Annals of emergency medicine
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To determine the feasibility of a case-finding program for cognitive impairment in elderly emergency department patients, and to describe the prevalence of cognitive impairment in screened patients and identify factors associated with impairment. ⋯ Screening for cognitive impairment in elderly ED patients using the OMC Test is feasible. There is a high prevalence of cognitive impairment in elderly ED patients, and the prevalence increases with age. Identification of cognitive impairment is important in the assessment of elderly ED patients and may affect clinical evaluation, patients' understanding of medical information, and compliance with discharge instructions.
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To report the type and frequency of battlefield casualties and the procedures performed to treat them. ⋯ The composite casualty admitted to US Navy-Marine trauma facilities was injured by shrapnel in the lower extremity and required surgical debridement only. Soldiers with land mine injuries, as in other wars, were among those in greatest need of emergency resuscitation.
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To describe the conventional triage consequences of war zone casualties compared against expected NATO triage casualty estimates; the influence of the Revised Trauma Score on triage sensitivity; and evaluation of physiological parameters considered potentially useful to improved triage specificity and sensitivity. ⋯ Conventional triage is a useful tool for war and conflict; it is experience dependent. Had the anticipated number of casualties actually occurred in this war, we conclude that the triage process would have benefitted from additional information, probably physiologic information, to improve the sensitivity and specificity of our findings.
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To determine the effect of Hurricane Andrew on a pediatric emergency department. ⋯ Following a hurricane, personnel in a pediatric ED can expect to see an increased census, with more diagnoses of open wounds, gastroenteritis, and skin infections. They may also see hydrocarbon and bleach ingestions. Alerting parents to the potential for injury and accidental poisoning in their children after a hurricane may help prevent the reported morbidity.
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To measure emergency care providers' attitudes toward quality of life after spinal cord injury (SCI) and to determine if their perceptions influence the care they provide. ⋯ The quality of life, self-esteem, and outcomes that emergency health care providers imaging after SCI are considerably more negative than those reported by SCI survivors. Because providers' knowledge and attitudes may affect the care they provide and may influence patients and families struggling with critical treatment decisions, emergency care providers must be aware of outcomes, well-being, and life satisfaction following severe SCI.