J Emerg Med
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Review Case Reports
Recurrent spontaneous globe subluxation: a case report and review of manual reduction techniques.
Spontaneous globe subluxation is an uncommon problem that develops acutely and can present with significant patient distress from ocular pain and vision loss. ⋯ There are a number of manual reduction techniques used for treating spontaneous globe subluxation.
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Multicenter Study
The association between self-reported exercise intensity and acute coronary syndrome in emergency department chest pain patients.
Regular exercise is thought to be protective against coronary artery disease. As a result, some physicians believe that the likelihood of acute coronary syndrome (ACS) in patients with acute chest pain is reduced in those who exercise regularly. We studied the association between self-reported frequency of exercising and the likelihood of ACS in patients presenting to the Emergency Department (ED) with chest pain. ⋯ Although self-reported frequency of exercise was significantly associated with a decrease in ACS in ED patients with chest pain, it should not be used to exclude ACS in symptomatic ED patients.
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Comparative Study
Emergency ultrasound of the gall bladder: comparison of a concentrated elective experience vs. longitudinal exposure during residency.
It is unknown how an intensive emergency ultrasound (EUS) experience compares with comparable exposure done over the course of residency training. ⋯ Physicians who participated in a 2-week, semi-structured EUS elective demonstrated EUS accuracy for biliary disease that was comparable with those who performed the same number of examinations over a longer period of time.
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Boarding of inpatients in the Emergency Department (ED) has been widely recognized as a major contributor to ED crowding and a cause of adverse outcomes. We hypothesize that these deleterious effects extend to those patients who are discharged from the ED by increasing their length of stay (LOS). ⋯ In this retrospective study, increasing boarder burden was associated with increasing LOS of patients discharged from the ED, with the greatest effect between 11:00 a.m. and 11:00 p.m. on medium-acuity patients. This relationship between LOS and ED capacity limitation by inpatient boarders has important implications, as ED and hospital leadership increasingly focus on ED LOS as a measure of efficiency and throughput.