The American journal of emergency medicine
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We sought to examine racial and ethnic disparities in test positivity rate and mortality among emergency department (ED) patients tested for COVID-19 within an integrated public health system in Northern California. ⋯ We report a significant disparity in COVID-19 adjusted test positivity rate and crude mortality rate among Latinx and Black patients, respectively. Results from ED-based testing can identify racial and ethnic disparities in COVID-19 testing, test positivity rates, and mortality associated with COVID-19 infection and can be used by health departments to inform policy.
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Comparative Study Observational Study
Using Canadian CT head rule in a developing nation: Validation and comparing utilisation by emergency physicians and neurosurgeons.
The objective of this study was to test the validity of the Canadian CT Head rule (CCHR) in cases of minor traumatic brain injury (TBI) in an Indian emergency department (ED). A secondary objective was to compare of the patterns of neuroradiology references between the emergency physician (EP) and the neurosurgeon. ⋯ The CCHR has 100% sensitivity as a screening tool for patients requiring CT brains in case of TBI though the specificity is found to be rather low (45.8%). EPs show a higher level of awareness and inclination to use CDRs in cases of minor TBI to direct the decision for neuro-radiology, in comparison to neurosurgeons. ED residents reported comfort in mobile application based usage of the rule.
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Multicenter Study Observational Study
Weather and temporal models for emergency medical services: An assessment of generalizability.
Emergency medical services (EMS) response volume has been linked to weather and temporal factors in a regional EMS system. We aimed to identify if models of EMS utilization incorporating these data are generalizable through geographically disparate areas in the United States. ⋯ With minor differences, regional models demonstrated consistent associations between dispatches and time and weather variables. Findings demonstrate the generalizability of associations between these variables with respect to EMS use. Weather and temporal factors should be considered in predictive modeling to optimize EMS staffing and resource allocation.
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Comparative Study
Antibiotic prescribing patterns for adult urinary tract infections within emergency department and urgent care settings.
Urinary tract infections (UTI) are a common reason for emergency department (ED) and urgent care (UC) visits. Fluoroquinolones (FQ) are frequently prescribed for treatment of UTI in the outpatient setting; however, data evaluating prescribing patterns after FDA safety warnings is limited, especially in UC. The study goal was to investigate and compare antimicrobial prescribing for UTIs in a single-site ED and an off-site UC in an urban, academic health system. ⋯ Predictors of FQ prescribing on logistic regression were male, recurrent UTI, and malignancy. FQ prescribing rate for UTI treatment was low with no difference between ED and UC. Opportunity exists to improve treatment duration and antimicrobial choice.
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Comparative Study
Comparison of physician-staffed helicopter with ground-based emergency medical services for trauma patients.
Few studies have discussed whether physician-staffed helicopter emergency medical services (HEMS) provide temporal and geographical benefits for patients in remote locations compared to ground emergency medical services (GEMS). Our study seeks to clarify the significance of HEMS for patients with severe trauma by comparing the mortality of patients transported directly from crash scenes by HEMS or GEMS, taking geographical factors into account. ⋯ HEMS may provide equal treatment opportunities and minimize trauma deaths for patients transported from a greater distance to an emergency medical center compared to GEMS for patients transported from nearby regions.