Articles: emergency-services.
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Multicenter Study Comparative Study
Asthma audit: a multicentre pilot study.
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Multicenter Study Comparative Study
Emergency-department diagnosis of acute myocardial infarction and ischemia: a cost analysis of two diagnostic protocols.
To assess the potential cost savings of the emergency-department (ED) diagnosis of acute myocardial infarction (AMI) and other myocardial ischemia using a nine- hour ED evaluation protocol. ⋯ At both centers, hospital charges related to the acute evaluation of chest pain were significantly lower with this ED diagnostic protocol for AMI and myocardial ischemia.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Prehospital-initiated vs hospital-initiated thrombolytic therapy. The Myocardial Infarction Triage and Intervention Trial.
To determine the effect of prehospital-initiated vs hospital-initiated treatment of myocardial infarction on clinical outcome. ⋯ There was no improvement in outcome associated with initiating treatment before hospital arrival; however, treatment within 70 minutes of symptom onset--whether in the hospital or in the field--minimized the infarct process and its complications.
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Multicenter Study
Missed diagnoses of acute myocardial infarction in the emergency department: results from a multicenter study.
To determine the rate of missed acute myocardial infarction (AMI) in the emergency department and the factors related to missed diagnoses. ⋯ The rate of missed AMI in the ED was only 1.9%. However, 25% of these might have been prevented had ST-elevation not been missed, and another 25% might have been prevented had patients who were recognized to have ischemic heart disease by the physician in the ED been admitted.
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To assess the timing of key decisions and clinical events in the treatment of acute myocardial infarction with thrombolytic therapy. ⋯ Thrombolytics should be stocked and started in the ED. Emergency physicians should generally make the decision to administer thrombolytic therapy with reference to accepted protocols without awaiting an ED consultation from either private attendings or cardiologists.