Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The objective of this study was to measure the effect of scripting language at triage on the likelihood of elopements, controlling for patient volume and other potential confounding variables. ⋯ The use of triage scripting was found to significantly reduce elopement rates in patients placed in the ED waiting room, even after controlling for other confounding variables. Scripting is a simple and underutilized technique that can have a positive effect for patients and the ED.
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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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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.
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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.