Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine the rate of unrecognized endotracheal tube misplacement when performed by emergency medical services (EMS) personnel in a mixed urban and rural setting. ⋯ The incidence of unrecognized misplacement of endotracheal tubes by EMS personnel may be higher than most previous studies, making regular EMS evaluation and the out-of-hospital use of devices to confirm placement imperative. The authors were unable to show a difference in misplacement rates based on provider experience or level of training.
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To determine if there is an association between total out-of-hospital time and trauma patient mortality. ⋯ Provider-assigned CUPS status, patient age, Injury Severity Score, and Revised Trauma Score all were significant predictors of trauma patient mortality. Total out-of-hospital time was not associated with mortality.
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A multidisciplinary panel of experts is developing standardized reporting criteria for risk stratification studies of emergency department (ED) patients with potential acute coronary syndromes (ACS). The authors assessed the need for such criteria by reviewing published studies to determine whether these core criteria currently are being reported. ⋯ Many of the 47 items considered core criteria by the expert committee writing standardized reporting guidelines for risk stratification studies of potential ACS patients were not reported often in major cardiology and emergency medicine journals. There seems to be a need for standardized reporting guidelines because important information is not currently being reported.
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An 82-year-old women presented with altered mental status, seizure, and apnea after an accidental ingestion of concentrated hydrogen peroxide. Ingestion of concentrated peroxide can result in gas embolism of the cerebral vasculature. ⋯ To the best of the authors' knowledge, this is the first reported case of reversal of significant altered mental status associated with hydrogen peroxide ingestion in temporal relation with hyperbaric oxygen therapy. Emergency physicians need to be aware of the dangers of peroxide ingestion and may wish to consider hyperbaric oxygen as a potential additional treatment for severe cases.
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Comparative Study
Comparative analysis of adult versus adolescent sexual assault: epidemiology and patterns of anogenital injury.
To compare the characteristics of sexual assault in pubertal girls (<18 years old) and adults in a community-based population of women presenting to an urban sexual assault clinic. ⋯ Of women presenting to an urban sexual assault clinic, 43% were adolescents. The epidemiology of sexual trauma and the pattern of anogenital trauma in this age group are unique and may pose special challenges to emergency health care providers.