False-negative FAST examination: associations with injury characteristics and patient outcomes.

Study Objective: Focused assessment with sonography in trauma (FAST) is widely used for evaluating patients with blunt abdominal trauma; however, it sometimes produces false-negative results. Presenting characteristics in the emergency department may help identify patients at risk for false-negative FAST result or help the physician predict injuries in patients with a negative FAST result who are unstable or deteriorate during observation. Alternatively, false-negative FAST may have no clinical significance.

Validation and refinement of a rule to predict emergency intervention in adult trauma patients.

Study Objective: Trauma centers use "secondary triage" to determine the necessity of trauma surgeon involvement. A clinical decision rule, which includes penetrating injury, an initial systolic blood pressure less than 100 mm Hg, or an initial pulse rate greater than 100 beats/min, was developed to predict which trauma patients require emergency operative intervention or emergency procedural intervention (cricothyroidotomy or thoracotomy) in the emergency department. Our goal was to validate this rule in an adult trauma population and to compare it with the American College of Surgeons' major resuscitation criteria.

Validation of the Simplified Motor Score for the prediction of brain injury outcomes after trauma.

Study Objective: The Glasgow Coma Scale (GCS) score is widely used in the initial evaluation of patients with traumatic brain injury. This 15-point score, however, has been criticized as unnecessarily complex. Recently, a 3-point Simplified Motor Score (defined as obeys commands=2; localizes pain=1; withdrawals to pain or worse=0) was developed from the motor component of the GCS and was found to have a similar test performance for predicting outcomes after traumatic brain injury when compared with the GCS score as the criterion standard.

An evaluation of out-of-hospital advanced airway management in an urban setting.

Objectives: To determine the success and complication rates associated with endotracheal intubation in an urban emergency medical services (EMS) system.

Methods: This study evaluated consecutive airway interventions between March 2001 and May 2001 performed by paramedics from the Denver Health Paramedic Division in Denver, Colorado. Patients were identified and enrolled prospectively with the identification of all patients for whom intubation was attempted.

Emergency medical vehicle collisions and potential for preventive intervention.

Background: Emergency medical vehicle collisions (EMVCs) cause significant injury, death, and property damage every year in the United States and result in significant delays in transporting patients to the hospital.

Objective: To identify factors associated with EMVCs that are potentially amenable to preventive intervention.

Methods: The authors reviewed data from the Paramedic Division of the Denver Health and Hospital Authority (DHHA) on all EMVCs occurring from 1989 through 1997.