J Emerg Med
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Emergency physicians are less likely to suspect the presence of a severe or unstable cervical spine injury in patients who have been ambulatory since the traumatic episode. We present the case of a man with multiple cervical fractures and a 75% anterior subluxation of C6 and C7 who did not seek medical care for six weeks after falling from a height. Previous reports of delayed or occult cervical spine injuries are reviewed. Physicians must aggressively search for injuries whenever a history of neck pain is present or a strong mechanism of injury exists, even if the patient has been ambulatory for days or weeks following the injury.
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Emergency physicians as individuals, as groups, or as corporations, have medical and legal relationships with hospitals, other physicians, and nurses. These relationships sometimes result in liability for alleged negligence being applied in complex and unexpected ways. ⋯ Conversely, other parties, such as hospitals, may be held liable for the acts of emergency physicians. This paper explores the history of hospital responsibility for patient care and examines how hospital policies and actions often impact on emergency care.
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This article is the first of two parts outlining the objectives for a resident rotating in the intensive care unit (ICU). It is part of a larger continuing series on the goals and objectives to direct the training of emergency medicine residents on off-service rotations. ⋯ Critical care is a logical continuum for the sick and injured patient as he moves from the prehospital and emergency department (ED) settings to the ICU. These objectives are designed to focus the resident's reading and study during a critical care rotation.