J Emerg Med
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Case management (CM) is a commonly cited intervention aimed at reducing Emergency Department (ED) utilization by "frequent users," a group of patients that utilize the ED at disproportionately high rates. Studies have investigated the impact of CM on a variety of outcomes in this patient population. ⋯ CM interventions can improve both clinical and social outcomes among frequent ED users.
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Comparative Study
Emergency Medicine resident anesthesia training in a private vs. academic setting.
Airway management is an essential part of any Emergency Medicine (EM) training program. Academic centers typically provide training to many learners at various training levels in a number of medical specialties during anesthesiology rotations. This potentially creates competition for intubation procedures that may negatively impact individual experiences. ⋯ Number of intubations performed and residents' rating of the educational value were more favorable for a private practice anesthesiology rotation. Alternative settings may provide benefit for training in areas that have competition among trainees.
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Case Reports
Commotio cordis, therapeutic hypothermia, and evacuation from a United States military base in Iraq.
Therapeutic hypothermia (TH) has been demonstrated to improve clinical outcomes after out-of-hospital ventricular fibrillation (VF) cardiac arrest. It remains unclear if TH can be safely and effectively used in the setting of traumatic arrest. Furthermore, the use of TH methods in the pre-hospital and transport environments remain poorly established and a domain of active investigation. ⋯ The patient's successful resuscitation suggests that care should not be withheld for blunt trauma patients without vital signs in the field if VF is present, until the differential diagnosis of commotio cordis has been considered.
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Disturbing trends regarding the sex, age, and race of gunshot victims have been reported in previous national studies; however, gunshot trends have not been well documented in individual cities in the southeastern United States. ⋯ Our study demonstrates that black patients between 18 and 25 years of age presenting to this trauma center are more likely to be victims of gun violence than their non-black counterparts. Our study evaluates trends in gun violence in the Southeast, particularly in relation to race, age, and insurance status.
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Peripheral venous blood gas (pVBG) analysis in replacement of arterial blood gas (ABG) is limited by the unpredictable differences between arterial and venous values, especially for PCO2 and pH (ΔPCO2 and ΔpH). ⋯ The variability of ΔPCO2 and ΔpH is significantly lowered when the venous values are corrected according to the SpvO2 value, and pVBG is therefore more accurate and valid for detecting an arterial abnormality.