Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial
Development and implementation of an emergency practitioner-performed brief intervention for hazardous and harmful drinkers in the emergency department.
1) To develop and teach a brief intervention (BI) for "hazardous and harmful" (HH) drinkers in the emergency department (ED); 2) to determine whether emergency practitioners (EPs) (faculty, residents, and physician associates) can demonstrate proficiency in the intervention; and 3) to determine whether it is feasible for EPs to perform the BI during routine clinical care. ⋯ A BNI for HH drinkers can be successfully developed for EPs. EPs can demonstrate proficiency in performing the BNI in routine ED clinical practice.
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Randomized Controlled Trial Comparative Study
The utility of the bispectral index in procedural sedation with propofol in the emergency department.
The bispectral index (BIS) may be a useful monitor to predict the level of awareness in patients undergoing procedural sedation in the emergency department (ED). ⋯ There was a lower rate of RD when physicians had access to the BIS during procedural sedations. This difference was greater in sedations requiring multiple doses of propofol. There was no difference in the rate of RD when only a single dose was given.
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To examine factors associated with motivation to quit smoking and interest in an emergency department (ED)-based intervention. ⋯ Approximately 50% of smokers reported at least moderate interest in an ED-based intervention and a willingness to stay 15 extra minutes, but only 8% reported receiving counseling during their ED visit. Considering time and resource constraints, counseling/referral may be best suited for patients characterized by a strong desire to quit, multiple previous quit attempts, high self-efficacy, a smoking-related ED visit, and strong interest in ED-based counseling.
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Comparative Study
An electronic chart prompt to decrease proprietary antibiotic prescription to self-pay patients.
Emergency physicians unaware of patients' insurance status may prescribe expensive proprietary antibiotics for patients who cannot afford them. The objective of this study was to develop a clinical decision support system to display patient insurance status before prescription writing for outpatient conditions. ⋯ A clinical decision support system, integrated into a prescription-writing program, can decrease the prescription of proprietary antibiotics for self-pay patients in the ED.
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As demand for emergency services outpaces available allocated resources, emergency department (ED) triage systems face increasing scrutiny. Longer waits for care make the use of reliable, valid triage systems imperative to patient safety. Little is known about the reliability and validity of triage systems in children. The purpose of this study was to evaluate the reliability and validity of the Emergency Severity Index version 3 (ESIv.3) triage algorithm in a pediatric population. ⋯ The ESI triage algorithm demonstrated reliability and validity between triage assignment and resource use in this group of ED pediatric patients.