Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The goal of a global health elective is for residents and medical students to have safe, structured, and highly educational experiences. In this article, the authors have laid out considerations for establishing a safe clinical site; ensuring a traveler's personal safety, health, and wellness; and mitigating risk during a global health rotation. Adequate oversight, appropriate mentorship, and a well-defined safety and security plan are all critical elements to a successful and safe experience.
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Multicenter Study Comparative Study Clinical Trial
The use of delayed telephone informed consent for observational emergency medicine research is ethical and effective.
The objective was to describe the rate of successful consent using an altered (deferred telephone) consent process in emergency department (ED) patients. ⋯ The authors achieved a very high rate of successful telephone follow-up in this predominantly older ED population. Obtaining consent to participate in a research study using a deferred telephone contact process was effective and well received by both subjects and surrogates. IRBs should consider deferred telephone consent for minimal-risk studies requiring telephone follow-up, as opposed to a consent process requiring written documentation at the time of initial ED visit.
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Comparative Study
A survey of emergency department resources and strategies employed in the treatment of pediatric gastroenteritis.
Although leading organizations have developed gastroenteritis management guidelines, little is known about emergency department (ED) use of clinical tools to improve outcomes. Our objective was to describe pediatric gastroenteritis clinical decision tools employed in EDs in the province of Ontario and to determine if a greater number of clinical decision tools are employed in academic, high-volume institutions staffed primarily by emergency medicine (EM)-trained physicians. ⋯ Clinical decision tools designed to improve pediatric gastroenteritis management are not commonly implemented. Such strategies are more common in high-volume EDs and those staffed primarily by physicians with EM training.
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Comparative Study
Impact of seasonal and pandemic influenza on emergency department visits, 2003-2010, Ontario, Canada.
Weekly influenza-like illness (ILI) consultation rates are an integral part of influenza surveillance. However, in most health care settings, only a small proportion of true influenza cases are clinically diagnosed as influenza or ILI. The primary objective of this study was to estimate the number and rate of visits to the emergency department (ED) that are attributable to seasonal and pandemic influenza and to describe the effect of influenza on the ED by age, diagnostic categories, and visit disposition. A secondary objective was to assess the weekly "real-time" time series of ILI ED visits as an indicator of the full burden due to influenza. ⋯ Influenza appears to have had a much larger effect on ED visits than was captured by clinical diagnoses of influenza or ILI. Throughout the study period, ILI ED visits were strongly associated with excess respiratory complaints. However, the relationship between ILI ED visits and the estimated effect of influenza on ED visits was not consistent enough from year to year to predict the effect of influenza on the ED or downstream in-hospital resource requirements.
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Burns are common injuries that can result in significant scarring, leading to poor function and disfigurement. Unlike mechanical injuries, burns often progress both in depth and in size over the first few days after injury, possibly due to inflammation and oxidative stress. A major gap in the field of burns is the lack of an effective therapy that reduces burn injury progression. Because stem cells have been shown to improve healing in several injury models, the authors hypothesized that species-specific mesenchymal stem cells (MSCs) would reduce injury progression in a rat comb-burn model. ⋯ Intravenous injection of rat MSCs reduced burn injury progression in a rat comb-burn model.