Annals of emergency medicine
-
Review Comparative Study
Google Versus PubMed: Comparison of Google and PubMed's Search Tools for Answering Clinical Questions in the Emergency Department.
We assess which search tool returns the highest-quality, most relevant citations for standardized clinical questions arising at the point of care in the emergency department (ED). ⋯ For the common clinical questions assessed in this study, PubMed Clinical Queries narrow search had the highest-quality, most relevant, and most readable hits. Google Scholar performed well, in some cases retrieving citations that other search engines did not. PubMed and Google Web were not as efficient.
-
We conduct a systematic review with meta-analysis to provide an overview of the different manners of providing discharge instructions in the emergency department (ED) and to assess their effects on comprehension and recall of the 4 domains of discharge instructions: diagnosis, treatment, follow-up, and return instructions. ⋯ Communicating discharge instructions verbally to patients in the ED may not be sufficient. Although overall correct recall was not significantly higher, adding video or written information to discharge instructions showed promising results for ED patients.
-
In 2014, Maryland launched a population-based payment model that replaced fee-for-service payments with global budgets for all hospital-based services. This global budget revenue program gives hospitals strong incentives to tightly control patient volume and meet budget targets. We examine the effects of the global budget revenue model on rates of admission to the hospital from emergency departments (EDs). ⋯ Implementation of the global budget revenue model led to statistically significant although modest declines in ED admission rates within its first 2 years, with declines in ED admissions most pronounced among certain clinical conditions.
-
There is a paucity of evidence to guide the diagnostic evaluation of emergency department (ED) patients presenting after nonfatal strangulation (manual strangulation or near hanging). We seek to define the rate of serious injuries in alert strangled patients and determine which symptoms and examination findings, if any, predict such injuries. ⋯ Alert, strangled patients had a low rate of injuries. All patients with neck injuries had concerning findings besides neck pain; specifically, GCS score less than 15 or dysphagia. Our findings suggest, but do not prove, that a selective imaging strategy is safe in alert patients after strangulation findings besides neck pain.