Emergency medicine journal : EMJ
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The sensitivity and specificity of consensus triage criteria for identifying which apparently inebriated patients could be triaged to care in a sobering centre were determined. Sensitivity and specificity for modifications to these criteria were also investigated. ⋯ Most apparently inebriated individuals in this study did not require ED care, but prospective identification of these persons is difficult. A low exclusion cut-off for tachycardia may improve sensitivity.
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To assess the way different terms used to describe a fracture affect the understanding a patient has of that fracture. The perceived severity of the injury and how the patient expects to be treated were also recorded with a view to optimising patient understanding. ⋯ It is important that doctors in the emergency department use terminology that is understood by the patient, as well as emphasising the potential seriousness of the injury. It is possibly better therefore to use informed lay terminology such as 'a break in a bone' rather than more formal vocabulary such 'a fracture' when discussing the diagnosis and treatment options.
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Review Meta Analysis
Does computer-aided clinical decision support improve the management of acute abdominal pain? A systematic review.
Acute abdominal pain is a common reason for emergency presentation to hospital. Despite recent medical advances in diagnostics, overall clinical decision-making in the assessment of patients with undifferentiated acute abdominal pain remains poor, with initial clinical diagnostic accuracy being 45-50%. Computer-aided decision support (CADS) systems were widely tested in this arena during the 1970s and 1980s with results that were generally favourable. ⋯ Included articles underwent meta-analysis with a random-effects model. Ten studies underwent meta-analysis that demonstrated an overall mean percentage improvement in clinical diagnostic accuracy of 17.25% with the use of CADS systems. There is a role for CADS in the initial evaluation of acute abdominal pain, which very often takes place in the emergency department setting.
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Randomized Controlled Trial
Early prehospital use of non-invasive ventilation improves acute respiratory failure in acute exacerbation of chronic obstructive pulmonary disease.
To evaluate the use of prehospital non-invasive ventilation (NIV) in patients with acute exacerbation of chronic obstructive pulmonary disease. ⋯ ISRCTN47620321.