JACEP
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A Medical Specialty Preference Inventory (MSPI) containing 199 items relating to the practice of medicine was developed through ratings by a national sample of over 1,000 board certified physicians in internal medicine, obstetrics-gynecology, pediatrics, psychiatry, surgery, and family practice. Sixty-one emergency physicians completed the MSPI for emergency medicine. ⋯ Results showed emergency medicine most similar to surgery and least similar to psychiatry, although the similarity to surgery was two standard deviations below the mean overall surgery score. A more extensive and systematic effort to characterize emergency medicine using the MSPI rating system could create a national representative factorial characterization of emergency medicine to be used by medical students and physicians when choosing a specialty.
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During 1975, 332 animal bite injuries accounted for 1.2% of all surgical problems treated at the UCLA Hospital Emergency Department. Data on 307 bite injuries were available and analyzed for environmental, animal, human, interaction, and clinical factors. More than half of the dog bites and almost three fourths of the cat bites-scratches happened at or near the victims' homes. ⋯ Over 2% of patients were hospitalized. Five percent of dog bite victims and 29% of cat bite-scratch victims returned with complications, mostly cellulitis or lymphangitis. Pasteurella multocida was the most common pathogen cultured, as evidenced by the 50% and 80% culture-positive rates for dog and cat bite-scratches respectively in this series.
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The Glasgow Coma Scale (GCS) is used in central Virginia by emergency medical technicians (EMT's), emergency department personnel and neurosurgical staff to evaluate patients with central nervous system (CNS) trauma. In a series of 406 patients admitted to the neurosurgical services at the University of Virgina Hospital between October 1977 and February 1978, a GCS score was recorded by the neurosurgeon, nurse, and EMT. All 250 data points, including clinical diagnosis and incidence of associated injuries were entered into our information system analysis. ⋯ The GCS has substantial clinical value in the management of the nuerotrauma patient. It is presently being employed in all phases of the emergency medical system to monitor the progression of the neurologic injury. Ultimately, this injury severity scoring system will be used to standardize patient populations in well controlled clinical studies in which different treatment parameters will be assessed.
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The Emergency Medicine Core Content represents the central body of knowledge of emergency medicine and is presented as an itemized list of clinical diseases, major clinical symptoms, administrative entities, and physician skills. It comprises the nucleus of the actual practice of clinical emergency medicine. Finally, it describes the educational scope of postgraduate training and continuing medical education in emergency medicine. ⋯ All diseases and symptoms were included on the basis of four criteria: conditions which pose immediate life or limb threat; conditions which potentially require inhospital treatment; conditions which give rise to significant discomfort to the patient and conditions with medicolegal implications. The Emergency Medicine Core Content has been widely circulated and has input from numerous individuals and committees. All critiques were closely reviewed and employed to derive the final document as it now exists.