Annals of emergency medicine
-
WHAT IS ALREADY KNOWN ON THIS TOPIC: The Centers for Disease Control and Prevention recommends that HIV screening be incorporated into routine care unless patients opt out, but most emergency departments (EDs) have not adopted routine screening. WHAT QUESTION THIS STUDY ADDRESSED: Will patients accept routine HIV testing in the ED without separate written consent or traditional pre- and posttest counseling? WHAT THIS STUDY ADDS TO OUR KNOWLEDGE: In this survey, 81% were willing to receive free HIV testing in the ED, but many required explanation of opt-out testing. ⋯ Nevertheless, screening is unlikely to be adopted in busy EDs unless payment and workload issues can be resolved. The yield of routine ED screening may be low in most settings.
-
Historical Article
The many faces of MRSA: community-acquired infection knows no bounds.
-
The Centers for Disease Control and Prevention (CDC) recently released revised recommendations for HIV testing in health care settings, calling for the performance of nontargeted opt-out HIV screening, the integration of informed consent for HIV testing into the general consent for medical care, and the uncoupling of prevention counseling and testing. It is unclear, however, whether patients will understand opt-out screening or be satisfied with integration of the consent for HIV testing into the general medical consent or the uncoupling of counseling from testing. The objective of this study is to evaluate patients' acceptance of the CDC's revised recommendations in an urban emergency department (ED). ⋯ A large proportion of ED patients appear willing to be screened for HIV infection in accordance with the CDC's revised recommendations for HIV testing in health care settings. Similar proportions were willing to be tested when opt-out or opt-in screening strategies were used; however, a significantly greater proportion required explanation of opt-out screening.
-
Routine ECG testing is recommended in the evaluation of syncope, although the value of such testing in young patients is unclear. For ECG testing, we assess the diagnostic yield (frequency that ECG identified the reason for syncope) and predictive accuracy for 14-day cardiac events after an episode of syncope as a function of age. ⋯ ECG testing in patients younger than 40 years did not reveal a cardiac cause of syncope and was associated with a significant frequency of abnormal ECG findings unrelated to syncope. Although our findings should be verified in larger studies, it may be reasonable to defer ECG testing in younger patients who have a presentation consistent with a benign cause of syncope.