Although the mean intubation times between the groups were not significantly different, the overall success rate was significantly higher in the standard uniform group when compared with PPE group. The perceived difficulty rating was also noted to be significantly higher in the PPE group when compared with the standard uniform group.
Mumps is a rare pathology often not encountered in the emergency department setting. It is an especially unusual finding in a fully immunized individual. We present a case of a 26-year-old Army active duty male who was evaluated in the emergency department for mumps over the course of two visits. The military population is presumed fully immunized and immunocompetent, travels widely and often lives in close quarters. This case highlights the importance for providers to consider such a disease that carries a risk of significant morbidity, and rarely, mortality. A literature review was performed evaluating mumps in the vaccinated population.
Vertebral artery dissection is of special clinical importance because of its often-delayed presentation and the risk of potentially permanent neurological deficit, or even death, as a result of injury. Once a rarely discovered injury, the better availability and use of computed tomography and magnetic resonance imaging have contributed to an increased incidence. Early diagnosis and treatment can almost eliminate the threat of acute cerebral vascular injury and save lives. In this report, we review a case of delayed traumatic vertebral artery dissection and discuss the key clinical findings and management strategies.
of whom also satisfied the NIAID/FAAN criteria. The interrater agreement between allergists was substantial (k ¼ 0.70). Test characteristics of the NIAID/FAAN criteria for the diagnosis of anaphylaxis compared to the reference standard of the allergists' diagnosis are shown in the Table. Conclusion: NIAID/FAAN criteria are very sensitive (93%) when applied to ED patients with allergic symptoms compared to the reference standard of an allergist's diagnosis. However, only about half of patients who met NIAID/FAAN criteria were determined to have anaphylaxis. In the ED setting, high sensitivity is preferred over high specificity to prevent underrecognition and a missed opportunity to provide an epinephrine autoinjector and follow-up referral. Thus, the NIAID/FAAN diagnostic criteria are a useful screening tool in the ED but refinement may be necessary to further improve their clinical utility.
simulation 88% vs 67% of BA; CL verbal 62% vs 44% of BA; LP simulation 100% vs 67% of BA; verbal 100% vs 80% of BA). Conclusion: Our data suggest that a simulation-based assessment technique may provide a more robust assessment of ongoing physician competence in medical procedures than verbal assessment. Additionally, above average checklist performance appears to correlate with higher expert rater confidence regarding physician proficiency. Using a simulated setting for assessment may provide a better assessment of physician proficiency in the same environment where remedial training may be immediately provided.
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