Annals of emergency medicine
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Elderly patients with undiagnosed polymyalgia rheumatica and giant cell arteritis are not uncommon, and they may present to the emergency department with nonspecific physical complaints. We describe the cases of two patients who had the "typical" constellation of symptoms. It is important that emergency physicians consider the diagnosis and provide appropriate testing, therapy, and follow-up.
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To determine if there is a significant prevalence of drug or alcohol use among adolescents evaluated for significant acute trauma. ⋯ A significant number of adolescents admitted to the hospital for trauma-related injuries have a toxicology screen positive for alcohol or drugs of abuse. A toxicology screen should be a standard laboratory test in adolescents involved in significant trauma, especially if the mechanism was intentional.
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To determine the extent and diversity of involvement of pharmaceutical representatives in emergency medicine residency programs and to assess chief residents' beliefs and attitudes concerning this activity. ⋯ The interaction of pharmaceutical representatives with emergency medicine residents and residencies is widespread. More than 50% of the institutions supporting emergency medicine residency programs have no formal guidelines with regard to the interaction of their residents with pharmaceutical representatives or their guidelines are not known to the person most responsible for approval and arrangement of the pharmaceutical representative interaction--the emergency medicine chief resident. While most chief residents believed that accepting small gifts was reasonable, they also believed that accepting gifts valued at $100 or more and pharmaceutical representative sponsorship of trips was inappropriate.
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Randomized Controlled Trial Clinical Trial
A randomized, controlled trial of radiograph ordering for extremity trauma in a pediatric emergency department.
The objectives of this study were to determine whether triage nurses using the Brand protocol would order fewer radiographs than would physicians carrying out standard practice procedures, without missing an increased number of joint or bone injuries; the test characteristics and the interobserver reliability of the Brand protocol; and whether having triage nurses order radiographs could reduce total patient waiting time in the emergency department. ⋯ Having triage nurses use the Brand protocol reduced the number of radiographs ordered but at the same time increased the number of missed radiographic findings. However, having triage nurses order radiographs also significantly shortened waiting time in the ED.
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Comparative Study
Prognostic value of the emergency department cardiogram for in-hospital complications of acute myocardial infarction [corrected].
To identify patients who are admitted from the emergency department with chest discomfort who are at low risk for life-threatening complications. ⋯ Patients who meet low-risk group criteria have a low likelihood of immediate life-threatening events and could be admitted to an intermediate care unit.