Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
"Inappropriate" emergency department use: a comparison of three methodologies for identification.
To determine the level of agreement between the rates of "inappropriate" ED visits assigned to a cohort of ambulatory patients based on three methods of defining ED use appropriateness. ⋯ There is only moderate agreement between different methods of determining appropriateness of ED use. Until further refinement is made in triage assessment, managed care organizations and EPs should remain cautious when implementing a protocol that defines and restricts "inappropriate" ED visits.
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Randomized Controlled Trial Clinical Trial
Communicating information to patients: the use of cartoon illustrations to improve comprehension of instructions.
To evaluate the effect of cartoon illustrations on patient comprehension of and compliance with ED release instructions. ⋯ Cartoon illustrations are an effective strategy for conveying information and may improve patient compliance with ED release instructions.
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To evaluate the effectiveness of propofol and fentanyl when used by emergency physicians (EPs) for systemic sedation and analgesia in the ED. ⋯ Propofol appears to be an effective agent to provide systemic sedation and analgesia when used in conjunction with fentanyl for procedures in the ED. Given its rapidity of onset and elimination, it may become a useful agent to EPs for i.v. sedation in the ED.
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To demonstrate how continuous quality improvement (CQI) can identify rational and effective means to reduce length of stay for minor illness/injury in an ED. ⋯ The formal application of CQI techniques in the ED can change patient flow and reduce LOS for FT patients.
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To determine the ability to complete follow-up home telephone calls to ED patients. ⋯ Almost half of the patients who present to the ED and supply home telephone numbers give telephone numbers at which they cannot be reached in follow-up. Using telephone follow-up alone to reach patients seen in the ED may be an unreliable method of communication.