Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To examine the effect on patient care of HMO-mandated calls for authorization prior to ED evaluation. The study examined this phenomenon prior to implementation of a California law that discourages such calls. ⋯ Calls for payment authorization prior to ED patient evaluation delay patient care and place some patients' health and safety in jeopardy.
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Multicenter Study
Community-wide emergency department visits by patients suspected of drug-seeking behavior.
To measure community-wide ED use by patients at high risk for drug-seeking behavior. ⋯ Patients identified as being at high risk for drug-seeking behavior have high community-wide ED visit rates. Improving communication between and within hospitals may help identify patients who could benefit from more consistent community-wide care and appropriate treatment for addiction.
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Comparative Study
The emergency department electrocardiogram and hospital complications in myocardial infarction patients.
To determine whether acute myocardial infarction (AMI) patients who have negative ECGs on presentation have significantly lower complication rates than do those AMI patients who have positive ECGs on presentation. ⋯ Negative- and positive-ECG AMI patients do not have moderate or large differences in the rates of in-hospital complications. Most negative-ECG patients who suffer complications evolve ECG changes prior to the event and such changes indicate the potential need for a higher level of care.
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Comparative Study
Association of training level and short-term cosmetic appearance of repaired lacerations.
To determine the association between emergency practitioner level of training and cosmetic appearance of primarily closed wounds as evaluated at the time of suture removal. ⋯ Significant improvement in short-term cosmetic results following wound repair is associated with a training level beyond PGY1. These data reinforce the need for careful patient selection and close supervision of wound repair by trainees, especially of wound repair by medical students and interns.
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To determine the test performance of 24-lead variance cardiography (VC), an ECG technique that measures QRS morphologic variability, for ED evaluation of chest pain associated with coronary artery disease (CAD). ⋯ A CADI < 75, in addition to clinical impression and initial ECG, may identify chest pain patients who do not have significant CAD. Further prospective assessment of VC is warranted.