Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study Clinical Trial
Utility of base deficit for identifying major injury in elder trauma patients.
Early identification of serious injuries is especially important in elders. Base deficit (BD) is an indicator of serious injury in trauma patients. There are limited data to support the utility of BD in elders who have sustained trauma. ⋯ The preliminary data from this study indicate that in trauma patients aged 65 years and older, increased BD at emergency department arrival can predict life-threatening injury.
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Emergency department (ED) crowding has been a frequent topic of investigation, but it is a concept without an objective definition. This has limited the scope of research and progress toward the development of consistent and meaningful operational responses. ⋯ The basic pattern of ED census can be represented by a straightforward expression. This expression can be quickly adapted to a variety of inquiries regarding ED crowding, daily surge, and operational efficiency.
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To determine emergency medicine (EM) residents' perceptions and reported practices of obtaining informed consent for emergency department procedures. ⋯ Few residents have had formal training in informed consent, and there is wide variability in the perception of which procedures require informed consent. Residents are not confident in their knowledge of all risks and benefits of common procedures, and comfort levels in obtaining informed consent are low. Residents can benefit from additional resources that provide standardized information and formal training on the issue.
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To evaluate the progression in productivity of emergency medicine (EM) residents by postgraduate year, as measured by hourly work in relative value units (RVUs). ⋯ Hourly work productivity and acuity increased with experience within this ACGME-accredited EM residency. The progression in workload and acuity by PGY is measurable and commensurate with the graduated level of responsibility desired in an EM program.
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To validate the Mortality in Emergency Department Sepsis (MEDS) score, the Confusion, Urea nitrogen, Respiratory rate, Blood pressure, 65 years of age and older (CURB-65) score, and a modified Rapid Emergency Medicine Score (mREMS) in patients with suspected infection. ⋯ In this large cohort of patients with clinically suspected infection, MEDS, mREMS, and CURB-65 all correlated well with 28-day in-hospital mortality.