Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
The effect of emergency department crowding on length of stay and medication treatment times in discharged patients with acute asthma.
This study sought to determine if emergency department (ED) crowding was associated with longer ED length of stay (LOS) and time to ordering medications (nebulizers and steroids) in patients treated and discharged with acute asthma and to study how delays in ordering may affect the relationship between ED crowding and ED LOS. ⋯ Emergency department crowding is associated with longer ED LOS (by more than 1 hour) in patients who ultimately get discharged with asthma flares. Some but not all of longer LOS during crowded times is explained by delays in ordering asthma medications.
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Multicenter Study
Are all trauma centers created equally? A statewide analysis.
Prior work has shown differences in mortality at different levels of trauma centers (TCs). There are limited data comparing mortality of equivalently verified TCs. This study sought to assess the potential differences in mortality as well as discharge destination (discharge to home vs. to a rehabilitation center or skilled nursing facility) across Level I TCs in the state of Ohio. ⋯ There is considerable variability in the mortality of injured patients at Level I TCs in the state of Ohio. The patient differences or care processes responsible for this variation should be explored.
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Multicenter Study
Multicenter study of preferences for health education in the emergency department population.
Emergency departments (EDs) are increasingly proposed as high-yield venues for providing preventive health education to a population at risk for unhealthy behaviors and unmet primary care needs. This study sought to determine the preferred health education topics and teaching modality among ED patients and visitors. ⋯ Emergency department patients and visitors were most interested in health education on stress, depression, exercise, and nutrition, compared to topics more commonly targeted to the ED population such as substance abuse, sexual health (including HIV testing), and injury prevention. Despite many recent innovations in health education, most ED patients and visitors in our study preferred the traditional form of books and brochures. Future ED health education efforts may be optimized by taking into account the learning preferences of the target ED population.
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Multicenter Study
Prehospital ultrasound by paramedics: results of field trial.
The objective was to determine if 9-1-1 paramedics trained in ultrasound (US) could adequately perform and interpret the Focused Assessment Sonography in Trauma (FAST) and the abdominal aortic (AA) exams in the prehospital care environment. ⋯ This pilot study shows that with close supervision, paramedics can adequately obtain and interpret prehospital FAST and AA US images under protocol. These results support a growing body of literature that indicates US may be feasible and useful in the prehospital setting.
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Multicenter Study Comparative Study
Effect of mandated nurse-patient ratios on patient wait time and care time in the emergency department.
The objective was to evaluate the effect of mandated nurse-patient ratios (NPRs) on emergency department (ED) patient flow. ⋯ In these two EDs, throughput measures of WT and EDCT were shorter when the ED nurse staffing were within state-mandated levels, after controlling for ED census and patient acuity.