Annals of emergency medicine
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Randomized Controlled Trial Multicenter Study Comparative Study
Cost-effectiveness of lay responder defibrillation for out-of-hospital cardiac arrest.
Our objective is to evaluate the incremental cost-effectiveness of use of cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) by lay responders (CPR+AED) versus CPR only for cardiac arrest during a multicenter randomized trial. ⋯ Training and equipping lay volunteers to defibrillate in public places may have an incremental cost-effectiveness that is similar to that of other common health interventions.
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We evaluate the safety and efficacy of a pain protocol using 1 mg intravenous (IV) hydromorphone followed by an optional dose of 1 mg IV hydromorphone 15 minutes later. ⋯ A rapid titration protocol using IV hydromorphone (1 mg hydromorphone followed by an optional 1 mg 15 minutes later) is efficacious in nonelderly ED patients with acute severe pain. There were no serious adverse events.
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We evaluate the effect of an Internet-based, electronic referral system (termed IMPACT-ED for Improving Medical home and Primary care Access to the Community clinics Through the ED) on access and follow-up at primary care community clinics for safety net emergency department (ED) patients. ⋯ Although most patients still failed to follow up at the community clinics as directed, the use of an Internet-based scheduling program linking a safety net ED with local community clinics significantly improved the frequency of follow-up for patients without primary care.