J Emerg Med
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Hypnosis has been used in medicine for nearly 250 years. Yet, emergency clinicians rarely use it in emergency departments or prehospital settings. ⋯ Although it is safe, fast, and cost-effective, emergency clinicians rarely use hypnosis. This is due, in part, to the myths surrounding hypnosis and its association with alternative-complementary medicine. Genuine barriers to its increased clinical use include a lack of assured effectiveness and a lack of training and training requirements. Based on the results of further research, hypnosis could become a powerful and safe nonpharmacologic addition to the emergency clinician's armamentarium, with the potential to enhance patient care in emergency medicine, prehospital care, and remote medical settings.
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There is limited information on the extent and clinical importance of the delay in hospital presentation of acute pulmonary thromboembolism (PTE). ⋯ Our study showed that a significant portion of patients with acute PTE had delayed presentation. Also, patients with delayed presentation had worse echocardiographic findings and higher in-hospital mortality.
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Case Reports
Migrating Sternal Rod: Ultrasound Identification of an Unusual Soft Tissue Foreign Body.
Sternal hardware migration from its original site of implantation is a rare entity. Bedside ultrasound may identify migrated hardware if the site of migration is the subcutaneous tissue. ⋯ Sternal hardware migration is uncommon, but in patients who have undergone surgery involving sternal fixation, this diagnosis should be considered as a cause for unusual symptoms.
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Sodium azide is a chemical with a mechanism similar to cyanide. There is concern that it could be used as a chemical warfare agent. ⋯ The recurrence, and seriousness, of these events suggests a need for continued education of emergency providers. Emergency physicians should consider exposures to toxic chemicals in their differential when a cluster of patients presents with similar symptoms over a short period of time.
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The Standardized Letter of Recommendation (SLOR) was developed in an attempt to standardize the evaluation of applicants to an emergency medicine (EM) residency. ⋯ SLORs written by less experienced letter writers were more likely to have a GAS of "Outstanding" (p < 0.001) and a LOMA of "Very Competitive" (p < 0.001) than more experienced letter writers. The overall distribution of GAS and LOMA was heavily weighted to the highest scores. The length of time a letter writer knew an applicant was significantly associated with GAS and LOMA scores.