Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Clinical Trial
Does the lateral chest radiograph help pediatric emergency physicians diagnose pneumonia? A randomized clinical trial.
To determine whether the addition of the lateral chest radiograph to the frontal view influences the pediatric emergency physician's diagnosis and management of patients with pneumonia. ⋯ The addition of the lateral chest radiograph to the frontal view did not improve the sensitivity or specificity of pediatric emergency physicians in their diagnosis of pneumonia in children.
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To develop a clinical decision rule that would allow for the safe deferral of the digital rectal examination (DRE) in blunt trauma patients. ⋯ Adult patients with blunt trauma and a normal neurologic examination, with no blood at the urethral meatus, and who are less than 65 years old have an exceedingly low likelihood of a true-positive abnormal DRE. If validated, patients who meet these three criteria may have the DRE safely deferred.
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To date, no studies in emergency medicine (EM) have addressed the educational value of the Residency Review Committee for Emergency Medicine's (RRC-EM) requirement for patient follow-up (FU). The authors examined whether performance of patient FU improved EM resident education. ⋯ This study indicates that EM residents and faculty believe that the act of performing patient FU has educational value for EM residents; however, the interobserver agreement between residents and faculty was low.
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The diagnosis of heart failure in the outpatient setting can be difficult. A rapid assay for B-type natriuretic peptide (BNP) has been advocated for the diagnosis of heart failure, using a single cutoff of 100 pg/mL. ⋯ This multitude of causes of BNP elevation imposes limits on its diagnostic use for heart failure. The literature on the use of BNP testing for diagnosis of heart failure is reviewed, and improved guidelines for its interpretation are suggested.
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Randomized Controlled Trial Comparative Study Clinical Trial
Factors affecting pain scores during female urethral catheterization.
To compare pain and discomfort ratings of female patients undergoing urethral catheterization randomized to topical application of plain lubricant versus lidocaine gel prior to the procedure. ⋯ Catheter size and lubricant type did not affect the severity of pain after urethral catheterization in women.