, impairing normal cardiovascular and pulmonary function. Only with release of this tension can normal cardiopulmonary function return. The gills procedure is one of several possible therapeutic options.
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Workplace violence (WPV) is an important challenge faced by health care personnel in the emergency department (ED). ⋯ WPV is an important challenge in the EDs of large hospitals in Karachi. A majority of respondents feel that WPV is preventable, but only a minority of attackers face consequences.
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Identification of fluid in the elbow joint by physical examination alone can be challenging. Ultrasound can assist in the diagnosis of elbow effusion, and guide aspiration of the effusion. ⋯ Ultrasound-guided arthrocentesis of the elbow from a posterior approach is a helpful technique to guide the aspiration of the painful swollen elbow.
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The threat of rifles in the hands of criminals is now well recognized within law enforcement. Current emergency response systems are not equipped to operate in this combat-like environment. Growing statistics indicate that of the peace officers that were killed in the line of duty in the United States nearly half died by gunfire evidence. ⋯ It is time for the emergency medical system to evolve to meet the critical needs of today's law enforcement environment.