Annals of emergency medicine
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This study explored femoral arterial Doppler during active cardiopulmonary resuscitation (CPR) to identify and characterize the resumptions of cardiac activity without stopping CPR. ⋯ Arterial Doppler tracings may identify the resumption of native cardiac activity during active CPR; however, more research is needed.
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Acute aortic dissection is a challenging diagnosis for emergency physicians because of its high mortality and wide range of clinical presentations. We report a case of a previously healthy man who presented with hyperfamiliarity for faces syndrome as the predominant symptom of a large type A aortic dissection diagnosed by computed tomography angiography in the emergency department. ⋯ We discuss how evaluating these other diagnostic possibilities led to the correct diagnosis. Given increasing reports of painless aortic dissection, this case demonstrates the need to consider aortic dissection in patients with acute neurological symptoms.
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We prospectively assessed the diagnostic accuracy of YEARS and a modified age-adjusted clinical decision rule ("Adjust-Unlikely") for pulmonary embolism (PE) testing in the emergency department. ⋯ The "Adjust-Unlikely" rule would modestly reduce imaging and identify all cases of PE. YEARS would substantially reduce imaging but miss 1 in 14 cases of PE.
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Emergency departments (EDs) are common access points for patients who are at high risk for unintended pregnancy. Low-barrier access to effective contraception represents a crucial and low-cost intervention to address this public health need. ⋯ With this novel approach, we found that emergency clinicians voluntarily participated in trainings on contraception, including low-threshold long-acting reversible contraception initiation; and, after completing these trainings, clinicians integrated these skills into their workflow in the ED. We report our results after screening 38 patients during our current Pilot Phase of implementing this program.