Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study Clinical Trial
Can clinical parameters predict fractures in acute pediatric wrist injuries?
Fractures around the wrist are common in pediatric patients presenting to the emergency department (ED). This pilot study was aimed at identifying clinical variables that are most likely to be associated with a fracture. ⋯ Distal radius point tenderness and a 20% or more decrease in grip strength were predictive of fractures.
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Clinical Trial
Early discharge of patients with presumed opioid overdose: development of a clinical prediction rule.
To develop a clinical prediction rule to identify patients who can be safely discharged one hour after the administration of naloxone for presumed opioid overdose. ⋯ This prediction rule for safe early discharge of patients with presumed opioid overdose performs well in this derivation set but requires validation followed by confirmation of safe implementation.
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To determine the prevalence and assess documentation by emergency department (ED) physicians (EPs) of impaired mental status in elderly ED patients. ⋯ Impairment in mental status is highly prevalent among older ED patients. Lack of documentation and referrals by EPs suggests lack of recognition of these problems. Further education of physicians is needed to improve care in these areas.
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To determine the accuracy of POCT quality control testing of an ED maintained ABG Analyzer (Gem Premier)-Instrumentation Laboratory). ⋯ ED attendings are capable of quality control maintenance of an ABG analyzer as a POCT device under the quality control testing parameters set forth by the College of American Pathologists.
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Comparative Study
Maximizing the sensitivity and specificity of pediatric trauma team activation criteria.
Care of the severely injured child requires the rapid assembly of personnel trained in pediatric trauma care. Trauma team activation criteria, which are highly sensitive and maximally specific for identifying the child who requires resuscitation, are necessary to provide rapid care to all who need it, while using resources efficiently. ⋯ Criteria for TTA that include patients who meet mechanism criteria only are not specific for identifying patients who receive a resuscitative intervention. Use of anatomic and physiologic criteria only results in an increase in specificity, thereby reducing overtriage while retaining a high sensitivity.