CT scans are frequently done after minor head injury to evaluate for intracranial hemorrhage. While CT scans are an excellent tool for diagnosing or ruling out this disorder, they are not without harms including radiation exposure, cost and department delays. Much of the time, CTs are negative, or find injuries for which no intervention is ever done and do not clinically affect the patient.
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Emergency Departments (ED) are frequently tasked with managing HIV exposures and initiating post exposure prophylaxis (PEP). A survey of ED providers in early 2000 demonstrated that many were uncomfortable determining the need for PEP after non-occupational exposures, like sexual contact and injection drug use. For such cases, PEP management occurred 49-100% of the time. In 2005,
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Women presenting to the Emergency Department (ED) with abdominal pain present a diagnostic dilemma when it comes to selection of imaging modality. Differentiating pain originating from pelvic organs vs. intra-abdominal organs is difficult to do with history and physical alone, and many women ultimately end up undergoing both CT of the abdomen and pelvis (CTAP) and pelvic US in the ED.
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Morbidity and mortality of the self-poisoned patient is often related to respiratory complications resulting from the ingested drugs. As a result, these patients may require intensive care and monitoring. The ability to predict the clinical course of a patient would be helpful to potentially prevent subsequent complications.
Currently, there does not exist a clinical measurement that has been shown to be helpful in outcome prediction in the self-poisoned patient.
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Triage and prioritizing patient care is an important skill that Emergency Medicine physicians must develop to become efficient and effective providers. Previous studies have demonstrated statistically significant delays in door to provider time due to race and volume in the ED (Okunseri 2013, Sonnenfeld 2012). No previous study has investigated variances in door to provider time based on chief complaint.
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Cardiac arrest remains associated with very high morbidity and mortality, and neurologically meaningful recovery (the most important goal of cardiac arrest care) is a regrettably infrequent outcome despite the best efforts of providers. Resuscitative efforts in cardiac arrest patients typically center around ACLS algorithms and attempts to find and correct reversible causes of clinical decompensation,
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In patients with symptoms of pulmonary embolism (PE), we often turn to vital signs, including heart rate, respiratory rate and pulse oximetry, as part of our initial impression of the patient. Before even considering further testing, such as d-dimer or CTPA, we look first at the vital signs to form our gestalt impression of the patient.
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Iatrogenesis is an adverse patient condition directly resulting from medical treatment or error, occurring in nearly 4% of hospitalizations with 50% being preventable and 14% resulting in death (Berwick 1999, Brennan 2000). What is even more concerning is that studies have suggested that this rate is higher in pediatric patients. Research has focused primarily on patient-related factors like age and weight,
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