Articles: hospital-emergency-service.
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Arch Orthop Trauma Surg · Aug 2022
Comparative StudyHigher sensitivity with the lever sign test for diagnosis of anterior cruciate ligament rupture in the emergency department.
The objective of this study was to assess the diagnostic value of the "lever sign test" to diagnose ACL rupture and to compare this test to the two most commonly used, the Lachman and anterior drawer test. ⋯ When investigating acute ACL ruptures (< 8 days) in the ED, the lever sign test offers a sensitivity of 92.5%, far superior to that of other well-known clinical tests. The lever sign test is relatively pain-free, easy to perform and its visual interpretation requires less experience. Positive lever sign test at the ED should lead to an MRI to combine high clinical sensitivity with high MRI specificity.
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It is well documented that disparities in patient care based on race and ethnicity are prevalent in the emergency medical care setting. In most cases these evaluations are patient focused and outcome based. The timeliness of patient treatment in the emergency department (ED) is correlated with patient outcomes. In this study, we sought to evaluate whether the timeliness of care for patients with chest pain across stages of care was impacted by patient race. ⋯ Black patients have longer wait times for resident physician evaluation, advanced practice provider evaluation, attending physician evaluation, and ED disposition when presenting to the ED with chest pain.
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Spending on emergency department (ED) services in recent years has increased faster than spending in any other area of healthcare. Analyzing growth rates of ED treatment costs by patient and hospital attributes may illuminate ways to reduce overall hospital cost growth. Prior studies have examined changes in ED visit charges and expenditures over time, but little research has focused on changes in ED treatment costs. ⋯ By highlighting overall ED cost trends, as well as specific segments of the delivery system with the most rapidly increasing costs, this study provides important information for policymakers and hospital decisionmakers.