Annals of emergency medicine
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Review Comparative Study
Evidence-based emergency medicine. Update: do ophthalmic nonsteroidal anti-inflammatory drugs reduce the pain associated with simple corneal abrasion without delaying healing?
Some studies have suggested that ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs) decrease the pain associated with corneal abrasions without impairing healing. This evidence-based emergency medicine (EBEM) critical appraisal reviews the literature, including additional studies appearing since the publication of an earlier EBEM review in 1999. ⋯ Ophthalmic NSAIDs appear to be useful for decreasing pain in patients with corneal abrasions who can afford the medication and who must return to work immediately, particularly where potential opioid-induced sedation is intolerable.
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Cognitive errors underlie most diagnostic errors that are made in the course of clinical decisionmaking in the emergency department. These errors are universal and are prevalent in the special milieu of the ED. Their properties appear to be distinct from those associated with the performance of procedures. ⋯ Specific cognitive forcing strategies provide a formal cognitive debiasing approach to deal with what have previously been described as pitfalls in clinical reasoning. This metacognitive approach can be taught to practicing clinicians and to those in training to inoculate them against making diagnostic errors. The adoption of this method provides a systematic approach to cognitive root-cause analysis in the avoidance of adverse outcomes associated with delayed or missed diagnoses and with the clinical management of specific cases.
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Comparative Study Clinical Trial Controlled Clinical Trial
Cost-effectiveness of a brief two-stage emergency department intervention for high-risk elders: results of a quasi-randomized controlled trial.
: We determine the cost-effectiveness of a 2-stage emergency department intervention in addition to usual ED care compared with that of usual care alone. ⋯ In this study setting, the intervention is preferred over usual care because beneficial functional outcomes were observed, and overall societal costs were no higher than if usual care only was given.
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Comparative Study
Effect of current federal regulations on handgun safety features.
In the late 1960s, the Bureau of Alcohol, Tobacco, and Firearms implemented the "factoring criteria," a set of minimum size and safety standards required for any handgun imported into the United States. These standards, however, were not applied to guns manufactured domestically. We determine whether extending the factoring criteria to all handguns sold in the United States, as has been proposed in Congress, would increase the likelihood that safety devices would be included in new handgun designs. ⋯ Although pistol models that meet the factoring criteria are more likely to contain safety devices than those that do not, the net effect is modest. Thus, the factoring criteria alone are insufficient to ensure consistent incorporation of safety features into new handgun designs.