Annals of emergency medicine
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To determine the concordance of emergency physicians and radiologists in interpreting cranial computed tomography (CT) scans. The study also sought to determine the clinical significance of misinterpretations of cranial CT scans by emergency physicians. ⋯ The misinterpretation rate of cranial CT scans by emergency physicians is of potential clinical concern. However, clinical mismanagement is rare. We recommend that more formal education in CT interpretation be included in residency training and continuing medical education programs for emergency physicians.
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Blunt trauma to the anterior neck has been known to cause upper-airway obstruction requiring emergency tracheostomy. We report the case of a 26-year-old man who sustained blunt trauma to the anterior neck in whom upper-airway obstruction developed. ⋯ Emergency tracheostomy was performed, and the patient recovered uneventfully. A Medline search of the literature for the past 3 years failed to identify any individual case reports of bilateral vocal cord paralysis secondary to blunt anterior neck trauma.
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To determine whether the vehicle-at-scene-to-patient-access (VSPA) interval could be measured by means of crew reporting to a computer-aided dispatch operation. ⋯ Our study suggests that it is feasible for ambulance crews to report patient access times. Methods to improve the consistency and frequency of crew reporting should be considered. The VSPA access interval varies in length and is not normally distributed.
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To determine the reasons patients with suspected acute myocardial infarction (AMI) delay seeking medical care or do not call 911. ⋯ Maximal benefit from thrombolytic therapy is not realized in a substantial proportion of patients with AMI because of delays in seeking medical care. Knowledge of the reasons patients delay or do not call 911 can help focus efforts on achieving more rapid treatment of patients with AMI.