Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine trends in the numbers of drive-by shootings, individuals shot at, innocent bystanders shot at, and homicides by drive-by shootings in the city of Los Angeles from 1989 to 1993. ⋯ Drive-by shootings are a major public health problem in Los Angeles. While the rate of drive-by shootings decreased in 1992 and 1993, the proportion of fatal cases increased. To prevent drive-by shootings, the root causes of violent street gang formation must be addressed.
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Multicenter Study
Level I trauma certification and emergency medicine resident major trauma experience.
American College of Surgeons (ACS) and Residency Review Committee for Emergency Medicine (RRC-EM) guidelines conflict regarding the role of emergency physicians in directing major trauma resuscitations. This article describes the impact of ACS level I trauma certification on emergency medicine (EM) resident trauma experience. ⋯ EM residents direct a smaller percentage of major trauma resuscitations at ACS level I hospitals than they do at non-level I facilities. This finding is not offset by an increased trauma census at level I facilities and may be more pronounced in the Northeast and the Midwest.
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To determine the test performance of 24-lead variance cardiography (VC), an ECG technique that measures QRS morphologic variability, for ED evaluation of chest pain associated with coronary artery disease (CAD). ⋯ A CADI < 75, in addition to clinical impression and initial ECG, may identify chest pain patients who do not have significant CAD. Further prospective assessment of VC is warranted.
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To examine the effect on patient care of HMO-mandated calls for authorization prior to ED evaluation. The study examined this phenomenon prior to implementation of a California law that discourages such calls. ⋯ Calls for payment authorization prior to ED patient evaluation delay patient care and place some patients' health and safety in jeopardy.
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To describe the experience of a residency program in emergency medicine with an intensive observational evaluation of resident performance in the ED. ⋯ The program provided the faculty with protected teaching time, an opportunity to share clinical pearls, and unique insights into resident performance that are not obvious during standard clinical interactions.