Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Clinical Trial
Topical tetracaine attenuates the pain of infiltration of buffered lidocaine.
To determine whether topical tetracaine attenuates the pain of buffered lidocaine infiltration. ⋯ Topical tetracaine attenuates the pain of infiltration of buffered lidocaine.
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Multicenter Study
A multisite survey of factors contributing to medically unnecessary ambulance transports.
To determine the social and demographic factors associated with medically unnecessary ambulance utilization, and to determine the willingness of patients to use alternate modes of transportation to the ED. ⋯ Patient age < 40 years and Medicaid coverage were associated with medically unnecessary ambulance use. Those patients for whom ambulance use was considered medically unnecessary commonly had no alternate means of transportation. Providing alternate means of unscheduled transportation may reduce the incidence of unnecessary ambulance use.
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To determine whether out-of-hospital care charts selectively report trauma triage criteria, and the impact of such documentation on triage guideline development. ⋯ In the authors' EMS system, standard EMS report documentation underreports ACS trauma triage mechanism criteria. This underreporting appears to bias outcome analysis in the direction of a worse outcome and more resource utilization. Reporting of mechanism-of-injury criteria improves with use of a structured data instrument.
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Comparative Study Clinical Trial Controlled Clinical Trial
Subcutaneous lidocaine does not affect the success rate of intravenous access in children less than 24 months of age.
To determine whether subcutaneous lidocaine (SQL), when used to decrease the pain of IV catheter insertion, adversely affects IV access in children < 24 months of age. ⋯ SQL use prior to an IV attempt in children < 2 years of age does not impact vascular access. A secondary finding was that vascular access with and without SQL in infants and small children generally can be accomplished in 1 attempt.
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To determine the level of agreement between emergency physicians (EPs) and psychiatrists regarding the need for acute psychiatric hospitalization and treatment for patients presenting with alleged psychiatric complaints. ⋯ Moderate agreement between EPs and psychiatrists in key impressions and admission decisions suggests that shared training in psychiatric decision making, especially during residency training, is desired in this setting.