Crossbow Injuries: Predictors of Mortality.

Introduction: Crossbow injuries are rare but carry significant morbidity and mortality, and there is limited evidence in the medical literature to guide care. This paper reviews the case reports and case series of crossbow injuries and looks for trends regarding morbidity and mortality based on the type of arrow, anatomic location of injury, and intent of injury.

Methods: Multiple databases were searched for cases of crossbow injuries and data were abstracted into a spreadsheet.

Perceived and Received Support by Academic Medicine Faculty During the COVID-19 Pandemic: A Single Institution Study.

Objective: The COVID-19 pandemic negatively impacted healthcare worker well-being, leading to increased burnout and decreased workplace engagement. To combat expected stressors from the pandemic, our mid-sized academic health center implemented numerous institutional support, such as town halls, and virtual support groups. This study aimed to evaluate faculty utilization of institutional support, its association with perceived organizational support, received organizational support, and burnout.

Emergency department visits in Parkinson's disease: The impact of comorbid conditions.

Introduction: Older adults have complex, often overlapping, medical conditions requiring careful management that may lead to increased emergency department usage compared to younger adults. Parkinson's disease (PD), a progressive neurodegenerative disorder characterized by distinct motor and nonmotor features, frequently occurs with additional comorbid disease. Classifying comorbid conditions into clinical subgroups allows for further understanding of the heterogeneity in outcomes in patients with PD.

Plant identification applications do not reliably identify toxic and edible plants in the American Midwest.

Introduction: Exposure to potentially toxic plants is a global problem, resulting in thousands of calls to poison centers and emergency department visits annually and occasional deaths. Persons with limited botanical knowledge may be tempted to rely on smartphone applications to determine if plants are safe to forage. This study evaluated the reliability of several popular smartphone applications to identify foraged foods and distinguish them from potentially toxic plants in the Midwestern United States.

An electronic health record alert increases human immunodeficiency virus screening and case identification in a high-risk emergency department population.

Increased screening for HIV is required to reduce mortality and transmission. Patients with risk factors for HIV may lack access to routine care and emergency departments are an important site for screening and linkage to care. We implemented an electronic health record algorithm to identify patients meeting criteria for HIV screening.

Incidence of Emergency Department Visits for Electric Rental Scooters Using Detailed Ridership Data.

Introduction: Electric scooter (e-scooter) rental usage has increased exponentially around the country, expanding to more than 120 cities by the end of 2018. Early attempts to capture the safety effects of widespread adoption of this technology have been hampered by lack of accurate ridership data. Here we describe a 17-month evolution of ridership characteristics in St.

Firework injuries are increasing in the United States: An analysis of the National Emergency Department Sample.

Background: Firework-related injuries cause significant morbidity to persons in the United States and globally. Prior studies have shown that hands and eyes are frequently injured, with loss of hand function and blindness being common after serious injury. Many jurisdictions in the United States have relaxed laws governing sales of consumer fireworks in recent years.

Spontaneous Coronary Artery Dissection Causing Cardiac Arrest in a Post-Partum Patient - A Case Report.

Unlabelled: Spontaneous coronary artery dissection is a rare condition that can precipitate acute coronary syndrome in pregnant and peripartum women. A 32-year-old previously healthy female, 2-weeks post-partum, presented to the emergency department after sudden cardiac arrest. Return of spontaneous circulation was achieved after multiple rounds of resuscitation.

A Short-Term Medical Mission in Rural Nepal: Chief Complaints, Medications Dispensed, and Unmet Health Needs.

Background Although Nepal is striving to expand primary health services for its citizens, many remote areas have limited access to basic health care. Short-term medical missions (STMMs) are one way of supplementing human resources for health in underserved areas. This article describes the chief complaints, medications dispensed, and unmet health needs during an STMM in rural Nepal.

Depiction of Resuscitation on Medical Dramas: Proposed Effect on Patient Expectations.

The public has unrealistic views regarding the success of cardiopulmonary resuscitation, and one potential source of misinformation is medical dramas. Prior research has shown that depictions of resuscitation on television are skewed towards younger patients with acute injuries, while most cardiac arrests occur in older patients as a result of medical comorbidities. Additionally, the success rate of televised resuscitations on older shows has vastly exceeded good outcomes in the real world.

Rhabdomyolysis and Multisystem Organ Failure Due to Fulminant Ehrlichiosis Infection.

A previously healthy 51-y-old male presented to his local emergency department with subjective fevers, myalgias, dyspnea, and generalized weakness that had been progressive for several weeks. He was initially diagnosed with bilateral pneumonia, septic shock, and rhabdomyolysis requiring transfer to a tertiary care facility. He was treated for sepsis with broad-spectrum antibiotics, steroids, and a fluid bolus before transfer.

Coding of Sexual Assault by Emergency Physicians: A Nationally Representative Study.

Introduction: Sexual assault is a public health problem that affects many Americans and has multiple long-lasting effects on victims. Medical evaluation after sexual assault frequently occurs in the emergency department, and documentation of the visit plays a significant role in decisions regarding prosecution and outcomes of legal cases against perpetrators. The American College of Emergency Physicians recommends coding such visits as sexual assault rather than adding modifiers such as "alleged.

Principles of research ethics: A research primer for low- and middle-income countries.

Ethical oversight in the form of review boards and research ethics committees provide protection for research subjects as well as guidance for safe conduct of studies. As the number of collaborative emergency care research studies carried out in low- and middle-income countries increases, it is crucial to have a shared understanding of how ethics should inform choice of study topic, study design, methods of obtaining consent, data management, and access to treatment after closure of the study. This paper describes the basic principles of Western research ethics - respect for persons, beneficence, and justice - and how the principles may be contextualized in different settings, by researchers of various backgrounds with different funding streams.

What resources are used in emergency departments in rural sub-Saharan Africa? A retrospective analysis of patient care in a district-level hospital in Uganda.

Objectives: To determine the most commonly used resources (provider procedural skills, medications, laboratory studies and imaging) needed to care for patients.

Setting: A single emergency department (ED) of a district-level hospital in rural Uganda.

Participants: 26 710 patient visits.

Management of Burn Injuries in the Wilderness: Lessons from Low-Resource Settings.

Burns are a common source of injuries worldwide, with a high burden of disease in low- and middle-income countries. Burns also account for 2%-8% of wilderness injuries. Although many are minor, the potential for serious morbidity and mortality exists, and standard treatments used in high-resource settings are not readily available in the backcountry.