Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
Initial studies have shown improved reliability and validity of a new triage tool, the Emergency Severity Index (ESI), over conventional three-level scales at two university medical centers. After pilot implementation and validation, the ESI was revised to include pediatric and updated vital signs criteria. The goal of this study was to assess ESI version (v.) 2 reliability and validity at seven emergency departments (EDs) in three states. ⋯ ESI v. 2 triage produced reliable, valid stratification of patients across seven sites. ESI triage should be evaluated as an ED casemix identification system for uniform data collection in the United States and compared with other major ED triage methods.
-
Randomized Controlled Trial Clinical Trial
Clinically important change in the visual analog scale after adequate pain control.
To define the minimum clinically important difference (MCID) for the visual analog scale (VAS) of pain severity by measuring the change in VAS associated with adequate pain control. ⋯ A mean reduction in VAS of 30.0 mm represents a clinically important difference in pain severity that corresponds to patients' perception of adequate pain control. Defining MCID based on adequate analgesic control rather than minimal detectable change may be more appropriate for future analgesic trials, when effective treatments for acute pain exist.
-
Clinical Trial Controlled Clinical Trial
Emergency medicine subinternship: can we provide a standard clinical experience?
Medical students have varied experiences on the emergency medicine (EM) subinternship. Didactic curricula can be standardized. ⋯ Students can be directed to see patients with particular CCs. TG students saw more patients with certain CCs than CG students, p < 0.0001. This intervention can help educators provide a well-rounded, uniform clinical EM experience.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Evaluation of a new high-viscosity octylcyanoacrylate tissue adhesive for laceration repair: a randomized, clinical trial.
Tissue adhesives have recently been approved for skin closure. Their low viscosity may result in inadvertent migration. The authors compared the tendency of the adhesive to migrate after laceration closure with a high- or low-viscosity octylcyanoacrylate (OCA). ⋯ The high-viscosity OCA tissue adhesive was less likely to migrate than the lower-viscosity device. Wound dehiscence and infection rates were acceptably low in both treatment groups.
-
Multicenter Study
General competencies are intrinsic to emergency medicine training: a multicenter study.
The Accreditation Council for Graduate Medical Education (ACGME) has promulgated six areas called General Competencies (GCs) that residency programs are required to evaluate. The authors sought to determine if these domains were an intrinsic part of emergency medicine (EM) residency training by using a global assessment evaluation device. ⋯ EM residents from several residency programs showed statistically significant progressive acquisition of the ACGME GCs using a global assessment device. This suggests that the GCs may be an intrinsic component in the training of EM residents.