Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Impact of scribes on performance indicators in the emergency department.
The objective was to quantify the effect of scribes on three measures of emergency physician (EP) productivity in an adult emergency department (ED). ⋯ In this retrospective study, EP use of a scribe was associated with improved overall productivity as measured by patients treated per hour (Pt/hr) and RVU generated per hour by EPs, but not as measured by TAT to discharge.
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Multicenter Study Comparative Study
Effect of mandated nurse-patient ratios on patient wait time and care time in the emergency department.
The objective was to evaluate the effect of mandated nurse-patient ratios (NPRs) on emergency department (ED) patient flow. ⋯ In these two EDs, throughput measures of WT and EDCT were shorter when the ED nurse staffing were within state-mandated levels, after controlling for ED census and patient acuity.
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This review examines the prevalence of intra-abdominal injuries (IAI) and the negative predictive value (NPV) of an abdominal computed tomography (CT) in children who present with blunt abdominal trauma. ⋯ The rate of IAI after blunt abdominal trauma with negative CT in children is low. Abdominal CT has a high NPV. The review shows that it might be safe to discharge a stable child home after a negative abdominal CT.
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Randomized Controlled Trial
Heat or cold packs for neck and back strain: a randomized controlled trial of efficacy.
Acute back and neck strains are very common. In addition to administering analgesics, these strains are often treated with either heat or cold packs. The objective of this study was to compare the analgesic efficacy of heat and cold in relieving pain from back and neck strains. The authors hypothesized that pain relief would not differ between hot and cold packs. ⋯ The addition of a 30-minute topical application of a heating pad or cold pack to ibuprofen therapy for the treatment of acute neck or back strain results in a mild yet similar improvement in the pain severity. However, it is possible that pain relief is mainly the result of ibuprofen therapy. Choice of heat or cold therapy should be based on patient and practitioner preferences and availability.
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The objective was to examine the effectiveness of corticosteroid treatment for the relief of pain associated with acute pharyngitis potentially caused by group A beta-hemolytic Streptococcus (GABHS). ⋯ Corticosteroid administration for acute pharyngitis was associated with a relatively small effect in time to clinically meaningful pain relief (4.5-hour reduction) and in pain relief at 24 hours (0.9-point reduction), with significant heterogeneity in the pooled results. Decision-making should be individualized to determine the risks and benefits; however, corticosteroids should not be used as routine treatment for acute pharyngitis.