Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Computed tomography (CT) utilization has increased rapidly over the past 15 years. CT is the most common source for radiation exposure. ⋯ The amount of radiation delivered to pediatric patients during routine CT examinations of the head and abdomen was low. Regardless, a large proportion of older patients were exposed to elevated effective doses of radiation during abdominal CT.
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The Joint Commission Comprehensive Stroke Center certification requires that magnetic resonance imaging (MRI) be available on site, 24 hours a day, 7 days a week for evaluation of stroke in emergency department (ED) patients. Increased access to advanced diagnostic imaging has been shown to increase utilization, ED length of stay (LOS), and health care costs. EDs nationwide face decisions to pursue certification and increase MRI access. Understanding changes in utilization and the downstream effects may inform these decisions. ⋯ Emergency MRI utilization increased substantially after placement of a fully accessible MRI in the ED. Patients receiving emergency MRI had increased ED LOS, decreased admission rates for some patients (rule-out stroke), and reduced hospital LOS for those admitted. Potential changes in ED patient resource utilization should be considered when determining whether to acquire an MRI for Comprehensive Stroke Center certification.
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Multicenter Study Comparative Study Observational Study
Measurement and Monitoring of Nausea Severity in Emergency Department Patients: A Comparison of Scales and Exploration of Treatment Efficacy Outcome Measures.
The objective was to investigate the correlation of the visual analog scale (VAS) and numeric rating scale (NRS) for nausea severity measurement and to explore options for improved reporting of antiemetic efficacy trial results. ⋯ The VAS and NRS correlate highly. A VAS cutoff level of ≥-5 mm was a good predictor of symptom improvement, suggesting that its inclusion as an outcome measure would enhance reporting in antiemetic efficacy trials.