Annals of emergency medicine
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We conduct a prospective independent validation of the San Francisco Syncope Rule to identify emergency department (ED) syncope patients with short-term serious outcomes. ⋯ In this independent validation study, sensitivity and negative likelihood ratio of the San Francisco Syncope Rule were substantially lower than reported in the original studies and suggest that the rule has limited generalizability.
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The rise in emergency department (ED) use in the United States is frequently attributed to increased visits by the uninsured. We determine whether insurance status is associated with the increase in ED visits. ⋯ The rise in ED visits between 1996 and 2003 cannot be primarily attributed to the uninsured. Major contributors to increasing ED utilization appear to be disproportionate increases in use by nonpoor persons and by persons whose usual source of care is a physician's office.
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Many emergency departments and trauma centers utilize extensive radiologic studies during the assessment of trauma patients. A point of concern arises about the possible biological effects of these cumulative radiation doses. The objective of this study is to determine the amount of ionizing radiation received by adult blunt trauma patients at a Level I trauma center during the first 24 hours of their care. ⋯ Trauma patients meeting the less acute major triage criteria are exposed to clinically important radiation doses from diagnostic radiographic imaging during the first 24 hours of their care.