The western journal of emergency medicine
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The U. S. national out-of-hospital and in-hospital cardiac arrest survival rates, although improving recently, have remained suboptimal despite the collective efforts of individuals, communities, and professional societies. ⋯ The reality of current approaches to sudden cardiac arrest is that they are often lacking an integrative, multi-disciplinary approach, and without deserved funding and outcome analysis. In this manuscript, a multidisciplinary group of authors propose practice, process, technology, and policy initiatives to improve cardiac arrest survival with a focus on neurologic function.
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Randomized Controlled Trial
Randomized trial of a novel ACLS teaching tool: does it improve student performance?
Mounting evidence suggests that high-fidelity mannequin-based (HFMBS) and computer-based simulation are useful adjunctive educational tools for advanced cardiac life support (ACLS) instruction. We sought to determine whether access to a supplemental, online computer-based ACLS simulator would improve students' performance on a standardized Mega Code using high-fidelity mannequin based simulation (HFMBS). ⋯ The reduction in time to defibrillate ventricular fibrillation and to pace symptomatic bradycardia among the intervention group subjects suggests that the online computer-based ACLS simulator is an effective adjunctive ACLS instructional tool.
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Multicenter Study Observational Study
Impact of a health information exchange on resource use and Medicare-allowable reimbursements at 11 emergency departments in a midsized city.
Use clinician perceptions to estimate the impact of a health information exchange (HIE) on emergency department (ED) care at four major hospital systems (HS) within a region. Use survey data provided by ED clinicians to estimate reduction in Medicare-allowable reimbursements (MARs) resulting from use of an HIE. ⋯ Observational data provided by ED clinicians practicing at eleven EDs in a mid-sized Southeastern city showed an average reduction in MARs of $1,947 per patient who had information available in an HIE. The majority of reduced MARs were due to avoided radiology studies and hospital admissions. Over 80% of participants reported that quality of care was improved and valuable time was saved.
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Comparative Study
Learning curves for direct laryngoscopy and GlideScope® video laryngoscopy in an emergency medicine residency.
Our objective is to evaluate the resident learning curves for direct laryngoscopy (DL) and GlideScope® video laryngoscopy (GVL) over the course of an emergency medicine (EM) residency training program. ⋯ Over the course of residency training there was no significant improvement in EM resident first pass success with the DL, but substantial improvement with the GVL.
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Clinical Trial
Pilot study of ultrasound-guided corticosteroid hip injections by emergency physicians.
Our objective was to assess the efficacy of ultrasound-guided hip injections performed by emergency physicians (EPs) for the treatment of chronic hip pain in an outpatient clinic setting. ⋯ Under the supervision of an attending EP, junior emergency medicine resident physicians can safely and effectively inject hips for chronic pain relief in an outpatient clinical setting using ultrasound guidance.