The American journal of emergency medicine
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Observational Study
Prognostic value of lactate in prehospital care as a predictor of early mortality.
Prehospital Emergency Medical Services must attend to patients with complex physiopathological situations with little data and in the shortest possible time. The objective of this work was to study lactic acid values and their usefulness in the prehospital setting to help in clinical decision-making. ⋯ The level of lactic acid can be a complementary tool in the field of prehospital emergencies that will guide us early in the detection of critical patients.
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Multicenter Study Observational Study
A study of time saved by emergency medicine physicians through working with clinical pharmacists in the emergency department.
To describe quantitatively the impact on physician efficiency when an Emergency Medicine Clinical Pharmacist (EMCP) is available to Emergency Department (ED) physicians while working under a collaborative care agreement in a Michigan-based Health System. ⋯ EMCPs in the ED save physicians a significant amount of time per shift, and categorically the most time saved was in fielding general questions, time spent with critically ill patients, and following up on urine cultures. The time saved by physicians could translate into more patients seen per shift.
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Observational Study
Effect of hypoxia on mortality and disability in traumatic brain injury according to shock status: A cross-sectional analysis.
This study aimed to test the association between hypoxia level and outcomes according to shock status in traumatic brain injury (TBI) patients. ⋯ There was a trend toward worsened outcomes with mild and severe hypoxia in patient with and without shock, however, the only met statistical significance for patients with both severe hypoxia and non-shock status.
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Observational Study
The effect of practice settings on individual Doctor Press Ganey scores: A retrospective cohort review.
The Press Ganey (PG) survey is a patient experience survey mailed to patients upon discharge from the emergency department (ED). It is a nationally recognized survey that is commonly used to measure patient's perception of the healthcare delivered. Emergency medicine physicians at Staten Island University Hospital staff two distinct sites: a tertiary-care setting (SIUH-N) and a community setting (SIUH-S). The goal of our study was to compare the effect of different ED practice settings, within the same hospital and healthcare system, on individual attending physician PG scores. ⋯ Variables other than the individual doctor may be influencing the PG survey responses and perceptions of care. The PG survey may underestimate the impact of different practice settings on individual doctor PG scores.
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Non-contrast magnetic resonance imaging (MRI) and ultrasound studies in pediatric patients with suspected appendicitis are often non-diagnostic. The primary objective of this investigation was to determine if combining these non-diagnostic imaging results with white blood cell (WBC) cutoffs improves their negative predictive values (NPVs). ⋯ In pediatric patients with suspected appendicitis, MRI studies with incomplete visualization of a normal appendix without secondary signs have a high NPV that does not significantly change with the use of these WBC cutoffs. In contrast, combining WBC cutoffs with ultrasound studies with the same interpretation identifies low-risk groups.