Annals of emergency medicine
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Inferential and descriptive statistics continue to be used incorrectly when analyzing biomedical data. Glasgow Coma Score (GCS) and Revised Trauma Score (RTS) data have recently been described and analyzed using parametric statistical methods in several studies despite the ordinal nature of these data scales. The objective of this study was to determine whether GCS and RTS data are normally distributed, despite their ordinal nature. ⋯ Parametric statistical descriptors and inferential methods are inappropriate for use with GCS and RTS data. Ordinal data should be tested for normality before statistical analysis with parametric statistical methods.
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While health care has become one of the leading policy concerns of the American public, cost containment has emerged as the most prominent underlying factor. Components of health care cost escalation include societal problems, consumer demand, an aging population, the technology explosion, administrative inefficiencies, the malpractice crisis, fraud and abuse, the lack of health promotion and disease prevention, the rising number of uninsured, and regulatory issues. The three major categories of health reform proposals, with characteristic cost containment features, are discussed. A comprehensive listing of available cost containment interventions is summarized in ten categories.
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To determine the effects of standard spinal immobilization on a group of healthy volunteers with respect to induced pain and discomfort. ⋯ Standard spinal immobilization may be a cause of pain in an otherwise healthy subject.
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Case Reports
Pneumocephalus following an epidural blood patch procedure: an unusual cause of severe headache.
Pneumocephalus is a rare complication of anesthetic procedures involving the epidural space. We report the case of a 36-year-old woman who developed a severe headache due to pneumocephalus that occurred during an epidural blood patching procedure. This report reviews the blood patch procedure and its attendant complications. Emergency physicians should be aware of the potential complications of this commonly performed procedure and include iatrogenic pneumocephalus in the differential diagnosis of severe headache in the proper clinical scenario.
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A model curriculum for the implementation and training of physicians in emergency medicine ultrasonography is described. Widespread use of limited bedside ultrasonography by emergency physicians will improve diagnostic accuracy and efficiency, increase the quality of care, and prove to be a cost-effective technique for the practice of emergency medicine.