Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
Multicenter Study
Classification of Cardiopulmonary Resuscitation Chest Compression Patterns: Manual Versus Automated Approaches.
New chest compression detection technology allows for the recording and graphical depiction of clinical cardiopulmonary resuscitation (CPR) chest compressions. The authors sought to determine the inter-rater reliability of chest compression pattern classifications by human raters. Agreement with automated chest compression classification was also evaluated by computer analysis. ⋯ In this study, good inter-rater agreement in the manual classification of CPR chest compression patterns was observed. Automated classification showed strong agreement with human ratings. These observations support the consistency of manual CPR pattern classification as well as the use of automated approaches to chest compression pattern analysis.
-
Randomized Controlled Trial
Emergency Department-triggered Palliative Care in Advanced Cancer: Proof of Concept.
The American College of Emergency Physicians and the American Society of Clinical Oncology recommend early palliative care consultation for patients with advanced, life-limiting illnesses, such as metastatic cancer. ⋯ This study documented a low baseline rate of palliative care involvement as part of usual care in patients with advanced cancer being admitted from the ED. Early referral to palliative care in the context of a research study significantly increased the likelihood that patients received a consult, thus meriting further investigation of how to generalize this approach.
-
The objective was to describe transfers out of hospital-based emergency departments (EDs) in the United States and to identify different characteristics of sending and receiving hospitals, travel distance during transfer, disposition on arrival to the second hospital, and median number of transfer partners among sending hospitals. ⋯ Among high-transfer conditions in U.S. EDs, patients are often transferred great distances, more commonly to large teaching hospitals with greater resources. The large number of transfer partners indicates a possible lack of stable transfer relationships between U.S. hospitals.
-
In this study, the objective was to characterize emergency department (ED) transfer relationships and study the factors that predict the stability of those relationships. A metric is derived for ED transfer relationships that may be useful in assessing emergency care regionalization and as a resource for future emergency medicine research. ⋯ United States EDs that transfer patients to other hospitals often have multiple transfer partners. The stability of the transfer relationship, assessed by the transfer instability index, differs by condition. Less stable transfer relationships (i.e., hospitals with greater numbers of transfer partners) were more common in EDs with higher proportions of publicly insured patients.