Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Multicenter Study
Evaluation of a novel wound closure device: a multicenter randomized controlled trial.
A novel wound closure device combining a mesh tape and octylcyanoacrylate (OCA) topical skin adhesive (TSA) was developed to facilitate wound closure and enhance the adhesive's strength. The objective of this study was to determine whether the incidence of wound dehiscence after laceration repair with the new device was equivalent to that after use of a high-viscosity OCA. We hypothesized that the rate of complete wound edge apposition would be equivalent for the two closure devices. ⋯ When compared with OCA alone, the novel tape-OCA combination is equivalent with regard to complete wound edge apposition and cosmetic appearance.
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Most multisource feedback (MSF) evaluations are performed asynchronously, with raters reflecting on the subject's behavior. Numerous studies have demonstrated poor inter-rater reliability of MSF. This may be due to cognitive biases that are inherent in such a process. We sought to determine if within- and between-rater group reliability is increased when evaluations are gathered synchronously and relate to a specific patient interaction. ⋯ Synchronous collection of MSF did not provide clinically different EM-HS scores within rater groups and did not result in improved correlations. Our small, single-center study supports asynchronous collection of MSF.
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Randomized Controlled Trial
A randomized trial of computer kiosk-expedited management of cystitis in the emergency department.
The objective was to assess the efficiency and safety of an interactive computer kiosk module for the management of uncomplicated urinary tract infections (UTI) in emergency departments (EDs). ⋯ An interactive computer kiosk accurately, efficiently, and safely expedited the management of women with uncomplicated UTI in a busy, urban ED. Expanding the use of this technology to other conditions could help to improve ED patient flow.
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Comparative Study
Anterior versus lateral needle decompression of tension pneumothorax: comparison by computed tomography chest wall measurement.
Recent research describes failed needle decompression in the anterior position. It has been hypothesized that a lateral approach may be more successful. The aim of this study was to identify the optimal site for needle decompression. ⋯ With commonly available angiocatheters, the lateral approach is less likely to be successful than the anterior approach. The anterior approach may fail in many patients as well. Longer angiocatheters may increase the chances of decompression, but would also carry a higher risk of damage to surrounding vital structures.
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The purpose of this study was to describe the associations between individual health insurance and ambulance utilization using a national sample of patients who receive emergency department (ED) care. ⋯ Ambulance use varies by health insurance status. Medicaid coverage and lack of insurance are each independently associated with increased odds of ambulance use, suggesting a disproportionate role for emergency medical services (EMS) in the care of patients with limited financial resources.