Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Clinical Trial
How useful are clinical features in the diagnosis of acute, undifferentiated chest pain?
To measure the predictive value and diagnostic performance of clinical features used to diagnose coronary syndromes in patients presenting with acute, undifferentiated chest pain. ⋯ Important differences exist when clinical features are specifically investigated in patients with acute chest pain and a nondiagnostic electrocardiogram. Clinical features have a limited role to play in triage decision making.
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A Singapore airline crash in 2000 was the first documented mass casualty incident (MCI) caused by an aircraft disaster in Taiwan. This report reviews the emergency medical preparedness of the airport and examines its effects on the medical response during this incident. The anticipated benefits from the new MCI plan and prior medical preparedness were not achieved during this disaster. ⋯ Site medical teams responding from hospitals could not function as the plan had been designed. This article discusses factors causing the poor compliance, various problems, and related issues in medical response to the incident. As learned from this experience, a properly and practically designed MCI plan, good compliance of responders, and a strong support system of responding agencies are the most important factors for successful emergency response to any MCI.
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Comparative Study Clinical Trial
Assessment of clinically significant changes in acute pain in children.
To quantify, using two pain assessment scales, the amount of change in pain severity required to achieve a clinically significant improvement in pain in children presenting to a pediatric emergency department (ED) with pain. ⋯ The assessment and treatment of pain in children are an important component of pediatric practice, especially in the ED. This study provides health care professionals and clinical investigators the information necessary to assess whether their method of pain control in children is clinically relevant.
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With increasing availability and utilization of advanced technologic modalities in medicine, questions frequently arise regarding the appropriate use of recorded images of patients. While recorded images (photography, video, etc.) of patients may often be appropriate for documentation, medical record use, peer review, and teaching, the nonmedical use of recorded images for entertainment or commercial purposes is more problematic, both ethically and procedurally. Practices regarding filming of patients in academic emergency departments are reviewed, and suggested guidelines are provided regarding the appropriate and inappropriate filming of patients.
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To determine whether intravenous (IV) hypertonic sodium bicarbonate is effective in the reversal of QRS widening associated with severe Taxus intoxication. ⋯ Hypertonic sodium bicarbonate was ineffective in reversing the widening of QRS interval associated with Taxus poisoning in this swine model.