Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The purpose of this study was to determine the fraction of children with acute appendicitis who had recent false-negative diagnoses and to analyze the association of a missed diagnosis of appendicitis with patient outcome. ⋯ Of children diagnosed with appendicitis, 4.8% may have had a missed opportunity for earlier diagnosis. These false-negative diagnoses are associated with higher rates of perforation, postoperative complications, and need for postoperative interventions, as well as longer hospitalizations.
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Comparative Study Clinical Trial
Emergency ultrasound-assisted examination of skin and soft tissue infections in the pediatric emergency department.
The objective was to evaluate the test characteristics of clinical examination (CE) with the addition of bedside emergency ultrasound (CE+EUS) compared to CE alone in determining skin and soft tissue infections (SSTIs) that require drainage in pediatric patients. ⋯ For clinically evident lesions, the addition of ultrasound (US) did not significantly improve the already highly accurate CE for diagnosing lesions requiring drainage in this study population. However, there were many lesions that were not clinically evident, and in these cases, US may improve the accuracy of the CE.
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Comparative Study
Computer-facilitated review of electronic medical records reliably identifies emergency department interventions in older adults.
An estimated 14% to 25% of all scientific studies in peer-reviewed emergency medicine (EM) journals are medical records reviews. The majority of the chart reviews in these studies are performed manually, a process that is both time-consuming and error-prone. Computer-based text search engines have the potential to enhance chart reviews of electronic emergency department (ED) medical records. The authors compared the efficiency and accuracy of a computer-facilitated medical record review of ED clinical records of geriatric patients with a traditional manual review of the same data and describe the process by which this computer-facilitated review was completed. ⋯ A practical, non-resource-intensive, computer-facilitated free-text medical record review was completed and was more efficient and accurate than manually reviewing ED records.
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The purpose of this study was to describe the epidemiology of bicycle-related injuries presenting to United States emergency departments (EDs). ⋯ The study identified the characteristics of bicycle-related injuries across various age groups of riders. This information will aid in developing more effective age-appropriate injury prevention strategies. The frequency of MVC-related injuries deserves attention and suggests the need to examine strategies for limiting interactions between moving vehicles and bicyclists.