James C Mitchiner

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Traumatic "handlebar" hernia, produced by impaction of a bicycle handlebar on the abdominal wall, is a rare entity. Presented is the case of a 7-year-old boy who sustained such a hernia, which contained an incarcerated loop of small bowel. The use of abdominal computed tomography to confirm the diagnosis before operative reduction of the hernia appears to(More)
Previous studies have reported inadequate pain control in the emergency department (ED). The primary purpose of this study was to determine the proportion of ED patients with acute fractures who actually wanted pain medication given in the ED. A convenience sample of 107 adults with acute long-bone fractures seen in a community hospital ED were surveyed on(More)
During a 12-month period, 20,838 patients with acute traumatic injuries were seen in the Emergency Department (ED) of Denver General Hospital. Of these patients, 520 (2.5%) were admitted to the ED Observation Unit, a seven-bed acute care unit situated within the ED and sufficient data were available on 485 (93%) for inclusion into the study. Fifty-three(More)
OBJECTIVE Rapid onset of sleep, brief duration of action, and ease of administration are properties that make rectal methohexital (MXT) an attractive choice for sedating stable pediatric emergency department (ED) patients for computed tomography (CT) imaging. METHODOLOGY One hundred stable patients between 3 and 60 months of age who presented to any of 3(More)
In this study, we compared large urban teaching hospitals (group 1) with small nonurban nonteaching hospitals (group 2) in terms of administering antibiotics to patients admitted with pneumonia within 4 hours of hospital arrival. The following 2 independent data sets were used: hospital-reported data (comprising 22 193 patients with pneumonia discharged(More)
The clinical findings in three patients who ingested 260-900 mg cyclobenzaprine (Flexeril) consisted of delayed onset and long duration of anticholinergic symptomatology. In two of these patients, symptoms responded to treatment with physostigmine. The third patient recovered without specific therapy. Despite its structural similarity to amitriptyline,(More)
OBJECTIVE Low back pain (LBP) is a common reason for emergency department (ED) visits. This study aimed to determine the frequency and type of nonindicated imaging during LBP ED visits and to describe demographic and prior health care use characteristics among the nonindicated population. METHODS This study included index ED events for LBP occurring(More)
The objective of this study was to evaluate the effectiveness of a health communication campaign designed to reduce the rate of serious warfarin-related drug interactions. The B-SAFE campaign was conducted in 2009 to educate patients located in a Michigan hospital's service area about the risk of serious adverse drug events associated with warfarin. The(More)
The Emergency Medical Treatment and Active Labor Act (EMTALA) is a federal statute that should be recognized and understood by all nurses who work in an emergency department or other settings where patients with potential emergencies may present themselves for care. It is a law that imposes specific legal requirements on hospitals in terms of medical(More)