Annals of emergency medicine
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Comparative Study
Seizure patient selection for emergency computed tomography.
We evaluated the need for emergency noncontrast cranial computed tomography (CT) among patients presenting to an emergency department with a complaint of seizure. ⋯ Our data suggest that patients with either a history of malignancy or an abnormal neurologic examination at the time of examination in the ED will derive the greatest benefit from emergency CT.
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Case Reports
Treatment of massive pulmonary embolism with centrally administered tissue-type plasminogen activator.
We report the use of centrally administered tissue-type plasminogen activator for three patients who presented with massive pulmonary embolism to the emergency department. In all patients, rapid improvement of pulmonary arterial pressures ensued by the end of the drug infusion, while the presenting symptoms of chest pain and shortness of breath subsided.
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To assess the perceived impact of emergency medicine residency programs on other program directors' perceptions of emergency medicine as a distinct service and educational entity. ⋯ Residency directors in other specialties have a generally positive view of emergency medicine as a specialty and as an important component of their residents' education. The presence of an emergency medicine training program appears to have positively influenced their attitudes, improved their residents' education, and improved emergency care. Older programs have positively influenced attitudes to a greater degree than have newer programs.
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To assess the current state of clinical and academic emergency medicine at Veterans Affairs medical centers in the nation's largest health care system. ⋯ In many EDs at Veterans Affairs medical centers, nonemergency medicine staff physicians and house staff unsupervised by emergency physicians care for patients seeking emergency medical care. In addition, there is a growing need for more emergency medicine staff physicians and emergency medicine house staff in the Veterans Affairs system. Organized emergency medicine should initiate efforts to inform administrators and legislators responsible for Veterans Affairs policy making and funding.