Can J Emerg Med
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Randomized Controlled Trial Multicenter Study
Dilute proparacaine for the management of acute corneal injuries in the emergency department.
Dogma discourages the provision of topical anesthetics to patients with corneal injuries discharged from the emergency department because of the toxicity of concentrated solutions. We compared the analgesic efficacy of dilute topical proparacaine with placebo in emergency department patients with acute corneal injuries. ⋯ Dilute topical proparacaine is an efficacious analgesic for acute corneal injuries. Although no adverse events were observed in our study population, larger studies are required to evaluate safety.
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Randomized Controlled Trial Comparative Study
The effectiveness of training with an emergency department simulator on medical student performance in a simulated disaster.
Training in practical aspects of disaster medicine is often impossible, and simulation may offer an educational opportunity superior to traditional didactic methods. We sought to determine whether exposure to an electronic simulation tool would improve the ability of medical students to manage a simulated disaster. ⋯ Participation in an electronic disaster simulation using the disastermed.ca software package appears to increase the speed at which medical students triage simulated patients and increase their score on a structured command-and-control performance indicator instrument. Participants indicated that the simulation-based curriculum in disaster medicine is preferable to a lecture-based curriculum. Overall student satisfaction with the simulation-based curriculum was high.
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Randomized Controlled Trial
Emergency department patient compliance with follow-up for outpatient exercise stress testing: a randomized controlled trial.
Numerous patients are assessed in the emergency department (ED) for chest pain suggestive of acute coronary syndrome (ACS) and subsequently discharged if found to be at low risk. Exercise stress testing is frequently advised as a follow-up investigation for low-risk patients; however, compliance with such recommendations is poorly understood. We sought to determine if compliance with follow-up for exercise stress testing is higher in patients for whom the investigation is ordered at the time of ED discharge, compared with patients who are advised to arrange testing through their family physician (FP). ⋯ When ED staff order an outpatient exercise stress test following investigation for potential ACS, patients are more likely to complete the test if it is booked for them before ED discharge. After discharge, many low-risk chest pain patients feel they are not at risk and do not return to their FP for further testing in a timely manner as advised. Changing to a strategy of ED booking of exercise stress testing may help earlier identification of patients with coronary heart disease.
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Randomized Controlled Trial Clinical Trial
Impact of a standardized communication system on continuity of care between family physicians and the emergency department.
It has been suggested that continuity of care is hampered because of the lack of communication between emergency departments (EDs) and primary care providers. A web-based, standardized communication system (SCS) that enables family physicians (FPs) to visualize information regarding their patients' ED visits was developed. This paper aims to evaluate the impact of this SCS on continuity of care. ⋯ The use of SCS between an ED and FPs led to significant improvements in continuity of care by increasing the usefulness of transferred information and by improving FPs' perceived patient knowledge and patient management.
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Randomized Controlled Trial
Intravenous dexamethasone to prevent the recurrence of benign headache after discharge from the emergency department: a randomized, double-blind, placebo-controlled clinical trial.
To evaluate whether the addition of intravenous (i.v.) dexamethasone to standard emergency department (ED) benign headache therapy would reduce the incidence of headache recurrence at 48-72 hours. ⋯ In this study, IV dexamethasone reduced headache recurrence at 48-72-hour follow-up. Given its excellent safety profile and likely benefit, IV dexamethasone should be considered for ED headache patients after standard evaluation and therapy.