Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To compare the demographic and injury characteristics of children visiting the emergency department (ED) for nonfatal injuries occurring at school with those of same-aged children who were injured outside of school. ⋯ A significant proportion of injuries to school-aged children occur at school. Notable differences exist between the epidemiology of in- and out-of-school injuries. The nature of these injuries differs by age group. Efforts to reduce school injuries will require that these differences be examined further and incorporated into prevention initiatives.
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Patients in emergency departments who use methadone frequently use tricyclic antidepressants (TCAs) and/or benzodiazepines (BZDs). This is a potentially dangerous drug combination. The authors hypothesized that the presence of methadone and a TCA, a BZD, or both is associated with an "accidental" overdose (AOD) death more often than a death from any other cause. ⋯ Among the methadone-positive cases, testing positive for a TCA, a BZD, or both was associated with an AOD death.
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Soccer, an increasingly popular sport among children in the United States, is a common precipitant to injury-related emergency department (ED) visits. The authors estimated the number of children treated in EDs for soccer-related injuries and described the nature of these injuries. ⋯ Substantial numbers of children were treated in EDs for soccer-related injuries. Injury types and affected body regions varied by age. Injury prevention efforts to reduce soccer-related injuries may need to be age specific.
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Controlled Clinical Trial
Computed tomographic angiography for the evaluation of aneurysmal subarachnoid hemorrhage.
Computed tomography (CT) followed by lumbar puncture (LP) is currently the criterion standard for diagnosing subarachnoid hemorrhage (SAH) in the emergency department (ED); however, this is based on studies involving a limited number of patients. The authors sought to assess the ability of CT angiography (CTA), a new diagnostic modality, in conjunction with CT/LP to detect SAH. ⋯ In this pilot study, CTA was found to be useful in the detection of cerebral aneurysms and may be useful in the diagnosis of aneurysmal SAH. A larger multicenter study would be useful to confirm these results.
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Comparative Study
Comparison of the National Emergency Department Overcrowding Scale and the Emergency Department Work Index for quantifying emergency department crowding.
Emergency department (ED) crowding is just beginning to be quantified. The only two scales presently available are the National Emergency Department Overcrowding Scale (NEDOCS) and the Emergency Department Work Index (EDWIN). ⋯ Both scales had high AUCs, correlated well with each other, and showed good discrimination for predicting ED overcrowding. This establishes construct validity for these scales as measures of overcrowding. Which scale is used in an ED is dependent on which set of data is most readily available, with the favored scale being the NEDOCS.