Articles: emergency-medicine.
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Historical Article
Legal history of emergency medicine from medieval common law to the AIDS epidemic.
The early development of legal obligation in emergency medicine is traced through medieval English common law to the first stages of American law after Independence. An identifiable set of legal principles in the nineteenth and early twentieth centuries is described. ⋯ In the modern era, there has been a substantial legal and ethical change to a requirement of extensive duties to operate open-admission emergency services in virtually all acute-care hospitals. The AIDS epidemic is utilized as a case example of expanded legal and ethical duties to offer emergency care in a nondiscriminatory manner to all patients presenting at hospital emergency departments.
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Multicenter Study Clinical Trial
Evaluation of a bedside whole-blood rapid troponin T assay in the emergency department. Rapid Evaluation by Assay of Cardiac Troponin T (REACTT) Investigators Study Group.
To evaluate the performance of a new bedside whole-blood rapid assay for cardiac troponin T (cTnT) in patients presenting to the ED with symptoms consistent with acute coronary ischemia. ⋯ The sensitivity of this whole-blood rapid cTnT assay for detecting AMI is comparable to that of current serum assays and offers the advantage of providing rapid bedside results. Discrepancies between serum and whole-blood assays for cTnT noted in this study may indicate the need for further education for the test reader prior to patient use.
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The use of ultrasonography, traditionally performed by radiologists, is becoming increasingly widespread in emergency medicine. Consequently, much debate has evolved over whether emergency medicine physicians are qualified to provide this service, and the criteria by which training and credentialing can be achieved. This article discusses training and credentialing guidelines, paths to becoming credentialed in emergency sonography, and quality assurance issues. Also, strategies are proposed for emergency departments seeking to perform emergency sonography.
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Based on the hypothesis that managing pediatric death--particularly, communicating with survivors--is extremely difficult for most emergency physicians, 122 general emergency physicians at a written board review course were surveyed to assess their attitudes toward pediatric death. Sixty-six percent reported that communicating with the family of a child who had died was the most difficult experience in emergency medicine. ⋯ Only 8% of physicians were aware of published guidelines regarding managing pediatric emergency department (ED) deaths, and only 14% of physicians had ever had any training in death notification. Ninety-two percent of physicians responded that a course directed toward managing the family of a child who had died in the ED would be helpful in dealing with this difficult situation.