Emergency medicine journal : EMJ
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Multicenter Study Comparative Study
Observer agreement of the Manchester Triage System and the Emergency Severity Index: a simulation study.
To compare inter and intra-observer agreement of the Manchester Triage System (MTS) and the Emergency Severity Index (ESI). ⋯ Using paper-based clinical scenarios, MTS was found to have a greater inter and intra-observer agreement than ESI.
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Severe pain is a common presenting symptom for emergency patients. One major challenge in the management of severe pain is the objective measurement of pain. Due to the subjective nature of pain, it can be very difficult for clinicians to quantify pain intensity and measure the qualitative features of the pain experience. ⋯ This paper reviews the characteristics required of a prehospital acute pain measure and appraises the relative utility of a number of currently used pain measures. At present, the verbal numerical rating scale appears the most appropriate pain measure to administer in the prehospital setting for adult patients as it is practical and valid. Either the Oucher scale or the faces pain scale is suitable for prehospital care providers to assess pain in children.
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Randomized Controlled Trial
Role of surgeon-performed ultrasound on further management of patients with acute abdominal pain: a randomised controlled clinical trial.
The use of bedside ultrasound performed by the surgeon or emergency physician on duty at the emergency department is increasing. A study was performed which is the first randomised study to evaluate the benefits of surgeon-performed ultrasound for the management of the acute abdomen. ⋯ This study shows benefits in the management of the acute abdomen resulting in fewer further requested examinations, fewer admissions and shorter lead times to surgery. On the basis of these results, it is recommended for implementation in emergency departments.
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The growing demand for inpatient beds in Singapore has led Tan Tock Seng Hospital to set up an observation medicine unit where patients are monitored and discharged within a 24-h period. ⋯ With patient satisfaction becoming increasingly important as an indicator of the quality of care in the present healthcare environment, doctors and nurses should seek to improve their communication with their patients so as to ensure that patients are satisfied and receive quality care.