J Emerg Med
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Luxatio erecta (inferior glenohumeral dislocation) is an uncommon type of shoulder dislocation. Early recognition and reduction is important to prevent neurovascular sequelae. We report two cases of luxatio erecta in order to describe the clinical presentation and reduction technique in the Emergency Department.
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The object of this study was to derive a clinical decision rule for therapeutic laparotomy among adult blunt trauma patients with a positive abdominal ultrasound for trauma (FAST) examination. ⋯ In the absence of fluid in the RUQ, there are other clinical variables that may allow for the development of a clinical decision rule regarding the need for therapeutic laparotomy.
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Clinical Trial Controlled Clinical Trial
Patient attitudes toward emergency physician attire.
Previous studies have suggested that Emergency Department (ED) patient satisfaction is unaffected by physician attire. We conducted a before-and-after trial to test this hypothesis. A convenience sample of ED patients was surveyed during a 2-week period. ⋯ There were 111 patients surveyed. There were no significant differences between patients' evaluation of appearance (Delta=-.68 mm VAS, 95% confidence interval [CI] -5.5 to 4.1), satisfaction (Delta=.83 mm VAS, 95% CI -3.0 to 4.6), or professionalism (Delta=-.46 mm VAS, 95% CI -3.6 to 2.6) between the two dress styles. Emergency physician attire does not affect patient satisfaction.
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The diagnosis of bacterial meningitis is rarely a difficult diagnostic dilemma when a patient presents with fever, headache, neck stiffness, and altered mental status. Unfortunately for the practicing clinician, patients are rarely that straightforward. Patients who are elderly, very young, or immuno-compromised often present with subtle findings, making the correct diagnosis a challenge. ⋯ The following case report details a woman diagnosed with Streptococcus pneumoniae meningitis with an extremely high cerebrospinal white blood cell count. Although this is typically thought to be caused by abscesses or malignancy, meningitis alone may cause such an elevation. In addition, a brief review of the current epidemiology and treatment regimens for meningitis is discussed.