The American journal of emergency medicine
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Ethnic disparities in emergency department (ED) analgesic use have been noted previously; the purpose of this study was to determine if current ED practice has been altered subsequent to the widespread recognition of these inequalities. ⋯ There is evidence that previously described racial inequalities in analgesic use have decreased over time.
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Arterial dissection is a rare but serious cause of acute childhood stroke. Here, we present the case of a 15-year-old adolescent boy, an art school student, who suddenly experienced left hemi-paralysis after performing repeated backward somersaults, diagnosed as right-sided middle cerebral artery (MCA) hyperacute infarct due to isolated MCA dissection. Middle cerebral artery dissection in childhood is rare, as in our patient; however, pediatricians and emergency physicians should take MCA dissection into consideration in the differential diagnosis when hyperdense MCA sign is detected from unenhanced cranial computed tomography (CT) of childhood and/or adolescent stroke, with a special history such as backward somersault as in this case. Besides, unenhanced cranial CT and further imaging studies, including CT angiography and magnetic resonance imaging, provide a crucial role in early diagnosis to design proper treatment of acute childhood stroke in the ED.
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Each year there are over 7 million lacerations requiring wound closure in the emergency department. Traditionally, most lacerations have been closed with sutures. ⋯ As a result, new topical skin adhesives are expected to enter the market in the near future. This article will review the structure and function of cyanoacrylates as well as their advantages, indications, and usage.
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To determine the predictive capability of heart rate variability (HRV) measures of patients with sepsis in the ED for in-hospital death. ⋯ Heart rate variability measures, especially the SDNN and nHFP, may be used as valuable predictors of in-hospital mortality in patients with sepsis attending the ED.
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Medical support is an important part of military operations. The aim of war surgery is to achieve the return of the greatest number of injured to combat and the preservation of life, limb, and eyesight. War surgery is different from current traumatology because of many reasons. ⋯ Recently, changes in the dogma of war necessitated significant changes in the organization schema of military services supporting modern military operations. The concept of highly mobile, easily deployed, forward surgical facilities is the most important change in the philosophy of modern war injury. Military surgeons are now facing new challenges; appropriate education is required to achieve success in their mission.