Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To describe a new chief-complaint categorization schema, the development of a computer text-parsing algorithm to automatically classify free-text chief complaints into this schema, and use of these coded chief complaints to describe the case mix of a community emergency department (ED). ⋯ The CCC-EDS is a new comprehensive, granular, and useful classification schema for categorizing chief complaints in an ED. A CCC-EDS text-parsing algorithm successfully classified the majority of free-text chief complaints from an ED computer log. These coded chief complaints were used to describe the case mix of a community teaching-hospital ED.
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Patients without a history of diabetes mellitus may be incidentally found to be hyperglycemic in the emergency department (ED). If the hyperglycemia is due to undiagnosed diabetes, then an opportunity for detection exists. Hemoglobin A1c (HbA1c) provides a weighted average of blood glucose levels over the past several months; high HbA1c levels could indicate diabetes. The objective of this study was to determine whether hyperglycemia in ED patients without a history of diabetes was associated with higher HbA1c levels. ⋯ Elevated HbA1c levels are found in ED patients with elevated random plasma glucose values. ED patients with hyperglycemia may warrant referral for diabetes testing.
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To determine if blood cultures identify organisms that are not appropriately treated with initial empiric antibiotics in hospitalized patients with community-acquired pneumonia, and to calculate the costs of blood cultures and cost savings realized by changing to narrower-spectrum antibiotics based on the results. ⋯ Appropriate empiric antibiotics were administered in all bacteremic patients. Antibiotic regimens were rarely changed based on blood culture results, and the potential savings from changes were minimal.
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As part of the Outcome Project of the Accreditation Council for Graduate Medical Education, training programs are required to evaluate trainees across six general competencies. Assessment of the patient-care competency by direct observation can be supplemented with a quantification of overall experience through the use of case logs. However, manual entry of information into such registries frequently is incomplete. ⋯ Specific examples of use of the case log are provided. The authors use a pediatric emergency medicine fellowship as a paradigm to demonstrate the potential utility across all emergency medicine training programs. In addition, the authors discuss how additional information technologies might be incorporated to further these evaluative efforts in the future.