Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Clinical Trial
A randomized controlled trial of mist in the acute treatment of moderate croup.
To determine whether the use of mist improves clinical symptoms in children presenting to the emergency department (ED) with moderate croup. ⋯ Mist therapy is not effective in improving clinical symptoms in children presenting to the ED with moderate croup.
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Ethnic and racial differences in the provision of emergency department (ED) analgesia for long-bone fractures have recently been reported in two large cities. The authors sought to determine, in a third city, whether nonwhite patients with long-bone fractures were less likely to receive analgesics than white patients with similar injuries. ⋯ In contrast to two recently reported studies, at this urban trauma center and teaching hospital ED, there was no difference in the administration of analgesics to white and nonwhite patients with long-bone fractures.
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The emergency department (ED) and HIV specialty clinics are primary sources of care for persons infected with HIV. HIV disease may be complicated by vague and complex symptomatology, and determining the degree of illness at triage is often difficult. The goals of this project were to characterize the ED presentation of HIV-related conditions, to develop a clinical decision rule to triage HIV-infected patients, and to validate the rule in clinical practice. ⋯ The Clinical Triage Instrument was not sufficiently accurate for clinical use. Until accurate and reliable triage methods are developed, all patients infected with HIV who present to the ED for care should receive timely evaluation and care.
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Comparative Study
Adverse cardiac events in emergency department patients with chest pain six months after a negative inpatient evaluation for acute coronary syndrome.
To evaluate the impact of the diagnostic test setting-inpatient versus outpatient-on adverse cardiac events (ACEs) after six months in emergency department (ED) patients with chest pain who were admitted to the hospital and subsequently had a negative evaluation for acute coronary syndrome (ACS). ⋯ Long-term cardiac morbidity of patients after a negative ACS evaluation may be higher than previously thought. Risk of ACE is significantly higher in subjects scheduled for outpatient diagnostic tests. Inpatient diagnostic testing is justified for subjects at risk for poor compliance.
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To examine whether dissatisfaction with one's usual source of care (USC) and perceived access difficulties to one's USC were associated with nonurgent emergency department (ED) use. ⋯ Patients who are dissatisfied with their USC or perceive access barriers to their USC are more likely to have a nonurgent ED visit.