Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Focused assessment of sonography in trauma (FAST) has been shown useful to detect clinically significant hemoperitoneum in adults, but not in children. The objectives were to determine test characteristics for clinically important intraperitoneal free fluid (FF) in pediatric blunt abdominal trauma (BAT) using computed tomography (CT) or surgery as criterion reference and, second, to determine the test characteristics of FAST to detect any amount of intraperitoneal FF as detected by CT. ⋯ In this population of children with BAT, FAST has a low sensitivity for clinically important FF but has high specificity. A positive FAST suggests hemoperitoneum and abdominal injury, while a negative FAST aids little in decision-making.
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The objective was to describe a new method of studying correlations between real-time end tidal carbon dioxide (ETCO(2) ) data and resuscitation outcomes. ⋯ This preliminary study suggests that computerized ETCO(2) carries potential as a tool for early, real-time decision-making during some resuscitations.
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Randomized Controlled Trial Multicenter Study
Cost-effectiveness of point-of-care biomarker assessment for suspected myocardial infarction: the randomized assessment of treatment using panel Assay of cardiac markers (RATPAC) trial.
Chest pain due to suspected myocardial infarction (MI) is responsible for many hospital admissions and consumes substantial health care resources. The Randomized Assessment of Treatment using Panel Assay of Cardiac markers (RATPAC) trial showed that diagnostic assessment using a point-of-care (POC) cardiac biomarker panel consisting of CK-MB, myoglobin, and troponin increased the proportion of patients successfully discharged after emergency department (ED) assessment. In this economic analysis, the authors aimed to determine whether POC biomarker panel assessment reduced health care costs and was likely to be cost-effective. ⋯ Point-of-care panel assessment does not reduce costs despite reducing admissions and may even increase costs. It is unlikely to be considered a cost-effective use of health care resources.
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The Institute of Medicine (IOM) has recommended the development of national standards for the measurement of emergency care performance. The authors undertook this study with the goals of enumerating and categorizing existing performance measures relevant to pediatric emergency care. ⋯ A wide range of performance measures relevant to pediatric emergency care are available. However, measures lack a systematic and comprehensive approach to evaluate the quality of care provided.
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Oral examination is a method used to evaluate emergency medicine (EM) residents and is a requirement for board certification of emergency physicians. Second Life (SL) is a virtual three-dimensional (3-D) immersive learning environment that has been used for medical education. In this study we explore the use of SL virtual simulation technology to administer mock oral examinations to EM residents. ⋯ Application of SL virtual simulation technology is a potential alternative to traditional mock oral examinations for EM residents.