Annals of emergency medicine
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All original articles published in JACEP and Annals of Emergency Medicine in 1972, 1975, 1978, and 1981 were reviewed and classified according to topic, author's specialty, and funding source. The number of articles published in each category was as follows: toxicology, 44; emergency medical services (EMS), 34; general surgery, 31; emergency department, 28; educational techniques, 19; orthopedics, 17; cardiovascular disease, 15; pulmonary, 13; cardiopulmonary resuscitation (CPR), 10; shock, 8; airway management, 8; and other, 71. The number of authors per article ranged from one to eight; the mean number of authors increased from 1.1 in 1972 to 2.6 in 1981 (P less than .001). ⋯ The percentage of articles with specific funding sources increased from 2.9% in 1972 to 25% in 1978, then decreased to 14.3% in 1981. The percentage for each funding source was as follows: government, 7.9%; industry, 2.0%; university, 3.3%; foundation, 2.0%; other, 1.0%; and none, 83.8%. This study demonstrates that there is a defined body of knowledge in emergency medicine, that emergency physicians author the majority of publications in this emergency medicine journal, and that emergency medicine is not supported by traditional funding sources.
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The Trauma Score is a simple physiological measure of injury severity that has been shown to have a high correlation with mortality for blunt trauma patients. In this study, the Trauma Score was evaluated on two subsets of penetrating trauma patients. ⋯ The Score had modest numbers of false negatives (13/64 for the design set, and 3/380 for the test set) and a low number of false positives (5/380 for the design set, and 3/380 for the test set). The Trauma Score is thus an accurate predictor of mortality for both blunt and penetrating trauma patients.
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Reported is the case of an anaphylactic reaction following sulindac ingestion. A 64-year-old man developed marked shortness of breath following the ingestion of a 200-mg sulindac tablet. On admission he had a palpable blood pressure of 50 mm Hg and diffuse inspiratory and expiratory wheezes on auscultation. ⋯ He was treated successfully with a continuous intravenous infusion of epinephrine, a corticosteroid, and an antihistamine. Recovery was complete. This case demonstrates that caution is needed in prescribing sulindac and other nonsteroidal anti-inflammatory drugs.
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Despite the multiple organ involvement seen in meningococcal disease, there is little in the literature to support gastrointestinal symptoms as the predominant finding. In the past year four patients with meningococcemia and meningitis presented with gastrointestinal symptoms. In three cases the gastrointestinal findings were of such severity that the diagnosis of meningococcemia was obscured.