Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Review Meta Analysis
Determinants of emergency department visits by older adults: a systematic review.
To conduct a systematic review of the literature on the determinants of hospital emergency department (ED) visits by elders, using a modification of the Andersen behavioral model of health services, adapted to explain ED utilization. ⋯ Need is usually the primary determinant of ED visits in older people. Controlling for need, predisposing and enabling factors that promote access to primary medical care are associated with reduced ED utilization.
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Randomized Controlled Trial Clinical Trial
Intraosseous emergency access by physicians wearing full protective gear.
To assess prospectively and randomly the feasibility, speed, and success rate of establishing an intraosseous access using the Bone Injection Gun (BIG) while wearing antichemical outfits. ⋯ The intraosseous insertion of the BIG's needle is rapid and easy but requires 50% more time when wearing protective gear than without it. Its use during emergent treatment of toxic mass casualty is of potential benefit and needs further investigation.
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Comparative Study
Anogenital injuries in adolescents after consensual sexual intercourse.
To compare the types and locations of anogenital injuries occurring in adolescent females (13-17 years old) after consensual and nonconsensual sexual intercourse. ⋯ Anogenital trauma was documented in 73% of adolescent females after consensual sexual intercourse versus 85% of victims of sexual assault. The localized pattern and severity of anogenital injuries were significantly different when compared with victims of sexual assault.
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To develop and validate a risk score predicting arrhythmias for patients with syncope remaining unexplained after emergency department (ED) noninvasive evaluation. ⋯ In patients with unexplained syncope, a risk score based on clinical and ECG factors available in the ED identifies patients at risk for arrhythmias.
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Randomized Controlled Trial Clinical Trial
Short-axis versus long-axis approaches for teaching ultrasound-guided vascular access on a new inanimate model.
To determine whether a short-axis (SA) or long-axis (LA) ultrasound (US) approach to guidance for line placement results in faster vascular access for novice US users. Also, to assess if there was a difference in the number of skin penetrations and needle redirections between the two guidance techniques. ⋯ Novice US users obtain vascular access faster with an SA approach on an inanimate model.