Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Residential carbon monoxide (CO) poisoning represents a significant cause of unintentional morbidity and mortality in the United States. Screening by fire departments and utility companies is usually limited to instances in which there are symptoms of CO poisoning or there is activation of a home CO detector. ⋯ Emergency medical services personnel can perform routine CO screening and detect occult elevations in CO levels during 911 responses. Public knowledge of CO poisoning is limited and the use of home CO detectors is rare in this study population.
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To describe a novel endotracheal intubation technique, magnetically guided intubation (MGI), and its rate of success in inexperienced medical students and interns using an airway mannequin model. ⋯ A novel method of orotracheal intubation using magnetic guidance is described as achieving a high rate of successful intubations when performed by inexperienced intubators.
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Case Reports
Ethics seminars: Consent and refusal in an urban American emergency department: two case studies.
Patients in the emergency department frequently voice refusals of care or are unable or unwilling to consent to care. While general principles surrounding consent and refusal can be articulated in theory, it is often far more complicated in the real setting. Further, it is impossible to contemplate in advance every possible situation that might arise. ⋯ Emergency physicians face such complex decisions on a routine basis. Ethical reasoning skills are obviously a core competence in emergency medicine, even if easy answers are elusive. Two cases are presented that illustrate this complexity, and routes to resolution are discussed.
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To determine whether patient clinical and socioeconomic characteristics predict patient delay in coming to the emergency department (ED). ⋯ A patient's decision to delay coming to the ED often reflects a belief that his or her illness is either self-limited or not serious. The decision to delay correlates with patient characteristics and access to a regular physician. The correlates of delay in seeking ED care may depend on the delay measure used. Better understanding of patients at risk for delaying care may influence interventions to reduce delay.
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To develop a multivariable model predicting the level of care required by pediatric patients for use as a risk-adjustment tool in the evaluation of emergency medical services for children. ⋯ A model based on easily and routinely measured variables can accurately predict the level of care rendered in the PED. The predicted probabilities from such a model correlate well with other outcomes of care and may be useful in adjusting for differences in risk when evaluating quality of care.