Can J Emerg Med
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Randomized Controlled Trial Multicenter Study
Predictors Of admission to hospital of patients triaged as nonurgent using the Canadian Triage and Acuity Scale.
To identify factors known prior to triage that might have predicted hospital admission for patients triaged by the Canadian Triage Acuity Scale (CTAS) as level 5 (CTAS 5, nonurgent) and to determine whether inappropriate triage occurred in the admitted CTAS 5 patients. ⋯ Most of the CTAS 5 patients who were subsequently admitted to hospital may have qualified for a higher triage category. Two potential modifiers, age over 65 and arrival by ambulance, may have improved the prediction of admission in CTAS 5 patients. However, the consistent application of existing CTAS criteria may also be important to prevent incorrect triage.
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Traumatic dislocation of the elbow is rare in children and can most often be managed in the emergency department using procedural sedation and closed reduction with good functional outcome. Radiographs must be evaluated for associated avulsions and fractures around the elbow. We present the case of a 14-year-old girl who sustained a fracture of the radial neck subsequent to repeated attempts at closed reduction of a pure posterior elbow dislocation that was missed on postreduction radiographs. Careful use of reduction techniques and avoidance of repeated forceful manipulations is emphasized.
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Randomized Controlled Trial
Photodocumentation as an emergency department documentation tool in soft tissue infection: a randomized trial.
Current documentation methods for patients with skin and soft tissue infections receiving outpatient parenteral anti-infective therapy (OPAT) include written descriptions and drawings of the infection that may inadequately communicate clinical status. We undertook a study to determine whether photodocumentation (PD) improves the duration of outpatient treatment of skin and soft tissue infections. ⋯ PD as an intervention is acceptable to patients and has reasonable endorsement by the majority of physicians. This trial had significant limitations that threatened the integrity of the study, so the results are inconclusive.
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The objectives of this study are to determine the prevalence, risk factors, and time to onset of delayed hemothorax and pneumothorax in adults who experienced a minor blunt thoracic trauma. ⋯ The presence of at least one rib fracture between the third and ninth rib on the x-ray of the hemithorax is a significant risk factor for delayed hemothorax and pneumothorax.