Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine the effect of simultaneous ambulance diversion at multiple emergency departments (EDs) (gridlock) on transport delays for patients with chest pain. ⋯ Ambulance diversion was associated with delays in out-of-hospital ambulance transport for chest pain patients, but only when it resulted in gridlock. The magnitude of the out-of-hospital delay was the same regardless of the patient's severity of illness.
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To use a geographic information system (GIS) and spatial statistics to describe the geographic variation of burn injuries in children 0-14 years of age in a major metropolitan area. ⋯ This study shows the utility of geographic mapping in providing information about injury patterns within a defined area. The combination of mapping injury rates and spatial statistical analysis provides a detailed level of injury surveillance, allowing for identification of small geographic areas with elevated rates of specific injuries.
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The performance of out-of-hospital systems is frequently evaluated based on the times taken to respond to emergency requests and to transport patients to hospital. The 90th percentile is a common statistic used to measure these indicators, since they reflect performance for most patients. Traditional regression models, which assess how the mean of a distribution varies with changes in patient or system characteristics, are thus of limited use to researchers in out-of-hospital care. ⋯ In other words, ambulance diversion disproportionately affects those patients who already have longer transport intervals. Second, the distribution of transport intervals, conditional on a given set of variables, is positively skewed, and not uniformly or symmetrically distributed. The flexibility of quantile regression models makes them particularly well suited to out-of-hospital research, and they may allow for more relevant evaluation of out-of-hospital system performance.
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Comparative Study
The effect of a new emergency medicine residency program on patient length of stay in a community hospital emergency department.
It is not clear how emergency medicine residents affect emergency department (ED) efficiency. The objective of this study was to determine whether a new emergency medicine residency program affected the length of stay (LOS) of patients in a community hospital ED. ⋯ In this ED, there was a weak, positive correlation between ED patient length of stay and the presence of PGY-3 emergency medicine residents.
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Comparative Study
Surveillance of infectious disease occurrences in the community: an analysis of symptom presentation in the emergency department.
To determine the effectiveness of a simulated emergency department (ED)-based surveillance system to detect infectious disease (ID) occurrences in the community. ⋯ Surveillance of ED symptom presentation has the potential to identify clinically important ID occurrences in the community 24 hours prior to HD identification. Lack of weekend HD data collection suggests that the ED is a more appropriate setting for real-time ID surveillance.