J Emerg Med
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Fear of malpractice affects the daily life of many emergency physicians. Educational programs to prepare for litigation are lacking. ⋯ This novel educational collaboration taught residents about the process of litigation. It improved their communication skills and expanded their knowledge of documentation pitfalls, problems with staff interaction, and consequences of medical errors. This mutually beneficial partnership between a medical residency and a law school solidified it as a permanent feature of the residency program.
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The yield of urine culture testing in the emergency department (ED) is often low, resulting in wasted laboratory and ED resources. Use of a reflex culture cancellation protocol, in which urine cultures are canceled when automated urinalysis results predict that culture yield will be low, may help to conserve these resources. ⋯ These results suggest that a substantial reduction in urine culture testing might be achievable by implementing this protocol. Confirmation of these findings in a validation cohort is necessary.
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Heart failure (HF) emergency department (ED) visits are commonly due to HF self-care nonadherence. ⋯ Patients seeking ED care for decompensated HF had inaccurate HF beliefs and poor self-care adherence. Lack of association between HF beliefs and self care (and trend of an inverse relationship) reflects a need for predischarge HF education, including an explanation of what HF means and how it can be better controlled through self-care behaviors.
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Eagle syndrome is a rare condition characterized by an elongated styloid process that occasionally irritates or disrupts adjacent anatomical structures. Although this is well known in the literature, it is rarely on the forefront of the clinician's mind. In the trauma patient, awareness of Eagle syndrome and knowledge of the anatomy associated with it may help differentiate symptoms secondary to acute injury from the chronic symptoms of this syndrome. ⋯ In the trauma patient, awareness of Eagle syndrome and knowledge of the anatomy associated with it may help differentiate symptoms secondary to acute injury from the chronic symptoms of this syndrome.
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Upper-airway disruption is a rare but potentially life-threatening phenomenon. It can occur spontaneously, be due to trauma, or be iatrogenically induced. Even more rare are such events reported in the pediatric population. ⋯ The initial presentation of spontaneous tracheal rupture can be misleading and difficult to diagnose. After resuscitation, stabilization, and diagnosis, both surgical repair and nonoperative management have been reported as successful treatment measures for tracheal disruption.