Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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There is limited information on the financial implications of an emergency department ultrasound (ED US) program. The authors sought to perform a fiscal analysis of an integrated ED US program. ⋯ Determining an ROI is a required procedure for any business plan for establishing an ED US program. Our analysis demonstrates that an ED US program that captures charges for trauma and procedural US and achieves the potential billing volume breaks even in less than 5 years, at which point it would generate a positive margin.
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The principles of evidence-based medicine are applicable to all areas and professionals in health care. The care provided by paramedics in the prehospital setting is no exception. The Prehospital Evidence-based Protocols Project Online (PEP) is a repository of appraised research evidence that is applicable to interventions performed in the prehospital setting and is openly available online. This article describes the history, current status, and potential future of the project. ⋯ This project directly meets recent recommendations to improve EMS by using evidence to support interventions and incorporating it into protocols. Organizing and grading the evidence allows medical directors and paramedics to incorporate research findings into their daily practice. As such, this project demonstrates how knowledge translation can be conducted in EMS.
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Accurate adjustment for injury severity is needed to evaluate the effectiveness of trauma management. While the choice of injury coding scheme used for modeling affects performance, the impact of combining coding schemes on performance has not been evaluated. The purpose of this study was to use Bayesian logistic regression to develop models predicting hospital mortality in injured children and to compare the performance of models developed using different injury coding schemes. ⋯ Mortality models that incorporate additional injury coding schemes perform better than those based on ICD-9 codes alone in the setting of pediatric trauma. Combining injury coding schemes may be an effective approach for improving the predictive performance of empirically derived estimates of injury mortality.