Annals of emergency medicine
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Recommendations for the treatment of emergency department (ED) patients with asymptomatic severely elevated blood pressure advise assessment for occult, acute hypertensive target-organ damage. This study determines the prevalence of unanticipated, clinically meaningful test abnormalities in ED patients with asymptomatic severely elevated blood pressure. ⋯ Screening tests of urban ED patients with asymptomatic severely elevated blood pressure infrequently detect unanticipated hypertension-related abnormalities that alter ED management.
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Test the hypotheses that emergency department (ED) visits for skin and soft tissue infections became more frequent during the emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA), and that antibiotics typically active against community-associated MRSA were chosen increasingly. ⋯ US ED visits for skin and soft tissue infections increased markedly from 1993 to 2005, contemporaneously with the emergence of community-associated MRSA. ED clinicians prescribed more antibiotics typically active against community-associated MRSA, especially trimethoprim-sulfamethoxazole. Possible confounders are discussed, such as increasing diabetes or shifts in locus of care.
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Providing rural emergency medical care is often difficult because of limited resources and a scarcity of medical providers, including physicians trained in emergency medicine. Telemedicine offers promise for improving the quality of care in rural areas, but previous models were not well designed to provide affordable care to unstable or potentially unstable patients. ⋯ Since its inception in October 2003, the TelEmergency program has evaluated and treated more than 40,000 patients in 11 rural EDs throughout Mississippi, with a high degree of satisfaction from patients and hospital administrators. This article details the development and implementation of this system and describes the patient population that has been evaluated.