Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine the prevalence of cocaine use in a population of elder patients presenting to an inner-city academic emergency department (ED). ⋯ Elder patients may have a higher prevalence of cocaine use than previously estimated by national registries.
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The authors sought to modify and validate a composite assessment evaluation process that assesses resident acquisition of the Accreditation Council for Graduate Medical Education (ACGME) general competencies (GCs). ⋯ By using a structured development process, the authors were able to create valid evaluation items for determining resident acquisition of the ACGME GCs.
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Comparative Study
Initial emergency department trauma scores from the OPALS study: the case for the motor score in blunt trauma.
To compare the predictive accuracy of the Revised Trauma Score (RTS), the Glasgow Coma Scale (GCS), and their components in blunt trauma patients. ⋯ The initial emergency department motor score showed the highest predictive validity among all of the other components. These results suggest its validity for blunt trauma triage when compared with the GCS or RTS.
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Overwhelming gram-negative bacterial infection and life-threatening systemic inflammation are widespread problems in critically ill emergency department patients. Currently, the treatment of these patients is largely supportive, focusing on antibiotics, fluids, hemodynamic and ventilatory support, and intensive monitoring. The only Food and Drug Administration-approved pharmaceutical agent for the treatment of sepsis is activated protein C, with its use largely relegated to the intensive care unit. ⋯ High mobility group box 1 (HMGB1), a protein previously known only as a nuclear transcription factor, is now implicated as a late mediator of sepsis. Targeting late mediators of lethal systemic inflammation represents a novel approach that may widen the therapeutic window and lead to new strategies for inhibiting the deleterious effects of the inflammatory cascade. Here the authors review the studies that led to the discovery of HMGB1 as a late mediator of systemic inflammation and discuss the possibility of HMGB1 as a therapeutic target for septic patients in the emergency department.
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To assure a smooth transition to their new work environment, rotating students and housestaff require detailed orientations to the physical layout and operations of the emergency department. Although such orientations are useful for new staff members, they represent a significant time commitment for the faculty members charged with this task. ⋯ The videos are viewed through Web-based streaming technology that allows learners to complete the orientation process from any computer with Internet access before their first shift. This report describes the stepwise process used to produce these videos and discusses the potential benefits of converting to an Internet-based orientation system.