Articles: emergency-medicine.
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Since the initial hour after injury is the most crucial time for trauma patients, resuscitation technique is of vital importance. Standardized courses for first-hour management (ATLAS) have been widely accepted. A teaching format based upon video recording of every resuscitation has been developed. ⋯ Over a 3-month period, average resuscitation time to definitive care decreased for age- and injury severity-matched patient groups cared for by one team. Resuscitations have become more efficient and adherence to assigned responsibilities better. Weekly review of resuscitation contributes to improved technique and trauma care.
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The mental status evaluation is a useful test in the emergency department. The major purposes of the examination are to determine the presence of neuropsychiatric illness and to determine whether this illness is functional or organic. ⋯ This extensive test is rarely necessary in the emergency department; rather a short test of cognitive function, such as the Cognitive Capacity Screening Examination or Mini-Mental Status Examination, may be more appropriate. With frequent repetition in use and the concomitant development of clear standards for interpretation of the examination used, the emergency physician will become more comfortable with bedside mental status testing.