Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Little is known about whether emergency department (ED) patients or those who accompany them (visitors) are interested in smoking cessation. The authors hypothesized that several variables would be associated with stage of change, including nicotine dependence, self-efficacy, presence of a smoking-related illness, and anticipated cessation-related health improvement. ⋯ Because many disenfranchised Americans use the ED as a regular source of health care, increased attention to smoking in the ED setting holds tremendous public health potential. This study's results reinforce the validity of the stage-of-change model within the ED setting. Developers of ED-initiated interventions will have to consider the heterogeneity in stage of change when designing their treatments.
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To determine whether the Mac-technique test can detect kinking of the chest tube upon thoracostomy tube placement. ⋯ On the basis of this study, a positive Mac-technique test is useful to detect chest tubes that are likely to be kinked after insertion and before securing.
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To update the profile of author-reported funding of reports of original research published since 1994 in the four U.S. peer-reviewed general emergency medicine (EM) journals. ⋯ Author-reported extramural funding rates for original research have increased in the EM literature over the past decade. Foundations have funded the largest number of studies, with public (government) sources increasing in 2003.
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To determine the publication status and time to publication of randomized controlled trials (RCTs) that were presented at the Society for Academic Emergency Medicine (SAEM) meetings from 1995 to 2003. The impact of positive-outcome bias, time-lag bias, and gray literature bias also was assessed. ⋯ The proportion of emergency medicine RCT abstracts published is slightly lower than that for other biomedical specialties; however, biases reported by investigators in other biomedical areas do not appear to be as problematic in emergency medicine research. Differences between conclusions from abstracts and manuscripts must be considered when employing meeting abstracts as a source of evidence for future research or for systematic reviews in emergency medicine.
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Comparative Study
Description and evaluation of a pilot physician-directed emergency medical services diversion control program.
To describe the characteristics and feasibility of a physician-directed ambulance destination-control program to reduce emergency department (ED) overcrowding, as measured by hospital ambulance diversion hours. ⋯ A voluntary, physician-directed destination-control program that directs EMS units to the ED most able to provide appropriate and timely care is feasible. Patients were redirected to maximize continuity of care and optimally use available emergency health care resources. This type of program may be effective in reducing overcrowding.