Can J Emerg Med
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Randomized Controlled Trial
L'échographie équivaut-elle à la tomodensitométrie dans la prise en charge des patients avec suspicion d'urolithiase se présentant à l'urgence?
Smith-Bindman R, Aubin C, Bailitz J., et al. Ultrasonography versus Computed Tomography for Suspected Nephrolithiasis. New Engl J Med 2014;371;1100-10.
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Randomized Controlled Trial
Ultrasound during Critical Care Simulation: A Randomized Crossover Study.
We sought to compare two ultrasound simulation interventions used during critical care simulation. The primary outcome was trainee and instructor preference for either intervention. Secondary outcomes included the identification of strengths and weaknesses of each intervention as well as overall merits of ultrasound simulation during high-fidelity, critical care simulation. The populations of interest included emergency medicine trainees and physicians. ⋯ These findings support the use of ultrasound simulation during critical care simulations. The increased functional fidelity associated with edus2 suggests that it is the preferred intervention. Further study of the impact on clinical performance is warranted.
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Randomized Controlled Trial Comparative Study
Cost-effectiveness of a physician-nurse supplementary triage assessment team at an academic tertiary care emergency department.
The purpose of this study was to evaluate the cost-effectiveness of physician-nurse supplementary triage assistance team (MDRNSTAT) from a hospital and patient perspective. ⋯ The MDRNSTAT is not a cost-effective daytime strategy but appears to be more feasible during time periods with higher patient volume, such as late morning to evening.
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Randomized Controlled Trial
Effect of Triage Nurse Initiated Radiography Using the Ottawa Ankle Rules on Emergency Department Length of Stay at a Tertiary Centre.
To determine the effect of triage nurse initiated radiographs using the Ottawa Ankle Rules (OAR) on emergency department (ED) throughput. We hypothesized OAR use would reduce median ED length of stay (LOS) by 25 minutes or more. ⋯ Triage nurse initiated radiography using OAR leads to a statistically significant decrease of 20 minutes in the median ED LOS at a tertiary care centre. The overall impact of implementing such a process is likely site-specific, and the decision to do so should involve consideration of the local context.
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Randomized Controlled Trial
Mental practice: a simple tool to enhance team-based trauma resuscitation.
Effective trauma resuscitation requires the coordinated efforts of an interdisciplinary team. Mental practice (MP) is defined as the mental rehearsal of activity in the absence of gross muscular movements and has been demonstrated to enhance acquiring technical and procedural skills. The role of MP to promote nontechnical, team-based skills for trauma has yet to be investigated. ⋯ MP leads to improvement in team-based skills compared to traditional simulation-based trauma instruction. We feel that MP may be a useful and inexpensive tool for improving nontechnical skills instruction effectiveness for team-based trauma care.