Articles: emergency-services.
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Multicenter Study
Describing resident physician productivity in a Canadian academic emergency department.
This cohort study aimed to investigate resident physician productivity in an academic emergency department (ED) and assess the impact of longitudinal coaching relationships known as clinical coaching teams and co-learners (medical students) on resident productivity. ⋯ This study is the first of its kind to describe resident physician productivity in a Canadian emergency department. The results of this study demonstrate that resident physician productivity improves with seniority, and that co-learners and clinical coaching teams do not significantly impact productivity. This information will be useful to program directors and residents to help set realistic expectations around productivity and to ED physician leads in planning service delivery for patients in the context of a training program.
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Observational Study
Diagnostic accuracy of artificial intelligence for identifying systolic and diastolic cardiac dysfunction in the emergency department.
Cardiac point-of-care ultrasound (POCUS) can evaluate for systolic and diastolic dysfunction to inform care in the Emergency Department (ED). However, accurate assessment can be limited by user experience. Artificial intelligence (AI) has been proposed as a model to increase the accuracy of cardiac POCUS. However, there is limited evidence of the accuracy of AI in the clinical environment. The objective of this study was to determine the diagnostic accuracy of AI for identifying systolic and diastolic dysfunction compared with expert reviewers. ⋯ When compared with expert assessment, AI had high sensitivity and specificity for diagnosing both systolic and diastolic dysfunction.
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Pediatric emergency care · Dec 2024
Utility of a Smart Device Infrared Camera in Localizing Acute Pediatric Long Bone Fractures: A Pilot Study.
Musculoskeletal injuries are one of the top 10 reasons children present to the emergency department (ED). Infrared thermal imaging (IRT) is a noninvasive and nonradiating imaging modality that can detect subtle temperature differences. IRT may be used to detect the presence of musculoskeletal injury. ⋯ This pilot study shows that the use of smart device infrared camera attachments is feasible and has promising results in fracture localization. This could allow for a decrease in radiographs and be particularly useful in resource-limited areas.
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Observational Study
Safety of Diltiazem for Acute Management of Atrial Fibrillation (AF) in Patients with Heart Failure and Reduced Ejection Fraction in the Emergency Department.
Diltiazem is an effective rate control agent for atrial fibrillation with rapid ventricular rate (AF RVR). However, its negative inotropic effects may increase the risk for worsening heart failure in patients with a reduced ejection fraction (EF). ⋯ The development of worsening heart failure is multifactorial and may include the use of diltiazem in critically ill patients requiring hospital admission.
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This study investigated the feasibility of using the Roth score in the emergency setting to make hospitalization or discharge decisions for patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). ⋯ The Roth score (only counts) increased in discharged patients after AECOPD treatment. It appears to be a viable method for predicting hospitalization or discharge decisions in patients with AECOPD who present to the emergency department.