The American journal of emergency medicine
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Observational Study
A prospective study of suicide screening tools and their association with near-term adverse events in the ED.
The goal of this study was to evaluate the relationship between various suicide screening tools and clinical impression with subsequent patient psychiatric admission and near-term adverse emergency department (ED) events. ⋯ Clinical impression alone and the suicide screening tools showed poor predictive value for near-term events. Data from this study highlight the need for the development of ED-based suicide screening instruments capable of identifying those patients with suicidal ideation at greatest risk.
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Randomized Controlled Trial Comparative Study
Efficacy and safety of nebulized morphine given at 2 different doses compared to intravenous titrated morphine in trauma pain.
Our aim was to compare the efficacy and safety of intravenous (IV) titrated morphine with nebulized morphine given at 2 different doses in severe traumatic pain. ⋯ Nebulized morphine using boluses of 10 mg has similar efficacy and better safety than IV titrated morphine in patients with severe posttraumatic pain. Increasing nebulized boluses to 20 mg increases the effectiveness without increasing side effects.
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Randomized Controlled Trial
Child endotracheal intubation with a Clarus Levitan fiberoptic stylet vs Macintosh laryngoscope during resuscitation performed by paramedics: a randomized crossover manikin trial.
The main cause of cardiac arrest in pediatric patients is respiratory failure. ⋯ This study suggested that the FPS could be used as an option for airway management even for paramedics with little experience. Future studies should explore the efficacy of FPS in pediatric clinical emergency settings.
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Increasing the value of health care delivery is a national priority, and providers face growing pressure to reduce cost while improving quality. Ample opportunity exists to increase efficiency and quality simultaneously through the application of systems engineering science. ⋯ In this study, Lean-based reorganization of laboratory process flow significantly increased process efficiency. Broader application of systems engineering science might further improve health care quality and capacity while reducing waste and cost.