Annals of emergency medicine
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This article provides information supporting the need for new outcome measures in emergency care. It also addresses the use of outcome measures in emergency care, the impact of emergency care, identification of at-risk groups, new approaches to measuring patient satisfaction, quality of life and cost-effectiveness, and the unique related implications for emergency medicine. [Cairns CB, Garrison HG, Hedges JR, Schriger DL, Valenzuela TD: Development of new methods to assess the outcomes of emergency care. Ann Emerg Med February 1998;31:166-171.].
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Comparative Study
Radiologists' review of radiographs interpreted confidently by emergency physicians infrequently leads to changes in patient management.
To determine whether radiologists' review of radiographs is unwarranted when emergency physicians are confident in their interpretations. ⋯ Of 9,599 sets of radiographs interpreted confidently by the emergency physicians in this study, there were 11 clinically significant discordant interpretations (0.1%). The standard practice of radiologists' review of all ED radiographs may not be justifiable.
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The 1994 basic-EMT (EMT-B) curriculum recommended teaching EMT-Bs the skill of endotracheal intubation. In this study we assessed the success and complication rates of endotracheal intubations in the field by EMT-Bs. ⋯ EMT-Bs trained in a short course successfully intubated about half the patients they encountered in this study. This low intubation success rate calls into question the validity of the endotracheal-intubation training module in the 1994 EMT-B national curriculum. [Sayre MR, Sakles JC, Mistler AF, Evans JL, Kramer AT, Pancioli AM: Field trial of endotracheal intubation by basic EMTs. Ann Emerg Med February 1998;31:228-233.].
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The long-term goals of developing research within the specialty of emergency medicine include the following: (1) to continue to improve the quality and quantity of emergency patient care; (2) to maximize the research potential of emergency health care professionals to develop new emergency research talent and enthusiasm; and (3) to establish the academic research credentials of the specialty of emergency medicine to become competitive for federal research funding, and further improve emergency patient care. This article addresses the process by which the infrastructure for emergency medicine research can be developed at academic medical centers and provides recommendations. The roles of the academic chair, research director, senior researcher, and departmental faculty are discussed.
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Comparative Study
Interrater reliability of cervical spine injury criteria in patients with blunt trauma.
To determine the interrater reliability of previously defined risk criteria for cervical spine injury. ⋯ The combined cervical spine injury criteria have substantial interrater reliability. Individual criteria are slightly less reliable.