J Emerg Med
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The idea of doing a research or scholarly project can be very daunting, however, the satisfaction of seeing a project to its completion is very rewarding. In this article, we provide medical students with guidance on whether they should take on a research or scholarly project during medical school, and how to get started, publish, and then present their project. We also highlight how such a project can benefit an applicant applying for residency training.
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Randomized Controlled Trial
Evidence-Based Medicine Improves the Emergent Management of Peritonsillar Abscesses Using Point-of-Care Ultrasound.
Physical examination for peritonsillar abscess (PTA) has limited sensitivity. Traditional management involves blind needle aspiration, which has a false negative rate of 10-24%. A randomized controlled trial by Costantino et al. demonstrated that point-of-care ultrasound (POCUS) improves PTA management. ⋯ POCUS use has increased for PTA treatment, improves aspiration, and decreases consultations, CTs, return visits, and LOS.
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High-quality chest compressions are an important determinant for favorable neurological outcome. Associations of long-term mortality and neurological outcomes with chest compression types still require investigation. ⋯ Comparisons of mechanical and manual chest compressions in terms of survival rates and favorable neurological outcomes showed no significant differences. Further investigation of long-term neurological outcomes with mechanical CPR utilization is required.
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For 20 years, telemedicine has been waiting in the wings for its time in the spotlight. The Coronavirus Disease 2019 (COVID-19) pandemic, with its emphasis on personal protective equipment (PPE) and reducing high-risk contacts, was the catalyst needed to bring telemedicine into mainstream consciousness and acceptance. ⋯ We propose that the use of consumer products sourced from local vendors is a viable solution for telemedicine systems focusing on speed, reducing costs, and ease of deployment. Future work will focus on studying its performance characteristics vs. other systems in an evolving landscape.
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Aortic aneurysm ruptures are associated with high fatality. The timely diagnosis of a ruptured aortic aneurysm can be challenging for the emergency physician when hoarseness of voice is the only presenting symptom. Ortner's syndrome was first reported in 1897 as a case of left recurrent laryngeal nerve paralysis secondary to mitral stenosis and left atrial enlargement. In this case report, we describe a unique association of aortic aneurysm rupture with dysphonia presenting as Ortner's syndrome. ⋯ An 81-year-old man presented to our emergency department (ED) with an acute hoarse voice. Physical examination of his cardiovascular and neurologic systems was normal. Further evaluation with a nasoendoscope revealed a left vocal cord palsy. Consideration of Ortner's syndrome prompted an early call for thoracic imaging. A computed tomogram of the aorta showed a contained aortic aneurysm rupture with an acute hyperdense periaortic hematoma at the aortic arch. As our patient was a poor surgical candidate in view of concurrent comorbidities, he was managed conservatively. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We identified a unique presentation of a painless, ruptured aortic aneurysm. This is a fatal diagnosis that all emergency physicians struggle to make in a timely fashion. The imminent aortic aneurysm rupture, masked by the absence of pain in our patient, could have resulted in a potentially catastrophic event. In the evaluation of a patient with hoarse voice, early consideration of Ortner's syndrome could result in timely diagnosis of a ruptured aortic aneurysm.