The American journal of emergency medicine
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Racial disparities in emergency medical care are abundant, and processes aimed to increase throughput, such as a rapid triage fast-track (FT) systems, may exacerbate these inequities. A FT strategy may be more susceptible to implicit bias as subjective information is obtained quickly. We aim to determine whether a FT model was associated with greater disparities between Black and White emergency department (ED) patients. ⋯ These results suggest that, after controlling for potential confounders, racial disparities may have been exacerbated in a FT ED triage process. In a FT model utilizing physicians and midlevel providers, this may create tiered levels of care between Black and White patients - an unacceptable side-effect of an effort to increase ED throughput.
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A key component of trauma system evaluation is the Injury Severity Score (ISS). The ISS is dependent on the AIS, and as AIS versions are updated this effects the number of patients within a health system which are considered severely injured (ISS >15). This study aims to analyse the changes comparing AIS1998 and AIS2015, and its impact on injury severity scoring and survival prediction model in a major trauma centre. ⋯ Trauma centres should be aware of the impact of the AIS2015 update on the benchmarking of trauma care, and consider the need for updating the ISS cut off for major trauma definitions.
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The literature on scientific publication errors in medical research is limited, and no studies on emergency medicine publications have been conducted yet. This study aimed to investigate the characteristics of the publication errors in emergency medicine literature. ⋯ Publications errors are inevitable, but it is possible to minimize them. The number of corrections in emergency medicine literature is at a low rate and show many similarities with the previous literature.
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In the prehospital setting, early identification of septic shock (SS) at risk of poor outcome is mainly based on clinical vital signs alteration evaluation. The Charlson Comorbidity Index (CCI) is an in-hospital tool used for burden of co-morbidity assessment. We report the relationship between the modified prehospital CCI, and 30-day mortality of SS patients initially cared for in the prehospital setting by a mobile ICU (MICU). ⋯ Among septic shock patients initially cared for by a MICU in the prehospital setting, a significant association between 30-day mortality. A modified prehospital CCI of at least 6 appears to be useful for early identification of septic shock patients with poorer outcome.
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Orbital compartment syndrome is an ophthalmologic emergency that requires immediate intervention to preserve eyesight. This case highlights a rare, delayed presentation of orbital compartment syndrome requiring emergent lateral orbital canthotomy.