Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial
Arterial Puncture Using Insulin Needle Is Less Painful Than With Standard Needle: A Randomized Crossover Study.
Arterial punctures are important procedures performed by emergency physicians in the assessment of ill patients. However, arterial punctures are painful and can create anxiety and needle phobia in patients. The pain score of radial arterial punctures were compared between the insulin needle and the standard 23-gauge hypodermic needle. ⋯ Arterial punctures using insulin needles cause less pain and fewer procedural complications compared to standard needles. However, due to the higher rate of hemolysis, its use should be limited to conditions that do not require a concurrent potassium value in the same blood sample.
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Randomized Controlled Trial
Treatment of Pulmonary Embolism With Rivaroxaban: Outcomes by Simplified Pulmonary Embolism Severity Index Score from a Post Hoc Analysis of the EINSTEIN PE Study.
The objective was to assess adverse outcomes in relation to the simplified Pulmonary Embolism Severity Index (PESI) score in patients treated with rivaroxaban or standard therapy in the phase III EINSTEIN PE study and to evaluate the utility of the simplified PESI score to identify low-risk pulmonary embolism (PE) patients. ⋯ The findings support using risk stratification with the simplified PESI score to identify low-risk patients with PE.
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The American Board of Emergency Medicine (ABEM) Maintenance of Certification (MOC) program requires every ABEM-certified physician to attest to participating in a quality improvement (QI) activity every 5 years. Understanding the type and frequency of these QI activities could inform the emergency medicine community about the variety of QI activities in which emergency physicians (EPs) are involved. These QI activities could provide ideas for the development of additional quality measures. ⋯ This report demonstrates that diverse QI activities occur in emergency departments (EDs) across the United States. The majority of reported projects are nested in a few categories, following recognized areas of emphasis in emergency care, particularly in areas using time-sensitive metrics.
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The purpose of this study was to identify the structural quality of care domains and to establish a set of structural quality indicators (SQIs) for the assessment of care of older people with cognitive impairment in emergency departments (EDs). ⋯ This article presents a set of SQIs for the evaluation of performance in caring for older people with cognitive impairment in EDs.
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The objective was to assess relative incidence of clinical adverse effects between patients receiving, and not receiving, iodinated contrast prior to thrombolysis. ⋯ No consistent harms were observed in association with intravenous iodinated contrast prior to rt-PA administration. It is reasonable to continue CTA prior to thrombolysis as clinically indicated.