Treatment of Occipital Neuralgia by Thermal Radiofrequency Ablation.

Background: Occipital neuralgia is an uncommon disorder characterized by severe pain involving the posterior scalp in the distribution of the greater and lesser occipital nerves. In cases refractory to pharmacotherapy, invasive treatment options may be warranted. The aim of the present study was to examine the effects of thermal radiofrequency ablation (TRF) on occipital neuralgia.

The histological significance of atypical glandular cells on cervical cytology: Experience at Groote Schuur Hospital, Cape Town, South Africa.

Background: Atypical glandular cells (AGC) identified on Pap tests may be markers for potentially significant pathology.

Objectives: Primarily, to correlate AGC findings at Groote Schuur Hospital (GSH, Cape Town, South Africa) with subsequent histological investigations and attempt to identify predictors of pathology relevant to the clinical management of women with a cytological diagnosis of AGC. Secondly, to compare the GSH data with data from similar international studies.

Assessment of a chief complaint-based curriculum for resident education in geriatric emergency medicine.

Introduction: We hypothesized that a geriatric chief complaint-based didactic curriculum would improve resident documentation of elderly patient care in the emergency department (ED).

Methods: A geriatric chief complaint curriculum addressing the 3 most common chief complaints-abdominal pain, weakness, and falls-was developed and presented. A pre- and postcurriculum implementation chart review assessed resident documentation of the 5 components of geriatric ED care: 1) differential diagnosis/patient evaluation considering atypical presentations, 2) determination of baseline function, 3) chronic care facility/caregiver communication, 4) cognitive assessment, and 5) assessment of polypharmacy.

Comparison of Airtraq optical laryngoscope and Storz video laryngoscope in a cadaver model.

Background: Airway management in the emergency department is a critical intervention that requires both standard techniques and rescue techniques to ensure a high rate of success. Recently, video laryngoscope (VL) systems have become increasingly common in many large urban EDs, but these systems may exceed the budgets of smaller rural EDs and EMS services and the Airtraq optical laryngoscope (OL) may provide an effective, low-cost alternative. We hypothesized that laryngeal view and time to endothracheal tube placement for OL and VL intubations would not be significantly different.

A comparison of emergency medicine resident clinical experience in a rural versus urban emergency department.

Introduction: Strategies for increasing the numbers of American Board of Emergency Medicine certified/emergency medicine (EM) residency trained physicians practicing in rural emergency departments (EDs) include providing rural EM experiences during residency training. However, no studies to date describe the clinical work of EM residents rotating in a rural ED. The objective of the study was to compare the clinical experience of EM residents participating in a rural ED rotation with that on an urban university-based ED rotation.

Assessment of a new model for femoral ultrasound-guided central venous access procedural training: a pilot study.

Objectives: Repetitive practice with feedback in residency training is essential in the development of procedural competency. Lightly embalmed cadaver laboratories provide excellent simulation models for a variety of procedures, but to the best of our knowledge, none describe a central venous access model that includes the key psychomotor feedback elements for the procedure, namely intravascular contents that allow for determination of correct needle position by either ultrasonographic imaging and/or aspiration or vascular contents.

Methods: A cadaver was lightly embalmed using a technique that preserves tissue texture and elasticity.

Influence of assigned reading on senior medical student clinical performance.

Objective: This Institutional Review Board-approved, prospective, observational study compared the clinical performance of senior medical students in an emergency medicine (EM) clerkship using a clinical behavioral evaluation tool in which one group had mandatory, topic specific readings and the other did not.

Methods: The study took place in an urban, tertiary referral center emergency department treating 43,000 patients annually and supporting medical student clerkships and an EM residency. The grades of two groups of senior medical students participating in an elective EM clerkship were compared.

Self-reported emergency medicine residency applicant attitudes towards a procedural cadaver laboratory curriculum.

Objective: Residency applicants consider a variety of factors when ranking emergency medicine (EM) programs for their NRMP match list. A human cadaver emergency procedure lab curriculum is uncommon. We hypothesized that the presence this curriculum would positively impact the ranking of an EM residency program.

Clinical predictors of injuries not identified by focused abdominal sonogram for trauma (FAST) examinations.

This study's objective was to identify clinical characteristics of patients with a blunt traumatic injury that increased the risk of peritoneal or pericardial fluid collections and abdominal organ injuries not identified by a bedside focused abdominal sonogram for trauma (FAST) examination. This observational study used a retrospective chart review of a cohort of patients identified through a query of the University of Nebraska Medical Center's trauma registry, a tertiary referral center for portions of Nebraska, Iowa, and Missouri. Adult patients presenting to the Emergency Department (ED) for an evaluation of blunt traumatic injury from September 1996 to December 2002 were eligible if their ED course included admission to the trauma service after completion of a bedside FAST examination (US) and a confirmatory study (Conf) such as an abdominopelvic computed tomography scan or exploratory laparotomy within 12 h of completion of the ED FAST examination.

Cervical infections in emergency department patients with vaginal bleeding.

Unlabelled: To the best of the authors' knowledge, no previous study has compared the prevalences of Chlamydia trachomatis (CT) or Neisseria gonorrhoeae (NG) cervical infection among pregnant and non-pregnant patients presenting to the emergency department (ED) with vaginal bleeding.

Objectives: To determine the prevalence of these infections in a simultaneously assembled cohort, and to determine whether pregnancy is associated with altered rates of CT or NG cervical infection among patients with vaginal bleeding.

Methods: This was a prospective, seven-month, cross-sectional study of a convenience sample of patients (aged > or = 15 years) who presented to an urban, teaching ED with the chief complaint of vaginal bleeding.