Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial
44-55-66-PM, a mnemonic that improves retention of the Ottawa Ankle and Foot Rules: a randomized controlled trial.
Studies have suggested that poor knowledge of the Ottawa Ankle Rules (OAR) limits its clinical impact. This study evaluated the ability of a mnemonic to improve knowledge of the OAR. ⋯ Mid-term knowledge of the OAR drastically improved for all participants of the study. The use of the mnemonic 44-55-66-PM was associated with a better long-term knowledge of the OAR among medical students and residents. The improvement in knowledge of the OAR among the control group highlights the importance of using controlled trials for studies evaluating knowledge transfer.
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The 2007 Academic Emergency Medicine (AEM) consensus conference "Knowledge Translation in Emergency Medicine" yielded a number of initiatives in both education and research that directly reflected the conference's published objectives and recommendations. One research initiative, CONCERT, is a national consortium of chronic obstructive pulmonary disease (COPD) investigators who set forth an effort designed to optimize COPD care through the identification of gaps between research and practice in diagnosis and management of the chronic and acute care aspects of this disease. In addition to CONCERT, educational programs designed to identify barriers to evidence implementation and to develop solutions to achieve uptake through multidisciplinary collaboration have emerged that reflect the impact of the consensus conference. This article describes these initiatives and highlights the potential for future innovative opportunities.
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In the setting of acute ST-segment elevation myocardial infarction (STEMI), reperfusion therapy with emergent primary percutaneous coronary intervention (PCI) significantly reduces mortality. It is unknown whether a hospital's performance on the Centers for Medicare & Medicaid Services (CMS) quality metric for time from patient arrival to angioplasty is associated with its overall hospital acute myocardial infarction (AMI) mortality rate. ⋯ Hospitals with the highest and second highest quartiles of time-to-PCI quality measure had a significantly lower overall AMI mortality rate than the lowest quartile hospitals. Despite the fact that a minority of all patients with AMI get an emergent primary PCI, hospitals that perform this more efficiently also had a significantly lower mortality rate for all their patients admitted with AMI. The time-to-PCI quality measure in 2006 was a potentially important proxy measure for overall AMI quality of care.
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A decision support tool may guide emergency clinicians in recognizing assessment, analgesic and overall management, and health service delivery needs for patients with sickle cell disease (SCD) in the emergency department (ED). We aimed to identify data and process elements important in making decisions regarding evaluation and management of adult patients in the ED with painful episodes of SCD. ⋯ Participants identified several areas that are important in the assessment, management, and disposition decisions that may help guide best practices for SCD patients in the ED setting.
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Emergency departments (EDs) see a high number of youths injured by violence. In Ontario, the most common cause of injury for youths visiting EDs is assault. Secondary prevention strategies using the teachable moment (i.e., events that can lead individuals to make positive changes in their lives) are ideal for use by clinicians. An opportunity exists to take advantage of the teachable moment in the ED in an effort to prevent future occurrences of injury in at-risk youths. However, little is known about perceptions of youths, parents, and community organizations about such interventions in EDs. The aims of this study were to engage youths, parents, and frontline community workers in conceptualizing a hospital-based violence prevention intervention and to identify outcomes relevant to the community. ⋯ This study has been the springboard for the development of an ED-based youth violence intervention that is supported by the community and affected youth. Using information generated by youth that is grounded in their experience through participatory research methods is feasible for the development of successful and meaningful youth violence prevention interventions.