Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To describe and compare national trends in ED use by statistical analyses on data from the 1992 to 1996 National Hospital Ambulatory Medical Care Survey (NHAMCS) with a special interest in factors related to nonurgent visits. ⋯ Analyses of data from the NHAMCS identify trends in ED use. The study of nonurgent ED visits with this database has inherent methodologic problems such as retrospective coding and geographic coding inconsistency. Since the nonurgent visit is clearly linked to certain social-demographic factors, addressing these underlying issues by establishing a comprehensive health care system is a priority.
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Comparative Study
The effects of acute and chronic alcohol ingestion on outcome following multiple episodes of mild traumatic brain injury in rats.
Recent studies suggest that in some circumstances, alcohol intoxication at the time of severe head injury may be neuroprotective. The objective of this study was to determine the effect of acute and chronic alcohol ingestion on outcome in rodents sustaining multiple episodes of mild traumatic brain injury while intoxicated. ⋯ The injured intoxicated CA animals had a more rapid recovery of reflexes compared with the injured intoxicated NA animals. Despite initial MWM deficits, the injured NA rodents eventually began to learn the MWM. The injured CA rats never learned the maze. Under the conditions of this study, acute alcohol intoxication at the time of multiple episodes of minor head trauma did not provide neuroprotection for NA or CA rodents.
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To determine whether a geographic information system (GIS) and historical transport data can be used to create a map that identifies locations (zones) from which either ambulance or helicopter transport will result in shorter out-of-hospital times. ⋯ A GIS and historical transport data can be used to create a map identifying locations from which either helicopter or ambulance transport will minimize out-of-hospital time. Inappropriate choice of transport mode is associated with increased out-of-hospital time.
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This article seeks to provide readers with a framework to enable them to assess the quality of the published description or evaluation of a triage system. Similarities between the triage process and the process of diagnosis and the nature of clinical decision rules are noted. Criteria that triage evaluations should meet are recommended, based on methodology suggested from evidence-based medicine, the development of clinical decision rules, and evaluation of diagnostic tests.