Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
Multicenter Study
Lack of agreement in pediatric emergency department discharge diagnoses from clinical and administrative data sources.
Diagnosis information from existing data sources is used commonly for epidemiologic, administrative, and research purposes. The quality of such data for emergency department (ED) visits is unknown. ⋯ ED diagnoses retrieved from electronic administrative sources and manual chart review frequently disagree, even if similar diagnosis codes are grouped. Agreement varies by institution and by diagnosis. Further work is needed to improve the accuracy of diagnosis coding; development of a grouping system specific to pediatric emergency care may be beneficial.
-
Randomized Controlled Trial Comparative Study
Can untrained laypersons use a defibrillator with dispatcher assistance?
Automated external defibrillators (AEDs) provide an opportunity to improve survival in out-of-hospital cardiac arrest by enabling laypersons not trained in rhythm recognition to deliver lifesaving therapy. This study was performed to examine whether untrained laypersons could safely and effectively use these AEDs with telephone-guided instructions and if this action would compromise the performance of cardiopulmonary resuscitation (CPR) during a simulated ventricular fibrillation out-of-hospital cardiac arrest. ⋯ The quality of dispatcher-assisted CPR is poor. Dispatcher assistance in defibrillation by a layperson not trained to use an AED seems feasible and does not compromise the performance of CPR.
-
Comparative Study
Prospective study of the clinical features and outcomes of emergency department patients with delayed diagnosis of pulmonary embolism.
The authors hypothesized that emergency department (ED) patients with a delayed diagnosis of pulmonary embolism (PE) will have a higher frequency of altered mental status, older age, comorbidity, and worsened outcomes compared with patients who have PE diagnosed by tests ordered in the ED. ⋯ In this single-center study, the diagnosis of PE was frequently delayed and outcomes of patients with delayed diagnosis were worse than those of patients with PE diagnosed in the ED.
-
Randomized Controlled Trial
Determination of the effect of in vitro time, temperature, and tourniquet use on whole blood venous point-of-care lactate concentrations.
The authors sought to determine the effect of in vitro time, temperature, and removable tourniquet use on changes in venous point-of-care lactate concentrations. ⋯ Whole blood point-of-care lactate concentrations in healthy subjects do not change significantly over 15 minutes at either -1 degrees C or 23 degrees C, and the use of a tourniquet has no appreciable effect on lactate concentrations.