The objective of the study is to assess the impact of emergency department (ED) intimate partner violence (IPV) counseling and resource referrals on patient-perceived safety and safety planning. ED patients with risk factors were offered consultation with trained IPV advocacy counselors who completed safety assessments, provided resource referrals, and helped patients develop safety plans. Patients were contacted after ED intervention to assess progress and further assist in IPV counseling. Over 96% of patients perceived an increase in their safety after the intervention, and approximately 50% had completed a portion of their safety plan. Legal assistance and/or law enforcement were considered the most beneficial resource referrals. Although follow-up was limited, this study appears to demonstrate that an ED IPV intervention program may be useful in helping IPV victims achieve safer living environments and access local resources.
Objective: To determine the accuracy of a syringe esophageal detector device (EDD) for detecting esophageal intubations in an out‐of‐hospital setting.Methods: Prospective, observational study of adult (age ≥18 years) patients intubated by paramedics from October 1993 through May 1994 in an urban emergency medical services (EMS) system. Paramedics were instructed to record the EDD reading after endotracheal tube placement. However, paramedics were instructed not to modify their tube locations based on the EDD reading. Tube placement was evaluated by a physician upon patient arrival at a local ED.Results: Paramedics performed 374 intubations during the study period, and in 213, the EDD was used. Of these 213 patients, 45 were excluded from analysis (32—tube placement not confirmed, 11—paramedic uncertain of EDD reading, 2—too young). In the remaining 168 intubations, the EDD correctly identified 5 of 10 esophageal intubations (sensitivity 50%; 95% CI: 19%, 81%). The EDD correctly identified 156 of 158 tracheal intubations (specificity 99%; 95% CI: 96%, 100%).Conclusions: In this paramedic field study, the EDD demonstrated poor sensitivity for esophageal intubations. Further EMS studies of the EDD are needed to clarify the value of the device in out‐of‐hospital emergent clinical intubations.
The ability to buy a gun and access to a loaded gun within 3 hours are relatively common among ED adolescent patients. Having a gun in the home and witnessing a gun at school were independent predictors of the ability to access a loaded gun within 3 hours. Gang membership and drug use were associated with a self-reported ability to buy a gun.
Summary
To the authors' knowledge, this case is unique to the emergency medicine literature. Although testicular infarction from epididymitis is rare, it should be considered as a complication of severe or unresolving epididymitis. These patients should be Dlaced on broad spectrum antibiotcs, i.e., quinolones; color flow Dopp‐er of the testes should be obtained; md urologic consultation should be onsidered for possible admission ind surgical exploration.
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