Annals of emergency medicine
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Comparative Study
Chemical dependency in emergency medicine residency programs: perspective of the program directors.
To evaluate the educational background, knowledge, and experiences regarding chemical dependency among emergency medicine program directors. The program directors' awareness of substance use and alcohol abuse among emergency medicine residents was examined by comparing their estimates with the actual rates reported by the residents. ⋯ Emergency medicine program directors must be more attentive to potential alcohol abuse among emergency medicine residents and should receive additional education regarding chemical dependency.
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To identify and determine the rates of delivery and performance of telephone CPR in noncardiac arrest incidents. ⋯ We found a low rate of performance of telephone CPR in King County for incidents resembling cardiac arrest. This finding suggests that the protocols designed for dispatcher-assisted telephone CPR effectively screen out those incidents that may initially resemble cardiac arrest.
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To assess emergency medicine residents' perspectives on violence and personal safety in the emergency department. ⋯ Violence and personal safety in the ED are major concerns of emergency medicine residents.
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To assess the feasibility of coordinating home care services from an inner-city emergency department. ⋯ A significant proportion of elderly patients being discharged from the ED need home health services. Access to rapidly deployed home care services can obviate the need for hospital admission for a select group of debilitated patients. The provision of home care services from the ED is economically feasible.
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Garter snake bites are generally innocuous to human beings. We report a case of human envenomation from the Wandering Garter snake (Thamnophis elegans vagrans). The patient, who was bitten on his right third fingertip, rapidly developed local edema, ecchymosis, and hemorrhagic vesicles. ⋯ The clinical picture was similar to that in three previous patients with Thamnophis envenomation in that clinical signs followed a prolonged bite. Thamnophis species have Duvernoy's glands, which may be analogous to venom glands in Crotalidae (pit viper) species. The progressive local effects produced by secretions of these glands may be confused with early Crotalidae envenomation.