Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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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 primary individual research career development awards for emergency medicine (EM) investigators are the K08 and K23 awards. To the best of the authors' knowledge, postaward productivity of EM K08 and K23 awardees has not been previously described. The objectives were to describe EM researchers who have received K08 or K23 awards and to evaluate their postaward federal funding and publications. ⋯ Over 40% of EM K awardees who completed their career development training subsequently obtained federal funding as principal investigator (PI) or co-PI, while approximately one in six obtained R01 equivalent funding. Given the numerous barriers facing emergency care researchers, EM K awardees demonstrate good postaward productivity.
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Emergency medical services (EMS) personnel commonly use systolic blood pressure (sBP) to triage and treat acutely ill patients. The definition of prehospital hypotension and its associated outcomes are poorly defined. The authors sought to determine the discrimination of prehospital sBP thresholds for 30-day mortality and to compare patient classification by best-performing thresholds to traditional cutoffs. ⋯ Prehospital sBP is a modest discriminator of clinical outcomes, yet no threshold avoids substantial misclassification of 30-day mortality among noninjured patients.
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The objective was to compare readmission rates and hospital bed-days between acute decompensated heart failure (AHF) patients admitted or discharged following accelerated treatment protocol (ATP)-driven care in an emergency department observation unit (OU). ⋯ Selected acute heart failure (HF) patients managed by a rapid treatment protocol in the OU demonstrated favorable hospital use, with discharged patients using fewer bed-days and demonstrating readmission rates that were not higher than admitted patients.
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The objective of this study is to present an algorithm for improving the safety and effectiveness of transitions of care (ToC) in the emergency department (ED). ⋯ The authors present specific guidelines for an algorithm-based approach to transitioning care within the ED. This algorithm is based on surveys of perceived deficiencies and emphasizes informational and logistical parameters within a ToC. Standardizing the process of the ToC may allow for future research on the link between effective ToC and patient outcomes.