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Cervical spine injuries, although uncommon (0.9-6% of blunt trauma patients), (1-5) have the potential to result in permanent neurologic devastation for the patient. Appropriate suspicion for cervical spine injury, immobilization, [...]

Dealing with potential cervical spine injuries (CSIs) is a frequent occurrence for any physician who manages trauma patients. The importance of the routine practice of clearing the cervical spine should [...]

* Objective To survey the directors of emergency departments in California on their opinions of the extent and factors associated with overcrowding in emergency departments. * Methods Surveys were mailed to a random sample of emergency department directors. Questions included estimated magnitude, frequency, causes, and effects of overcrowding. * Results Of 160 directors surveyed, 113 (71%) responded, and 109 (96%) reported overcrowding as a problem. All (n = 21) university or county hospital directors and most (n = 88 [96%]) private or community hospital directors reported overcrowding. The 4 private or community hospital directors reporting no overcrowding serve smaller communities with populations less than 250,000. Thirty-two directors (28%) reported daily overcrowding. The most cited causes were increasing patient acuity and volume, hospital bed shortage, laboratory delays, and nursing shortage. These putative causes were similar between university or county and private or community hospital directors, except for consultant delays, which were more prevalent in university or county hospital emergency departments. * Conclusions Overcrowding is perceived to be a serious problem by emergency department directors. Many factors may contribute to overcrowding, and most are beyond the control of emergency departments., Summary points * Overcrowding is perceived to be a serious problem by California emergency department directors * Many factors may contribute to overcrowding, and most are beyond the control of [...]