Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine lung compliance in patients who had out-of-hospital cardiac arrests. ⋯ One previous publication suggested that lung compliance following resuscitation is 0.022 L/cm H2O. The results of this study, using the accepted standard measurements of static lung compliance, suggest that true compliance is twice this value. This finding has important ramifications for future research on ventilation during resuscitation and current ventilation standards.
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To evaluate the ability of noninvasive capnographic measurement of end-tidal CO2 tension (PetCO2) to predict arterial CO2 tension (PaCO2) in nonintubated ED patients with respiratory distress. ⋯ Noninvasive PetCO2 monitoring may adequately predict PaCO2 in nonintubated ED patients with respiratory distress who are able to produce a forced expiration. PetCO2 is less accurate for PaCO2 with tidal volume breathing and in patients with pulmonary disease.
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To evaluate a diagnostic protocol that includes the early use of endovaginal sonography (EVS) by emergency physicians of patients at risk for ectopic pregnancy. ⋯ The application of EVS to emergency practice appears promising. Emergency physicians trained in its use and who apply this diagnostic tool in conjunction with a defined protocol can stratify the risk of patients who have the potential for ectopic pregnancy.
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To determine how often trainees in emergency medicine (EM) are observed while performing a history, a physical examination, or specific procedures. ⋯ Many residents report that they are infrequently observed performing histories and physical examinations during their EM training, with a significant number of residents reporting that they were never observed performing basic bedside clinical skills. More direct observation with trained faculty observers may provide an opportunity for better evaluation and remediation of bedside clinical skills.
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To measure agreement beyond chance (kappa) for comparison interpretations of extremity radiographs by pediatric radiologists and emergency physicians (EPs) and to identify factors associated with disagreement. ⋯ There is good agreement between EPs and pediatric radiologists in interpreting extremity radiographs of injured children and adolescents. Disagreement occurs mainly for effusions or minor fractures and for the elbow region. Because of the importance of recognizing abnormalities in this region, an educational intervention to improve this area of deficiency is recommended.