Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To describe the consistency of a cosmetic scale for repaired lacerations and to determine whether the appearance of lacerations at the time of suture removal correlates with the appearance six to nine months later. ⋯ For our clinicians, the six-item categorical scale appears consistent as a tool for the assessment of the cosmetic appearance of wounds. However, correlation between laceration appearance at the time of suture removal and six to nine months later is poor.
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Clinical Trial Controlled Clinical Trial
Use of radiography in acute knee injuries: need for clinical decision rules.
To study: 1) the efficiency of the current use of radiography in acute knee injuries, 2) the judgments and attitudes of experienced clinicians in their use of knee radiography, and 3) the potential for decision rules to improve efficiency. ⋯ Emergency physicians order radiography for most patients with acute knee injuries, even though they can accurately discriminate between fracture and nonfracture cases and expect most of the radiographs to be normal. These findings suggest great potential for more efficient use of knee radiography, possibly through the use of a clinical decision rule.
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Practice Guideline Guideline
Ethics of emergency department triage: SAEM position statement. SAEM Ethics Committee (Society for Academic Emergency Medicine).
Emergency department overcrowding, the growth of managed care, and the high cost of emergency care are creating pressures to triage patients away from U. S. EDs. ⋯ S. health care system. The SAEM Ethics Committee evaluated the ethical implications of policies that triage patients out of the ED prior to complete evaluation and treatment. The committee used these implications to develop practical guidelines, which are reported.
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Randomized Controlled Trial Comparative Study Clinical Trial
Infiltration pain and local anesthetic effects of buffered vs plain 1% diphenhydramine.
To compare the levels of infiltration pain and local anesthetic effects of plain and buffered 1% diphenhydramine. ⋯ In a study with a sample size large enough to detect an 11-mm difference in VAS scores (power = 80%), no difference was found in pain of infiltration and anesthetic effects when plain 1% diphenhydramine was compared with buffered 1% diphenhydramine. Buffering of diphenhydramine does not appear to result in a clinically significant reduction in the pain of infiltration.