Articles: emergency-services.
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The charts of 175 patients who underwent emergency thoracotomy (ET) in the emergency room (ER) between 1972 and 1978 were reviewed to determine the efficacy of this procedure. Seven cases of nontraumatic cardiac arrest were excluded from analysis. Although 150 patients were transported to the ER within 1 hour of injury, 60% either had no vital signs (91 cases) or were agonal (20 cases) on admission to the ER. ⋯ Survival rates were higher for patients with stab wounds (40%), pericardial tamponade (38%), and injury to the heart (30%), or lungs (57%). A cost-benefit analysis revealed that total benefits were 2.4 times greater than total costs. Performing early thoracotomy in the ER is a life-saving measure for a substantial number of trauma patients who present to the ER in extremis.
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Our experience with the use of EEG in the diagnosis and management of acute neuropsychiatric patients in the emergency room is reported. The importance of the role of EEG in the diagnosis of different types of seizure disorders, toxic-metabolic encephalopathies, acute psychoses, and head injuries is emphasized. In many conditions EEG may be the only diagnostic tool to help the physician to arrive at an accurate diagnosis and management of the patient. The cost efficiency is more practical than other more expensive and more customarily used tests such as CT Scan, and the information obtained cannot be reproduced by such other tests.