Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
Uncovering heart failure in patients with a history of pulmonary disease: rationale for the early use of B-type natriuretic peptide in the emergency department.
Plasma B-type natriuretic peptide (BNP) can reliably identify acute congestive heart failure (CHF) in patients presenting to the emergency department (ED) with acute dyspnea. Heart failure, asthma, and chronic obstructive pulmonary disease (COPD) are syndromes where dyspnea and wheezing are overlapping signs, and hence, these syndromes are often difficult to differentiate. ⋯ The yield of adding routine BNP testing in patients with a history of asthma or COPD in picking up newly diagnosed CHF is approximately 20%. This group of patients presents a substantial therapeutic opportunity for the initiation and chronic administration of ACEI and BB therapy, as well as other CHF management strategies.
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The Research Agenda Setting Process (RASP), part of the American Geriatric Society's (AGS's) project "Increasing Geriatric Expertise in Surgical and Related Medical Specialties," was designed to define a research agenda for the geriatrics aspects of participating specialties. This paper presents a summary of the research agenda for emergency medicine. ⋯ A research agenda for geriatric emergency medicine has been developed, using a combination of review of current literature and expert opinion.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Rapid two-stage emergency department intervention for seniors: impact on continuity of care.
A two-stage intervention comprising screening and a brief standardized nursing assessment and referral, for emergency department (ED) patients aged 65 years and over, reduced the rate of functional decline four months after the visit, without increasing societal costs. In this study, the authors investigated the effects of the intervention on the process of care at, and during the month after, the ED visit. ⋯ The beneficial outcomes of the intervention appear to result primarily from the early provision of home care rather than early contact with the primary physician.
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Randomized Controlled Trial Comparative Study Clinical Trial
Nebulized fentanyl for relief of abdominal pain.
To compare the efficacies of nebulized vs. intravenous fentanyl for the relief of abdominal pain. ⋯ Nebulized fentanyl provides comparable analgesia to that of intravenous fentanyl.
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Multicenter Study
A brief risk-stratification tool to predict repeat emergency department visits and hospitalizations in older patients discharged from the emergency department.
To evaluate the predictive ability of a simple six-item triage risk screening tool (TRST) to identify elder emergency department (ED) patients at risk for ED revisits, hospitalization, or nursing home (NH) placement within 30 and 120 days following ED discharge. ⋯ Older ED patients with two or more risk factors on a simple triage screening tool were found to be at significantly increased risk for subsequent ED use, hospitalization, and nursing home admission.