Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Distracting painful injuries (DPIs) may mask symptoms of spinal injury in blunt trauma victims and form an important element in a decision instrument used to identify individuals who require cervical spine radiography. ⋯ A significant number of blunt trauma patients are believed by clinicians to have DPIs that can possibly mask the presence of cervical spinal injury. Fractures and trauma to soft tissues are the most common types of DPI.
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To determine what percentage of women presenting to an urban emergency department (ED) for any reason had been the victims of violence committed by another woman in the previous year. ⋯ Nine percent of the women in the study sample had been assaulted by another woman in the previous year. Further attention to the recognition and management of violence committed by women against other women may be warranted to ensure that patients receive appropriate treatment and referral.
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While etomidate is reported as a procedural sedative in adults, its use in children has not been extensively reported. The authors describe their experience with etomidate for procedural sedation in children with extremity fractures and major joint dislocations. ⋯ These results suggest that etomidate is a safe and effective agent for procedural sedation in children requiring fracture and major joint reductions.
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Comparative Study
A comparison of succinylcholine and rocuronium for rapid-sequence intubation of emergency department patients.
To compare rocuronium and succinylcholine for rapid-sequence intubation (RSI) in the emergency department (ED). ⋯ Both succinylcholine and rocuronium produced fast and reliable paralysis for RSI. Although succinylcholine had a faster onset and provided more relaxation, the difference had no clinical significance. Approximately a fourth of ED RSI patients qualified for use of rocuronium using these high-risk criteria.
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Heated debate persists regarding the role of resident moonlighting in emergency medicine (EM). The attitudes of EM residency applicants have not been assessed. The objectives of this study were to assess: 1) the level of educational debt among EM residency applicants, 2) their perception of increased risk potential to patients from unsupervised EM resident practice, and 3) their opposition to laws restricting moonlighting. The authors then report the relationship between the degree of indebtedness and these stated positions. ⋯ Emergency medicine residency applicant debt is large. The EM applicants' opposition to laws that would restrict moonlighting was mixed. This was inconsistent with the majority acknowledging an increased risk potential to patients. Nearly all EM applicants would still select EM as a career, even if moonlighting were to be banned.