Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Description and evaluation of a pilot physician-directed emergency medical services diversion control program.
To describe the characteristics and feasibility of a physician-directed ambulance destination-control program to reduce emergency department (ED) overcrowding, as measured by hospital ambulance diversion hours. ⋯ A voluntary, physician-directed destination-control program that directs EMS units to the ED most able to provide appropriate and timely care is feasible. Patients were redirected to maximize continuity of care and optimally use available emergency health care resources. This type of program may be effective in reducing overcrowding.
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Randomized Controlled Trial
Out-of-hospital auricular acupressure in elder patients with hip fracture: a randomized double-blinded trial.
Auricular acupressure is known to decrease the level of anxiety in patients during ambulance transport. The purpose of this randomized, double-blind, sham control study was to determine whether auricular acupressure can decrease not only the level of anxiety but also the level of pain in a group of elder patients with acute hip fracture. ⋯ The authors encourage physicians, health care providers, and emergency rescuers to learn this easy, noninvasive, and inexpensive technique for its effects in decreasing anxiety and pain during emergency transportation.
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Confirmation bias is a pitfall in emergency care and may lead to inaccurate diagnoses and inappropriate treatments and care plans. Because of the increasing severity and volume of emergency care, emergency physicians often must rely on heuristics, such as rule-out protocols, as a guide to diagnosing and treating patients. ⋯ Clinicians should recognize confirmation bias as a potential pitfall in medical decision making in the emergency department. Reliance on the scientific method, Bayesian reasoning, metacognition, and cognitive forcing strategies may serve to improve diagnostic accuracy and improve patient care.