Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Review
Effectiveness and Safety of Short-stay Units in the Emergency Department: A Systematic Review.
Overcrowding is a serious and ongoing challenge in Canadian hospital emergency departments (EDs) that has been shown to have negative consequences for patient outcomes. The American College of Emergency Physicians recommends observation/short-stay units as a possible solution to alleviate this problem. However, the most recent systematic review assessing short-stay units shows that there is limited synthesized evidence to support this recommendation; it is over a decade old and has important methodologic limitations. The aim of this study was to conduct a more methodologically rigorous systematic review to update the evidence on the effectiveness and safety of short-stay units, compared with usual care, on hospital and patient outcomes. ⋯ Insufficient evidence exists to make conclusions regarding the effectiveness and safety of short-stay units, compared with inpatient care.
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Topical Antibiotic Ointment Versus Silver-containing Foam Dressing for Second-degree Burns in Swine.
Second-degree burns are very common but their management is controversial. These burns may be treated with either topical antimicrobial agents or advanced occlusive dressings; however, there is no established treatment comparator for preclinical studies. This study was designed to determine which of two commonly used comparator therapies (a silver-containing advanced dressing or a topical antibiotic ointment) resulted in faster reepithelialization and less scarring. The hypothesis was that second-degree burns treated with a topical antimicrobial ointment would heal faster and with less scarring than those treated with a silver-containing occlusive foam dressing in a porcine model. ⋯ In this model of excised deep partial-thickness burns, a triple-antibiotic ointment enhanced reepithelialization and reduced scar depth and contraction compared with a silver-based foam dressing. This triple-antibiotic ointment should be considered as a control for studies evaluating novel topical burn therapies.
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The objective was to compare the rates of antimicrobial susceptibility in strains of Escherichia coli isolated from uncomplicated cystitis cases presenting to the emergency department (ED) of a tertiary care center to those reported on that institution's hospital-wide antibiogram. The hypothesis was that cases of uncomplicated cystitis presenting to the ED will exhibit higher antimicrobial susceptibility than is reported by the hospital-wide antibiogram. ⋯ The greater susceptibility of E. coli to TMP-SMX, cefazolin, and ciprofloxacin observed in this population supports the hypothesis that antimicrobial susceptibility rates in uncomplicated cystitis presenting to the ED are greater than those reported in the hospital-wide antibiogram. This could affect treatment guidelines by confirming that antimicrobials currently recommended for use in uncomplicated cystitis are more effective in this setting than currently reported by the hospital-wide antibiogram.
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The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a worldwide audience of academics and clinical practitioners. ⋯ In 2014, there were fewer total articles, but a slightly higher absolute number of articles screening in for formal scoring, when compared to the 2013 review. The number of EM development articles decreased, while the number of disaster and humanitarian response articles increased. As in prior years, the majority of articles focused on infectious diseases and trauma.
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A Preprocedural Checklist Improves the Safety of Emergency Department Intubation of Trauma Patients.
Endotracheal intubation of trauma patients is a vital and high-risk procedure in the emergency department (ED). The hypothesis was that implementation of a standardized, preprocedural checklist would improve the safety of this procedure. ⋯ Implementation of a preintubation checklist for ED intubation of trauma patients was associated with a reduction in intubation-related complications, decreased paralysis-to-intubation time, and improved adherence to recognized safety measures.