Can J Emerg Med
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ABSTRACTObjective:To determine the influence of early pain relief for patients with suspected appendicitis on the diagnostic performance of surgical residents. Methods:A prospective randomized, double-blind, placebo-controlled trial was conducted for patients with suspected appendicitis. The patients were randomized to receive placebo (normal saline intravenous [IV]) infusions over 5 minutes or the study drug (morphine 5 mg IV). ⋯ The perforation rates in each group were also similar (18.9% in the placebo group and 14.3% in the pain control group, p = 0.75). Receiver operating characteristic analysis revealed that the overall diagnostic accuracy in each group was similar (the area under the curve of the placebo group and the pain control group was 0.63 v. 0.61, respectively, p = 0.81). Conclusions:Early pain control in patients with suspected appendicitis does not affect the diagnostic performance of surgical residents.
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ABSTRACTObjective:Postdischarge emergency department (ED) communication with family physicians is often suboptimal and negatively impacts patient care. We designed and piloted an online notification system that electronically alerts family physicians of patient ED visits and provides access to visit-specific laboratory and diagnostic information. ⋯ Introduction of a web-based ED visit communication tool improved ED-family physician communication. The impact of this system on improved continuity of care, timeliness of follow-up, and reduced duplication of investigations and referrals requires additional study.