Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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In September 2006, the Centers for Disease Control and Prevention (CDC) recommended routine (nontargeted) human immunodeficiency virus (HIV) screening for all patients in the emergency department (ED). Although the American College of Emergency Physicians has endorsed these recommendations, the College expressed concern that that their adoption may lead to an increase in the length of stay (LOS) for ED patients. This study therefore analyzed the effect of nontargeted HIV screening on LOS in a cohort of ED patients. ⋯ Human immunodeficiency virus screening using an additional staff model has no clinically significant effect on the overall LOS for discharged patients.
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To determine the sensitivity and specificity of the San Francisco Syncope Rule (SFSR) electrocardiogram (ECG) criteria for determining cardiac outcomes and to define the specific ECG findings that are the most important in patients with syncope. ⋯ The ECG criteria from the SFSR are relatively simple, and if used correctly can help predict which patients are at risk of cardiac outcomes. Furthermore, any left bundle branch block conduction problems or any nonsinus rhythms found during the ED stay should be especially concerning for physicians caring for patients presenting with syncope.
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This study examined how frequently inhaled corticosteroids (ICS) are prescribed at discharge in U.S. emergency departments (EDs) for children presenting with asthma exacerbations. ⋯ Inhaled corticosteroids are infrequently prescribed for children with asthma at discharge from U.S. EDs. Other than the fall season, there are no identified demographic or clinical factors associated with the likelihood of ICS prescriptions. ED clinicians should consider interventions to increase ICS prescriptions for children with persistent asthma.
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Increasing the size of medical school classes has resulted in the use of community hospitals for emergency medicine (EM) clerkships. While differences in clinical experience are expected, it is unclear if they are significant. The authors set out to investigate whether or not clinical site affects student performance on a standard written exam as a measure of medical knowledge. ⋯ This study found no evidence that clerkship site affected final exam score. Academic EM clerkships may consider partnering with other hospitals for clinical experiences without compromising education.
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The objectives were to evaluate the presenting signs and symptoms of spinal cord and cauda equina compression (SCC) and to determine the incidence of emergency department (ED) misdiagnosis. ⋯ SCC can have a subtle presentation with absent or unilateral motor and sensory deficits, but gait ataxia may be an additional finding. ED misdiagnosis of SCC in nontrauma patients is common.