Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
Barriers to metered-dose inhaler/spacer use in Canadian pediatric emergency departments: a national survey.
Metered-dose inhalers and spacers (MDI+S) are at least as effective as nebulizers for treating children with mild to moderate asthma exacerbations. Despite advantages in terms of efficacy, side effects, and ease of use, MDI+S are not used in many North American pediatric emergency departments (PEDs). ⋯ MDI+S are infrequently used to treat patients with acute asthma in Canadian PEDs, despite the fact that most emergency staff believe they are effective. Important barriers to using MDI+S have been identified in this study and should be used to guide future implementation strategies.
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Multicenter Study
Lack of agreement in pediatric emergency department discharge diagnoses from clinical and administrative data sources.
Diagnosis information from existing data sources is used commonly for epidemiologic, administrative, and research purposes. The quality of such data for emergency department (ED) visits is unknown. ⋯ ED diagnoses retrieved from electronic administrative sources and manual chart review frequently disagree, even if similar diagnosis codes are grouped. Agreement varies by institution and by diagnosis. Further work is needed to improve the accuracy of diagnosis coding; development of a grouping system specific to pediatric emergency care may be beneficial.
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Randomized Controlled Trial Multicenter Study Comparative Study
A multicenter comparison of tap water versus sterile saline for wound irrigation.
To compare wound infection rates for irrigation with tap water versus sterile saline before closure of wounds in the emergency department. ⋯ Equivalent rates of wound infection were found using either irrigant. The results of this multicenter trial evaluating tap water as an irrigant agree with those from previous single institution trials.
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Multicenter Study
Estimated risk for undiagnosed diabetes in the emergency department: a multicenter survey.
One third of the 21 million Americans with diabetes remain undiagnosed. The emergency department (ED) is a novel setting for diabetes screening. ⋯ Many ED patients in the study had risk factors for undiagnosed diabetes. Patient attitudes toward ED-based diabetes screening support further exploration of this important and currently underutilized opportunity for public health intervention.
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To characterize the initial management of patients with sickle cell disease and an acute pain episode, to compare these practices with the American Pain Society Guideline for the Management of Acute and Chronic Pain in Sickle-Cell Disease in the emergency department, and to identify factors associated with a delay in receiving an initial analgesic. ⋯ Patients with an acute painful episode related to sickle cell disease experienced significant delays to administration of an initial analgesic.