Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To evaluate the evidence for interventions designed to improve outcomes for elders discharged from the emergency department (ED). ⋯ A significant number of programs to improve outcomes for elders discharged from the ED exist, but few have been systematically examined. Development of interventions to improve the care of elder patients following ED visits requires further research into system and patient-centered factors that impact health care delivery in this situation.
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Comparative Study
The contribution of the subjective component of the Canadian Pulmonary Embolism Score to the overall score in emergency department patients.
Clinicians frequently use their experience to determine the pretest probability of pulmonary embolism (PE), although scoring systems are promoted as being more reliable. The Canadian Pulmonary Embolism Score (CPES) combines six objective questions and one subjective question. The CPES has been validated and appears to be useful for risk-stratifying patients. However, research suggests that subjective gestalt performs similarly to the CPES, and the influence of the subjective question on the predictive value of the CPES is not clear. ⋯ The predictive value of the CPES appears to be derived primarily from its subjective component.
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To determine the availability of emergency contraception (EC) in Massachusetts emergency departments (EDs) and to identify patient, hospital, and system factors that could affect access to EC. ⋯ There was significant variability in access to EC in Massachusetts EDs and in services for sexual assault survivors. Hospital type and provider preference affected availability. This study suggests that access to EC is limited, and that there are not consistent services for women seeking EC, including for victims of sexual assault.
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Comparative Study
Prevalence of anemia in children presenting with apparent life-threatening events.
Anemia has been associated with apparent life-threatening events (ALTEs) in children. However, the nature of the association has not been well described. ⋯ Anemia is common in pediatric patients with recurrent ALTEs. Patients with recurrent ALTEs are older and have lower Hb, MCH, and MCV values than patients with a single ALTE and age-matched control patients. Significantly lower MCH and MCV values in patients with recurrent ALTEs suggest that iron deficiency may be associated with the recurrence of events.