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3 0 A REVISED MARCH 2003 ANNALS OF EMERGENCY MEDICINE 41:3 MARCH 2003 Manuscript Submission Agreement MANUSCRIPT TITLE (PLEASE TYPE OR PRINT) AUTHORSHIP All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing, or revision of the manuscript. Additionally, the corresponding author is responsible for providing a description of each author’s contributions to the article at the end of all Original Research and Brief Research Reports (see Instructions for Authors, Manuscript Submission section). Furthermore, each author certifies that this material or similar material has not been and will not be submitted to or published in any other publication before its appearance in Annals. If this study has been or will be presented at a national meeting, indicate the appropriate information on the title page. CONFLICT OF INTEREST/FUNDING Annals makes every effort to minimize the opportunity for potential conflicts of interest by authors, reviewers, and editors. Authors are required, on submission of their manuscript, to state in writing whether or not outside funding or other form of support was received and its source, as well as whether or not they have any financial interest in the subject of their study. This information is published with the article if it is accepted. I certify that any affiliations with or involvement (eg, honoraria; education grants; speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript are disclosed below and on the title page. Please complete the following items (your responses to these questions will be published with the article if it is accepted): 1. Was any outside funding or other form of support received for this research? Yes No If yes, list the sources of support. ______________________________________________________________________________________________ 2. Do you have any financial interest in the product studied or the company that makes it? Yes No If yes, please explain that interest. _____________________________________________________________________________________________ INSTITUTIONAL REVIEW BOARD APPROVAL/INFORMED CONSENT All studies involving human or animal subjects must be approved or exempted by an institution’s human or animal subject review committee. In any research on human beings, the subject’s informed consent should be obtained, preferably in writing. State this in the Methods section. To maintain blinded peer review, do not include the name of the institution when identifying the review committee in the manuscript. Institutional review board approval or exemption from full review is noted in the Methods section of the article on page______. STATISTICAL CONSULTANT All manuscripts that contain statistics must have been prepared in consultation with an individual with expertise in the field or with a statistician. One of the authors or an outside consultant may serve in this capacity. The individual responsible for statistical analysis should be listed as an author or in the acknowledgments. Review of statistical analyses was performed by _________________________________________________________________________________________ __________________________________________________________________________________________________ (provide name and affiliation). This consultant was involved in study design data analysis manuscript preparation (check all that apply) COPYRIGHT TRANSFER The undersigned author(s) transfer all copyright ownership to the American College of Emergency Physicians (ACEP), in the event that the work is published in any medium. In the case of authors who are officers or employees of the US government, ACEP recognizes that works prepared by officers or employees of the US government, as part of their official government duties, are in the public domain. Authors reserve all proprietary rights (other than copyright) including patent rights relating to the subject matter of the article and the right for personal use in lectures, lecture notes, and exhibits. For all other uses, authors must seek written permission from ACEP and the publisher, Mosby, Inc. AGREEMENT By means of signature below, the undersigned author(s) signifies acceptance of the terms and conditions listed above. (NOTE: All authors must sign this form or a copy of this form. The corresponding author must provide an original signature; signed copies or facsimile copies are acceptable for the other authors. These forms must be on file in the Annals’ office before the manuscript is processed.) For additional guidelines, see the Instructions for Web-Based Submission. _______________________________________________________________________________________________________________________ Signature (Corresponding Author) Print Name (Corresponding Author) Date _______________________________________________________________________________________________________________________ Signature Print Name Date _______________________________________________________________________________________________________________________ Signature Print Name Date _______________________________________________________________________________________________________________________ Signature Print Name Date Fax and mail this signed form to: Editor in Chief, Annals of Emergency Medicine, PO Box 619911, Dallas, TX 75261-9911; or 1125 Executive Circle, Irving, TX 75038, Fax 972-580-0051. Annals of Emergency Medicine is owned by the American College of Emergency Physicians and is published monthly by Mosby, Inc.

Manuscript Submission Agreement

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Manuscript Submission AgreementM A N U S C R I P T T I T L E ( P L E A S E T Y P E O R P R I N T )

A U T H O R S H I P

All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibilityfor the content, including participation in the concept, design, analysis, writing, or revision of the manuscript. Additionally, the corresponding author is responsible forproviding a description of each author’s contributions to the article at the end of all Original Research and Brief Research Reports (see Instructions for Authors,Manuscript Submission section). Furthermore, each author certifies that this material or similar material has not been and will not be submitted to or published in anyother publication before its appearance in Annals. If this study has been or will be presented at a national meeting, indicate the appropriate information on the titlepage.

C O N F L I C T O F I N T E R E S T / F U N D I N G

Annals makes every effort to minimize the opportunity for potential conflicts of interest by authors, reviewers, and editors. Authors are required, on submission of theirmanuscript, to state in writing whether or not outside funding or other form of support was received and its source, as well as whether or not they have any financialinterest in the subject of their study. This information is published with the article if it is accepted.

I certify that any affiliations with or involvement (eg, honoraria; education grants; speakers’ bureaus; membership, employment, consultancies, stock ownership, orother equity interest; and expert testimony or patent-licensing arrangements) in any organization or entity with any financial interest in the subject matter or materialsdiscussed in this manuscript are disclosed below and on the title page.

Please complete the following items (your responses to these questions will be published with the article if it is accepted):1. Was any outside funding or other form of support received for this research? ❒ Yes ❒ No

If yes, list the sources of support. ______________________________________________________________________________________________2. Do you have any financial interest in the product studied or the company that makes it? ❒ Yes ❒ No

If yes, please explain that interest. _____________________________________________________________________________________________

I N S T I T U T I O N A L R E V I E W B O A R D A P P R O V A L / I N F O R M E D C O N S E N T

All studies involving human or animal subjects must be approved or exempted by an institution’s human or animal subject review committee. In any research onhuman beings, the subject’s informed consent should be obtained, preferably in writing. State this in the Methods section. To maintain blinded peer review, do notinclude the name of the institution when identifying the review committee in the manuscript. Institutional review board approval or exemption from fullreview is noted in the Methods section of the article on page______.

S T A T I S T I C A L C O N S U L T A N T

All manuscripts that contain statistics must have been prepared in consultation with an individual with expertise in the field or with a statistician. One of the authorsor an outside consultant may serve in this capacity. The individual responsible for statistical analysis should be listed as an author or in the acknowledgments. Reviewof statistical analyses was performed by ___________________________________________________________________________________________________________________________________________________________________________________________ (provide name and affiliation).This consultant was involved in ❒ study design ❒ data analysis ❒ manuscript preparation (check all that apply)

C O P Y R I G H T T R A N S F E R

The undersigned author(s) transfer all copyright ownership to the American College of Emergency Physicians (ACEP), in the event that the work is published in anymedium. In the case of authors who are officers or employees of the US government, ACEP recognizes that works prepared by officers or employees of the USgovernment, as part of their official government duties, are in the public domain. Authors reserve all proprietary rights (other than copyright) including patent rightsrelating to the subject matter of the article and the right for personal use in lectures, lecture notes, and exhibits. For all other uses, authors must seek writtenpermission from ACEP and the publisher, Mosby, Inc.

A G R E E M E N T

By means of signature below, the undersigned author(s) signifies acceptance of the terms and conditions listed above. (NOTE: All authors must sign this form or acopy of this form. The corresponding author must provide an original signature; signed copies or facsimile copies are acceptable for the other authors. These formsmust be on file in the Annals’ office before the manuscript is processed.) For additional guidelines, see the Instructions for Web-Based Submission.

_______________________________________________________________________________________________________________________Signature (Corresponding Author) Print Name (Corresponding Author) Date

_______________________________________________________________________________________________________________________Signature Print Name Date

_______________________________________________________________________________________________________________________Signature Print Name Date

_______________________________________________________________________________________________________________________Signature Print Name Date

Fax and mail this signed form to: Editor in Chief, Annals of Emergency Medicine, PO Box 619911, Dallas, TX 75261-9911; or 1125 Executive Circle, Irving, TX75038, Fax 972-580-0051. Annals of Emergency Medicine is owned by the American College of Emergency Physicians and is published monthly by Mosby, Inc.