Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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It is hypothesized that high ambient noise in the emergency department (ED) adversely affects the ability of the examiner to hear heart and lung sounds. ⋯ This study demonstrated that most of the tested examiners have the ability to hear heart and lung sounds at the extreme of loudness found in one ED.
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Comparative Study
Impact of a transfer center on interhospital referrals and transfers to a tertiary care center.
The partnership of faculty physicians and senior clinical hospital administrators in the decision to accept interhospital transfers has not been fully studied. Transfers to academic medical centers on the basis of economics have been of particular concern. ⋯ The value of an administrator and physician team as partners in the interhospital transfer process was demonstrated. Active management of interhospital transfers supports transfer of patients who require tertiary care or who meet EMTALA criteria, thus conserving limited bed capacity and ensuring financial equity, while caring for the uninsured and underinsured patients throughout the state.
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Medical students are taught some procedural skills during medical school, but there is no uniform set of procedures that all students learn before residency. ⋯ In the cohort studied, new PGY1 EM residents had not attained competence in performing LPs from training in medical school. Most new PGY1 residents probably require training, practice, and close, direct supervision of this procedure by attending physicians until the residents demonstrate competent performance.
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Randomized Controlled Trial Comparative Study
Intensive intervention improves primary care follow-up for uninsured emergency department patients.
To test an intervention designed to improve primary care use and decrease emergency department (ED) utilization for uninsured patients using the ED. ⋯ This project has demonstrated that it is possible to improve primary care follow-up for uninsured ED patients.
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Randomized Controlled Trial Comparative Study
An evaluation of two screening tools for cognitive impairment in older emergency department patients.
Screening for cognitive impairment in older emergency department (ED) patients is recommended to ensure quality care. The Mini-Mental State Examination (MMSE) may be too long for routine ED use. Briefer alternatives include the Six-Item Screener (SIS) and the Mini-Cog. The objective of this study was to describe the test characteristics of the SIS and the Mini-Cog compared with the MMSE when administered to older ED patients. ⋯ The SIS, using a cutoff of