An ultrafast brain MRI technique for evaluating acute neurologic deficits in the emergency department.

Herein we share our preliminary experience with an ultrafast brain MRI technique for use in the ED consisting of axial T1-weighted (40 s), axial T2-weighted (62 s), axial diffusion-weighted (80 s), axial FLAIR (96 s), axial T2* (6 s), and axial susceptibility-weighted (108 s) imaging for a total scan time of 6 min and 53 s. Utilization of this ultrafast technique yields an efficient assessment of the brain, decreases ED length of stay and inpatient observation admissions, and may obviate the need for vascular imaging with either CTA or MRA in the ED.

Communicating end-of-life preferences.

The purpose of this survey was to explore how adults communicate their end-of-life preferences. Face-to-face interviews were conducted with 119 community-dwelling adults who had previously engaged in conversations about their end-of-life preferences. Factors that made it easier to initiate the discussion included having personal experience with illness or death (24.4%), being straightforward (24.4%), or having someone else facilitate the discussion (11.8%). Most described vague end-of-life preferences such as not wanting any machines (41.2%) or heroics (34.5%). Although 22.7% reported using a living will to make their preferences clear, only 5.9% mentioned repeating or reinforcing their preferences. In all, 21% had discussed their end-of-life preferences with their physicians. These findings show discussions about end-of-life preferences frequently lack the clarity and detail needed by significant others and health care providers to honor the preferences. Routine dialogue with health care providers and significant others about end-of-life preferences might provide greater clarity and comfort.