The American journal of emergency medicine
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Multicenter Study
The relative contribution of provider and ED-level factors to variation among the top 15 reasons for ED admission.
We examine adult emergency department (ED) admission rates for the top 15 most frequently admitted conditions, and assess the relative contribution in admission rate variation attributable to the provider and hospital. ⋯ For different conditions, there were different contributions to variation at the hospital- and provider-level. These findings deserve consideration when designing interventions to optimize admission decisions and in value-based payment programs.
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Multicenter Study Observational Study
Features of hospital and emergency medical service in out-of-hospital cardiac arrest patients with shockable rhythm.
Predicting the outcome of out-of-hospital cardiac arrest (OHCA) patients is crucial. We examined hospital characteristics and parameters of emergency medical service (including scene time interval and direct ambulance delivery to intensive heart hospitals) as survival or outcome predictors. ⋯ Direct ambulance delivery to intensive heart hospitals that had 24/7 PCI availability was associated with a higher probability of surviving until discharge in OHCA patients with shockable rhythms. Similarly, a witnessed collapse was correlated with being discharged alive from hospital and recovering with good cerebral performance. In addition, longer response time and scene time interval indicated poorer survival and neurological outcome.
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Multicenter Study
Lung ultrasonography to diagnose pneumothorax of the newborn.
To explore the reliability and accuracy of lung ultrasound for diagnosing neonatal pneumothorax. ⋯ Lung ultrasound is accurate and reliable in diagnosing and ruling out neonatal pneumothorax and, in our study, was found to be as accurate as chest X-ray.
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Letter Multicenter Study
A program of education and performance feedback reduces CT ordering in the emergency department.
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To determine the impact of a non-restrictive clinical decision rule on CT utilization for Emergency Department patients suspected of having an acute aortic syndrome (AAS). ⋯ A non-restrictive, collaboratively designed, clinical decision rule for Emergency Department patients with suspected AAS performed poorly in risk-stratifying patients for AAS. However, its implementation was associated with a significant and safe decrease in CT utilization.