Annals of emergency medicine
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Randomized Controlled Trial
Topical Lidocaine to Improve Oral Intake in Children With Painful Infectious Mouth Ulcers: A Blinded, Randomized, Placebo-Controlled Trial.
We establish the efficacy of 2% viscous lidocaine in increasing oral intake in children with painful infectious mouth conditions compared with placebo. ⋯ Viscous lidocaine is not superior to a flavored gel placebo in improving oral intake in children with painful infectious mouth ulcers.
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Multicenter Study Clinical Trial
Clinician Gestalt Estimate of Pretest Probability for Acute Coronary Syndrome and Pulmonary Embolism in Patients With Chest Pain and Dyspnea.
Pretest probability helps guide diagnostic testing for patients with suspected acute coronary syndrome and pulmonary embolism. Pretest probability derived from the clinician's unstructured gestalt estimate is easier and more readily available than methods that require computation. We compare the diagnostic accuracy of physician gestalt estimate for the pretest probability of acute coronary syndrome and pulmonary embolism with a validated, computerized method. ⋯ Compared with a validated machine-based method, clinicians consistently overestimated pretest probability but on receiver operating curve analysis were as accurate for pulmonary embolism but not acute coronary syndrome.
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We explore what emergency physicians with access to health information exchange have to say about it and strive to better understand the factors affecting their use of it. ⋯ The emergency physicians reported that health information exchange disrupted their workflow and was less than desirable to use. The health information exchange systems need to adapt to the needs of the end user to be both useful and useable for emergency physicians.
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A key to improving the quality of emergency care is improvement of the contact between patient and emergency department (ED) staff. We investigate what patients actually experience during their ED visit to better understand the patterns of relationships among patients and health care professionals. ⋯ Diligence for patient concerns enables ED staff to have a fruitful insight into patients' actual experience. It offers significant clues to improving relationship building in emergency care practice between patients and health care professionals.