Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
Comparative Study
Actual financial comparison of four strategies to evaluate patients with potential acute coronary syndromes.
Small studies have shown that a negative computed tomography coronary angiogram (CTA) in low-risk chest pain patients predicts a low rate of 30-day adverse events. The authors hypothesized that an immediate CTA strategy would be as effective but less costly than alternative strategies for evaluation of patients with potential acute coronary syndrome (ACS). ⋯ Compared to the other strategies, immediate CTA was as safe, identified as many patients with CAD, had the lowest cost, had the shortest LOS, and allowed discharge for the majority of patients. Larger prospective studies should confirm safety before immediate CTA replaces other strategies to rule out possible ACS.
-
The Clinical and Translational Science Awards (CTSA) represent a major new funding pathway for health science investigators seeking National Institutes of Health (NIH) funds. This new pathway provides institutional-level support for clinical and translational research and is not tied to one organ system or disease process, fitting well with emergency medicine (EM) research needs. These awards open unique opportunities for advancing EM research. ⋯ Some opportunities for participation provided by the CTSA include research training programs, joining multidisciplinary research teams, seed grant funding, and use of the CTSA-developed research infrastructure. Involvement of EM can benefit institutions by enhancing acute care research collaboration both within and among institutions. Emergency medicine researchers at institutions either planning to submit a CTSA application or with funded CTSA grants are encouraged to become actively involved in CTSA-related research programs.
-
Oral presentations are a critical element in the communication of medical knowledge between students and faculty, but in most locations, the amount of time spent on teaching the oral presentation is minimal. Furthermore, the standard oral presentation does not work well within the emergency medicine (EM) setting, due to time constraints and the different principles that make EM a unique specialty. This article provides a suggested approach on how to educate students on optimal oral presentations in EM, as well as providing a link to an online guide instructing medical students how to give oral presentations.
-
Multicenter Study
Race, ethnicity, and management of pain from long-bone fractures: a prospective study of two academic urban emergency departments.
The objective was to test the hypothesis that African American and Hispanic patients are less likely to receive analgesics than white patients in two academic urban emergency departments (EDs). ⋯ Receipt of analgesics for pain from long-bone fractures was not associated with patient race or ethnicity in two academic urban EDs.
-
The aim was to use a computer model to estimate the cost-effectiveness of 64-slice multidetector computed tomography (MDCT) of the coronary arteries in the emergency department (ED) compared to an observation unit (OU) stay plus stress electrocardiogram (ECG) or stress echocardiography for the evaluation of low-risk chest pain patients presenting to the ED. ⋯ In this computer-based model analysis, the MDCT risk stratification strategy is less costly and more effective than both OU-based stress echocardiography and stress ECG risk stratification strategies in chest pain patients presenting to the ED with low to moderate prevalence of CAD.