Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Studies in emergency department data collection: shared versus split responsibility for patient enrollment.
To compare patient enrollment in six clinical studies using shared coverage (24 emergency department [ED] rooms-two students share enrollment responsibility) with enrollment using split coverage (12 rooms each per student). The academic associate (AA) program uses undergraduate students to collect data for clinical studies in the ED by providing double coverage 16 hours/day, seven days/week. Prior studies have shown that this system captures >85% of eligible patients. Methods to obtain closer to 100% enrollment are desired. ⋯ Study subject enrollment was not affected by the use of either the shared or split responsibility strategy for recruitment. Students generally preferred the split strategy because it was more helpful and easier to monitor. Therefore, this may be the best option for similar student-oriented data collection programs.
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To determine the length of catheter required to perform a needle thoracostomy, as determined by chest wall thickness, to treat the majority of patients presenting to the emergency department (ED) with a potential tension pneumothorax. ⋯ In this study, a catheter length of 5 cm would reliably penetrate the pleural space of only 75% of patients. A longer catheter should be considered, especially in women.
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To report the pathology, toxicology, cause, and manner of death in 3,4-methylenedioxymethamphetamine (MDMA)-associated fatalities in the United States. Although use trends are increasing, data regarding the hazards of MDMA are limited. ⋯ The MDMA-associated fatal events typically occur in young, otherwise healthy individuals. MDMA's impact on the public health and safety of young adults and teenagers needs further assessment.
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The Trauma and Injury Severity Scoring (TRISS) system was developed in the 1980s to improve the prediction of patient outcomes following trauma through the use of physiological and anatomical criteria. The TRISS is used for a number of purposes, including quantifying the severity of injury of a patient population, calculating the probability of survival of patients for identification of cases for peer review, and comparing the death or survival rates of different populations/hospitals. ⋯ This article critically evaluates the development, structure, and practical use of TRISS to determine its value in the current trauma environment. Limitations of TRISS are discussed and suggestions are made for the future development of trauma prediction tools.
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To describe the availability of next-of-kin (NOK) for proxy consent over the 24-hour time period following presentation of major trauma patients to a Level I trauma center. ⋯ One third of the trauma patients in this study did not have NOK available two hours following arrival in the emergency department. For time-critical research protocols, the time to NOK contact can significantly impact the ability to ensure prompt enrollment and treatment in clinical trials. Further studies are needed to assess the generalizability and consistency of these data.