Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Historical Article
Ethics seminars: physician complicity in the Holocaust: historical review and reflections on emergency medicine in the 21st century, part II.
Part I of this seminar in ethics reviewed the participation of German physicians and the German medical establishment in carrying out Nazi policies and listed eight moral failures that could be attributed to doctors during the dark period of history known as the Holocaust. The collective acts that occurred during this period have, arguably, become a benchmark for abject ethical collapse on the part of mankind. ⋯ This article reviews and categorizes ethical pitfalls encountered by physicians during the Nazi era and examines them in relationship to several current issues. It also focuses on ethical concerns and challenges that confront contemporary emergency practitioners, some of which have parallels, though certainly not direct comparators, in the Nazi era.
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The Fire Department of the City of New York--Emergency Medical Services (EMS) Operations is one of the largest EMS systems in the country. On a daily basis, this system responds to approximately 3,000 to 3,500 calls for ambulance requests. ⋯ The magnitude of the attacks on the World Trade Center, however, was on a scale not previously seen by any system. This article is a case report of the September 11, 2001, incident.
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Randomized Controlled Trial Clinical Trial
Mild hypothermia induced before cardiac arrest reduces brain edema formation in rats.
The mechanisms by which hypothermia improves cardiac arrest (CA)-induced brain damage are unclear. The authors hypothesized that mild hypothermia induced before CA attenuates brain edema formation by preventing neutrophil-mediated dysfunction of the endothelial cell junction proteins. ⋯ Mild hypothermia before CA decreases CA-induced brain edema. The hypothermia-elicited reduction in brain edema does not appear to be neutrophil-dependent and the early brain edema formation may not involve the proteolysis of occludin.
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The shock index (SI), the ratio of heart rate to systolic blood pressure, has been reported to be a useful tool in the evaluation of trauma patients presenting to the emergency department (ED). ⋯ The range of values for SI for patients being evaluated for pain and/or vaginal bleeding within the first trimester of pregnancy, who do not have a ruptured EP, are within the previously reported range of 0.5-0.7 for nonpregnant patients. A SI > 0.85 made the diagnosis of ruptured EP 15.0 (95% CI = 5.6 to 40.4) times more likely. This study suggests that SI could impact directly on the diagnostic and therapeutic course of the patient.
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To describe emergency medicine residents' (EMRs') personal computer (PC) use and educational needs and to compare their perceived and actual PC skills. ⋯ Emergency medicine residents have much access to computer technology and possess some computer skills; however, many are unable to produce a usable product or conduct a literature search. Emergency medicine residents have not had sufficient computer training prior to residency. The computer skills of EMRs should be assessed through skills testing rather than self-assessment, and computer training during residency should be improved.