Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The objective was to estimate D-dimer interval likelihood ratios (iLRs) for diagnosing pulmonary embolism (PE). ⋯ A decision strategy based on these approximate iLRs agrees with several published strategies.
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Multicenter Study
Emergency Department Vital Signs and Outcomes after Discharge.
Vital signs are critical markers of illness severity in the emergency department (ED). Providers need to understand the abnormal vital signs in older adults that are problematic. We hypothesized that in patients age > 65 years discharged from the ED, there are abnormal vital signs that are associated with an admission to an inpatient bed within 7 days of discharge. ⋯ While we found a majority of patients discharged with abnormal vital signs as defined by the analysis, not to be admitted after discharge, we identified vital signs associated with at least twice the odds of admission.
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The objective was to characterize geriatric patients' use of online health information (OHI) relative to younger adults and assess their comfort ith OHI compared to health information (HI) from their physician. ⋯ Although many older patients used OHI, they were less likely than younger adults to use the Internet immediately prior to an ED visit. Despite often using OHI, patients of all age groups found healthcare information from their doctor easier to understand and more trustworthy than information from the Internet. As health systems work to efficiently provide information to patients, addressing these perceived deficiencies may be necessary to build effective OHI programs.
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Comparative Study
Comparing Emergency Department Patients to Inpatients Receiving a Pulmonary Embolism Response Team (PERT) Activation.
The development of pulmonary embolism response teams (PERTs) has been widely adopted nationally with the goal of providing multidisciplinary care to patients with high-risk PE. Most PERT activations originate from the emergency department (ED), while others are from the intensive care unit (ICU) or inpatient floors. It is unclear if ED PERT activations differ from non-ED PERT activation in terms of presentation, management, and outcome. ⋯ Pulmonary embolism response team activations from different clinical locations differ in terms of patient presentation, PE confirmation, treatments, and outcomes. PERTs should be customized to support the different needs of each clinical area.
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In the United States, emergency medicine (EM) researchers hold proportionately fewer federal career development awards than researchers in other specialties. Others hypothesize that this deficit may partly be attributed to lack of mentors, departmental resources, and qualified applicants. Our objectives were to examine the association between departmental and institutional resources and career development awards and to describe the barriers to conducting research and btaining grants in EM. ⋯ While more multiple departmental and institutional resources correlated with a greater number of funded career development awards, the single greatest predictor was the number of R-level-funded researchers in the department. Low motivation and insufficient mentorship were the most frequently reported barriers to junior faculty applying for career development awards. Further studies are needed to describe junior faculty perspectives on these issues and to explore strategies for overcoming these barriers.