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the ethical analysis of emergency triage with care ethics and also revised the manuscript. YD guided to design the ethical analysis, contributed on the distributive justice and revised the manuscript at this website several stages of preparation. All authors read and approved the final manuscript. Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/11/16/prepub Acknowledgements The authors are grateful to Prof. Peter Campion (University of Hull, United Kingdom) Inhibitors,research,lifescience,medical for reviewing the paper from a medical perspective and offering assistance in language matters.
During recent decades, emergency medicine research has continued to expand in scope and increasingly focuses not only on immediate patient outcomes but also on patient outcomes well beyond emergency department (ED) departure. Inception cohort studies examining long term outcomes among patients experiencing acute illness or trauma Inhibitors,research,lifescience,medical benefit from enrolling patients in the ED because it is the site of their initial care. In addition, for many patients the ED serves Inhibitors,research,lifescience,medical as their only source of care [1,2]. For these reasons, an increasing number of large scale multidisciplinary research projects have utilized ED-based inception cohorts to evaluate long term outcomes after screening, risk stratification, or
interventions performed in the ED [3-8]. This report describes the methods of Project CRASH, an example of a type of ED-based inception cohort study which we anticipate will become increasingly common in the future. Project CRASH uses an ED-based inception cohort to enroll patients soon after injury, and examines genetic factors associated with long
term patient outcomes. A prior study examined genetic variations in alcohol metabolism as a risk factor for trauma Inhibitors,research,lifescience,medical center admission [9], but to our knowledge no studies have used ED-based inception cohorts to examine genetic characteristics associated with long term patient outcomes in the hope of advancing understanding of Inhibitors,research,lifescience,medical disease pathophysiology. The goal of Project CRASH is to gain new insights into the pathophysiology of persistent pain and psychological sequelae after motor vehicle collision (MVC). Approximately 6 million people present to United States EDs each year for care after MVC. More than 90% of these individuals do not have serious physical injury and are discharged MRIP to home after ED evaluation [10]. However, persistent post-MVC pain (most commonly neck pain) is experienced by 10-20% of individuals after “minor” MVC [11,12] with significant associated economic cost [13]. The mechanisms by which patients develop acute and chronic pain after minor MVC remain poorly understood [14]. Interestingly, increasing evidence suggests that stress systems, such as the sympathetic nervous system and adrenomedullary hormonal system, may modulate neurosensory processing after trauma exposure, contributing to the development of chronic pain [15].