Emergency medicine journal : EMJ
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Meta Analysis
Clinical predictors of fracture in patients with shoulder dislocation: systematic review of diagnostic test accuracy studies.
Prereduction radiographs are conventionally used to exclude fracture before attempts to reduce a dislocated shoulder in the ED. However, this step increases cost, exposes patients to ionising radiation and may delay closed reduction. Some studies have suggested that prereduction imaging may be omitted for a subgroup of patients with shoulder dislocations. ⋯ Clinical prediction rules may have a role in supporting shared decision making after shoulder dislocation, particularly in the prehospital and remote environments when delay to imaging is anticipated.
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Medical errors are a global concern, and specifically, EDs are at considerable risk for medical errors. Few studies focus on the healthcare provider's self-perceived medical errors in hospitals, let alone the ED. Hence, this study explored perceived medical errors and their correlation with work-related factors and personal distress among physicians in EDs in China. ⋯ Self-perceived medical errors are prevalent among physicians working in EDs and are associated with their workplace environment and personal distress. Targeted interventions are required to reduce physicians' workload and improve their working environment. Accounting for healthcare providers' distress is imperative for reducing the incidence of medical errors and improving their health.
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Comment Letter Randomized Controlled Trial Multicenter Study
Letter to the editor: Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department: a non-inferiority multicentre randomised controlled trial.
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Benign paroxysmal positional vertigo (BPPV) is a common presentation to the ED. Evidence suggests low adherence to guideline-recommended care, but the reasons underlying this are poorly understood. This study used the theoretical domains framework (TDF) to explore the barriers and facilitators to medical and physiotherapy clinical practices in the management of BPPV in an Australian metropolitan ED. ⋯ Several modifiable barriers and facilitators to the management of BPPV in the ED have been identified. Differences were observed between the professional groups, and these findings will guide a future intervention to improve the use of guideline-recommended assessment and treatment techniques for BPPV in ED.