Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Rollover crashes are responsible for a large portion of motor vehicle occupant injuries and fatalities. ⋯ The risk of death for outside arc occupants was higher than for inside arc occupants in rollovers. In addition, outside arc occupants in SUV rollover crashes were more likely to incur moderate or severe traumatic injuries. Roof crush occurs more commonly on the outside arc, and head and neck injuries were more prevalent in rollover crashes.
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To measure the quality of emergency department (ED) care for patients with acute myocardial infarction (AMI) and pneumonia (PNA) and to estimate the number of preventable deaths in these patients. ⋯ Quality of care in the ED management of AMI and PNA is below national goals. This deficiency accounts for significant preventable deaths.
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Randomized Controlled Trial Comparative Study
Randomized clinical trial of nebulized fentanyl citrate versus i.v. fentanyl citrate in children presenting to the emergency department with acute pain.
To compare the pain relief achieved with nebulized fentanyl citrate with intravenous (i.v.) fentanyl citrate in children presenting to the emergency department (ED) with painful conditions to determine if nebulized fentanyl is a feasible alternative to i.v. fentanyl for the treatment of acute pain in children. ⋯ Nebulized fentanyl citrate 3 microg/kg through a breath-actuated nebulizer appears to be a feasible alternative to i.v. fentanyl citrate for a variety of painful conditions in patients older than 3 years.
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Randomized Controlled Trial
Caregiver and health care provider satisfaction with volumetric bladder ultrasound.
Conventional (nonimaged) bladder catheterization has lower first-attempt success rates (67%-72%) when compared with catheterization aided by volumetric bladder ultrasonography (US) (92%-100%), yet the total time to urine sample collection with US can be quite lengthy. Given the advantage and disadvantages, the authors assessed caregiver and health care provider satisfaction with these two methods. ⋯ Caregivers in the conventional group rated their children's discomfort higher than did caregivers in the US group. Both caregivers and health care providers expressed greater satisfaction with US and were more likely to prefer this imaging modality with future catheterization attempts.
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To compare the patient characteristics, clinical conditions, and short-term recidivism rates of emergency department (ED) patients who leave against medical advice (AMA) with those who leave without being seen (LWBS) or complete their ED care. ⋯ Patients who leave AMA may do so prematurely, as evidenced by higher emergent hospitalization rates compared with those who LWBS or complete their care.