Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Can the bispectral index monitor quantify altered level of consciousness in emergency department patients?
A daily part of emergency medicine practice includes assessing patients with altered levels of consciousness (ALOC). The authors hypothesized that a bispectral index monitor (BIS), a processed electroencephalographic monitor traditionally used to monitor patients under anesthesia, would represent an objective quantification of impairment of consciousness. They compared the BIS score with the Glasgow Coma Scale score (GCS) in emergency department (ED) patients with ALOC. ⋯ BIS monitoring does not reliably correlate with GCS in ED patients with ALOC, and does not appear to have potential to accurately quantify impairment of consciousness in this setting.
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Emergency department (ED) overcrowding is a common problem. Despite a widespread belief that low hospital bed availability contributes to ED overcrowding, there are few data demonstrating this effect. ⋯ Increased hospital occupancy is strongly associated with ED length of stay for admitted patients. Increasing hospital bed availability might reduce ED overcrowding.
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To determine which preventive health information the emergency department (ED) population (patients and visitors) would be most interested in having available to them while they spend time in the waiting area. ⋯ Of the 878 subjects in the study group, 96% were interested in obtaining information about one or more preventive health issues. An opportunity exists to respond to this interest by providing material for public health education in the waiting area of EDs.
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Medical schools and specialty societies have struggled to define a core content for medical students and practitioners but, to date, have been stymied by both political considerations and the sheer burden of the innumerable decisions that must be made to define the essence of a medical specialty. Six professional organizations representing the field of emergency medicine recently collaborated with the National Board of Medical Examiners to accomplish this objective by developing a Model of the Clinical Practice of Emergency Medicine. This document will provide support for the development of medical school and residency curricula, training program accreditation standards, board certification test specifications, and organizational agendas for postgraduate education, research, and patient advocacy for the specialty of emergency medicine. The authors present a description of the model and the process that was used to develop it with the belief that other medical disciplines that face similar issues and challenges could benefit from a similar undertaking.
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Comparative Study
Can emergency department triage nurses appropriately utilize the Ottawa Knee Rules to order radiographs?-An implementation trial.
To determine whether triage nurses can successfully interpret the Ottawa Knee Rule (OKR) and order knee radiographs according to the OKR. ⋯ Triage nurses showed fair to good ability to appropriately apply the OKR to pre-order knee radiographs.