The American journal of emergency medicine
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A large amount of EM information can be found on the Internet, but the accuracy of this information has not been determined. This study compares the "gold standards" of EM information on four common emergencies with top healthcare web sites. The study also examines the relationship of web sites' credentials and certification on content. ⋯ Despite recent efforts to improve web site content through certification, few web sites contained a significant amount of EM information on all four topics investigated. In fact, some of the information provided on these health information web sites has the potential to be dangerous. Thus, most web sites are not good sources of reference for the public to find out what to do in the case of a medical emergency.
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Letter Case Reports
Descending necrotizing mediastinitis from upper respiratory infection.
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Letter Case Reports
Rate-related bundle branch block: an uncommon wide complex tachycardia.
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The objective of this study was to determine if a neural network model can identify victims of intimate partner violence (IPV). A custom neural network model was constructed and trained using the 1995 ED databases at Truman Medical Center of all female visits. The input vector developed was an array of 100 binary elements containing, in coded form, the patient's age, day of week, primary diagnosis (excluding 995.81), disposition, race, time, and E-code. ⋯ The neural network identified 231 of 297 known IPV victims (sensitivity 78%) in the 1996 database. It also categorized 2234 false-positive patients out of 19,533 IPV-negative patients (specificity 89%). A computer-based neural network model, when supplied with information commonly available in the ED medical record, can identify victims of IPV.
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The Bispectral Index Monitor (BIS) is validated as a measure of sedation depth during general anesthesia, but its value otherwise remains unclear. We hypothesized that BIS scores would correlate with standard subjective measures of assessing sedation in intubated adult ED patients and that BIS would predict inadequate sedation. Sedation was assessed by recording clinical features and by having treating physicians complete a visual analog scale (VAS; rated "not sedated" to "completely sedated") at 10, 30, and 60 minutes after intubation. ⋯ Despite being statistically significant (p=.002), the correlation between BIS and VAS in our 147 paired readings was fair (Pearson's rho=-0.37) and displayed wide variability. Receiver operating characteristic curve analysis of BIS demonstrated no discriminatory power in predicting sedation adequacy (area under curve 0.53). BIS is not associated with and did not predict standard measures of sedation adequacy in intubated adults.