Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine the consistency of responses to a standardized 2-part "key" question (Key-Q) about acute symptom onset in patients presenting with chest pain when measured using alternative questions (Qs) about symptom perception and decisions to seek treatment. ⋯ The Key-Q elicited a response recalled near the time of first symptoms and generally before the patient had concluded something was "wrong or that he or she was ill." Measurement of the out-of-hospital delay in chest pain patients using the Key-Q appears promising.
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To determine the short-term medical outcome of hypoglycemic insulin-dependent diabetic patients who refuse transport after out-of-hospital therapy and return to baseline mental status. ⋯ The practice of treating and releasing most hypoglycemic insulin-dependent diabetic patients who return to normal mental status after D50W administration appears in general to be safe. Patients should be advised of the risks of recurrent hypoglycemia.
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To determine patient recall and understanding of instructions given to patients who refuse transport after initial paramedic assessment and medical treatment. ⋯ A substantial proportion of patients refusing transport do not recall receiving verbal or written instructions and would reconsider their transport decision, raising doubts about people's ability to make informed decisions at a time of great vulnerability. The majority of patients accessed health care after refusing transport and 6% were hospitalized.
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An important argument for emergency physician use of ultrasonography is that it results in more rapid patient disposition, but there are few articles to support this position. This study sought to demonstrate a significant decrease in the time spent in the ED when emergency physicians performed transvaginal ultrasonography (TVUS), as compared with when TVUS was performed by consultants, in the evaluation of first-trimester pelvic pain or vaginal bleeding. ⋯ This study demonstrates a more rapid ED transit time when TVUS was performed at the bedside by emergency physicians as compared with when pelvic ultrasonography required consultation. Additionally, fewer calls to consultants were required.
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To examine the population and geographic patterns, patient characteristics, and clinical presentations and outcomes of alcohol-related ED visits at a national level. ⋯ Alcohol abuse poses a major burden on the emergency medical care system. The age, gender, and geographic characteristics of alcohol-related ED visits are consistent with drinking patterns in the general population.