Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Review
Mechanism of Injury and Special Considerations as Predictive of Serious Injury: A Systematic Review.
The Centers for Disease Control and Prevention's field triage guidelines (FTG) are routinely used by emergency medical services personnel for triaging injured patients. The most recent (2011) FTG contains physiologic, anatomic, mechanism, and special consideration steps. Our objective was to systematically review the criteria in the mechanism and special consideration steps that might be predictive of serious injury or need for a trauma center. ⋯ Select mechanism and special consideration criteria contribute positively to appropriate field triage of potentially injured patients.
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Observational Study
Association Between Advanced Image Ordered in the Emergency Department on Subsequent Imaging for Abdominal Pain Patients.
Abdominal pain is associated with high rates of emergency department (ED) imaging utilization and revisits. While imaging often improves diagnosis, a better understanding is needed on when the decision to image is justified and how it influences subsequent resource utilization and outcomes for patients in the ED presenting with abdominal pain. We evaluated the association between advanced ED imaging on subsequent outpatient imaging and on revisits among abdominal pain patients discharged from the ED. ⋯ Abdominal imaging in the ED was associated with significantly lower imaging utilization after discharge and 30-day revisit rates, suggesting that imaging in the ED may replace downstream outpatient imaging.
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Observational Study
Physician Gestalt for Emergency Department Triage: A Prospective Videotaped Study.
Appropriate triage in patients presenting to the emergency department (ED) is often challenging. Little is known about the role of physician gestalt in ED triage. We aimed to compare the accuracy of emergency physician gestalt against the currently used computerized triage process. ⋯ Emergency physician gestalt for triage showed similar performance to a computerized system; however, physicians redistributed patients to lower triage levels. Physician gestalt has advantages for identifying low-risk patients. This approach may avoid undue time pressure for health care providers and promote rapid discharge.