Annals of emergency medicine
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Meta Analysis
Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta-analysis.
Ectopic pregnancy is a common concern in emergency departments (EDs) and remains the leading cause of first-trimester mortality. Pelvic ultrasonography by emergency physicians has been investigated as a diagnostic test for ectopic pregnancy. We present a meta-analysis of the use of emergency physician ultrasonography in the evaluation of patients at risk of ectopic pregnancy. ⋯ The results of this meta-analysis suggest that in a wide variety of clinical settings, the use of bedside ultrasonography performed by emergency physicians as a diagnostic test for ectopic pregnancy provides excellent sensitivity and negative predictive value. Visualization of an intrauterine pregnancy by an emergency physician is generally sufficient to rule out ectopic pregnancy.
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Comparative Study
Pandemic H1N1 influenza in the pediatric emergency department: a comparison with previous seasonal influenza outbreaks.
We compare the acuity of pediatric emergency department (ED) patients between the ongoing H1N1 influenza pandemic and previous seasonal influenza outbreaks. ⋯ The severity of illness during the 2009 H1N1 surge appeared similar to that of previous influenza seasons for the total population of the 2 pediatric tertiary care EDs, whereas an increase in the proportion of ICU admissions was observed for patients with influenza-like illness.
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Randomized Controlled Trial Comparative Study
Comparison of Web-versus classroom-based basic ultrasonographic and EFAST training in 2 European hospitals.
Training physicians in new skills through classroom-based teaching has inherent cost and time constraints. We seek to evaluate whether Web-based didactics result in similar knowledge improvement and retention of basic ultrasonographic principles and the Extended Focused Assessment with Sonography for Trauma (EFAST) compared with the traditional method. ⋯ Web-based learning provides the potential to teach physicians with greater flexibility than classroom instruction. Our data suggest that Web-based ultrasonography and EFAST didactics are comparable to traditional classroom lectures and result in similar knowledge retention.
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We evaluate the effectiveness of interventions for pediatric patients with suicide-related emergency department (ED) visits. ⋯ Transition interventions appear most promising for reducing suicide-related outcomes and improving post-ED treatment adherence. Use of similar interventions and outcome measures in future studies would enhance the ability to derive strong recommendations from the clinical evidence in this area.
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We test an initiative with the staff-based participatory research (SBPR) method to elicit communication barriers and engage staff in identifying strategies to improve communication within our emergency department (ED). ⋯ Involving staff in discussing barriers and facilitators to communication within the ED can result in a meaningful process of empowerment, as well as the identification of feasible strategies and solutions at both the individual and system levels.