Annals of emergency medicine
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Multicenter Study Comparative Study Clinical Trial
Multicenter comparison of two clinical decision rules for the use of radiography in acute, high-risk knee injuries.
Two separate clinical decision rules, one developed in Ottawa and the other in Pittsburgh, for the use of radiography in acute knee injuries have been previously validated and published. In this study, the rules were prospectively validated and compared in a new set of patients. ⋯ Prospective validation and comparison found the Pittsburgh rule for knee radiographs to be more specific without loss of sensitivity compared with the Ottawa rule.
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Prior research has established the futility of continued resuscitation efforts for patients in cardiac arrest who fail to respond to out-of-hospital advanced cardiac life support. Determination of both medical and nonmedical factors resulting in the transport of patients in continuing cardiac arrest to the hospital may encourage the development of new systems or strategies to increase the appropriateness of these transports. ⋯ Factors other than medical ones often influence the decision to transport patients in continuing cardiac arrest. In our urban system, physician, medical examiner, and paramedic education and protocols were needed to aid decision-making in this situation.
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To validate the Ottawa ankle rules to predict fractures in a French clinical setting when they are used by physicians not involved in their development. ⋯ Use of the Ottawa ankle rules by French emergency physicians not involved in the rules' development resulted in 99% sensitivity and had a potential of reducing radiography requests by 33%.
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Emergency medicine is growing rapidly as a specialty and is beginning to be recognized as an essential component of medicine in China. Traditional Chinese medicine and modern technology exist together. ⋯ The practice of emergency medicine in China was researched by direct observation at several Chinese cities and by literature review. China is taking the parts of the Western system it can use and implementing its own methods in the overall practice of emergency medicine.