Annals of emergency medicine
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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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Presented is the case report of a toddler who suffered delayed-onset paraplegia after a motor vehicle accident. An improperly used adult lap belt is postulated as the etiology causing a probable vascular event with ischemic injury to the distal cord; however, recurrent cord injury from presumed occult spinal instability was a possible explanation. This case highlights that the syndrome of spinal cord injury without radiographic abnormality can present subtly (in this case, foot "pain"), that full neurologic manifestations can be delayed, and that good neurologic recovery is possible.
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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.