Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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T-wave abnormalities on electrocardiograms (ECGs) are common, but their ability to predict 30-day cardiovascular outcomes at the time of emergency department (ED) presentation is unknown. The authors determined the association between T-wave abnormalities on the presenting ECG and cardiovascular outcomes within 30 days of presentation in patients with potential acute coronary syndromes (ACSs). ⋯ In patients with potential ACS presenting to the ED, T-wave abnormalities are associated with higher rates of 30-day cardiovascular events.
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Multicenter Study
Children with bacterial meningitis presenting to the emergency department during the pneumococcal conjugate vaccine era.
The epidemiology of bacterial meningitis in children in the era of widespread heptavalent conjugate pneumococcal vaccination (PCV7) is unknown. ⋯ Although now a rare infectious disease in United States, bacterial meningitis still causes substantial morbidity in affected children. Despite the introduction of PCV7, S. pneumoniae remains the most common cause of bacterial meningitis in U.S. children, with approximately half of cases due to nonvaccine serotypes.
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The emergency department (ED) environment presents unique barriers to the process of obtaining informed consent for research. ⋯ It is common practice in academic EDs for clinical investigators to rely on on-duty health care personnel to obtain research informed consent from potential research subjects. This practice raises questions regarding the sufficiency of the information received by research subjects, and further study is needed to determine the compliance of this consent process with federal guidelines.
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The Food and Drug Administration (FDA) requires researchers to consult with the community prior to conducting research with exception from informed consent, but little is known about whether people support this and, if they do, who researchers should consult. We sought to determine if people could identify communities and leaders of those communities who researchers should consult with to represent their views about research that requires an exception from informed consent. ⋯ Most participants identified a community and a leader of that community who researchers could consult about research with exception from informed consent. Geographic and faith-based organizations could play an important role in consultation.
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Joint Commission on Accreditation of Healthcare Organizations (JCAHO)-accredited hospitals must conduct disaster drills twice a year, with one incorporating a mass casualty incident to the emergency department (ED). The authors found no studies describing the potential negative impact on the quality of care real patients in the ED receive during these drills. The objective was to determine the impact that mass casualty drills have on the timeliness of care for nondisaster patients in a pediatric ED. ⋯ Disaster drills at this institution do not appear to significantly affect the timeliness of care to nondisaster drill ED patients. Attention should be paid to the quality of care "real" patients receive to ensure that their care is not jeopardized during an artificial stress to the system during a disaster drill.