Emergency medicine journal : EMJ
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Multicenter Study
Characteristics of general practices associated with emergency admission rates to hospital: a cross-sectional study.
To identify characteristics of general practices associated with emergency hospital admission rates, and determine whether levels of performance and patient reports of access are associated with admission rates. ⋯ The patient characteristics of deprivation, age, ethnicity and gender are important predictors of admission rates. Larger practices and greater distance from a hospital have lower admission rates. Being able to consult a particular GP, an aspect of continuity, is associated with lower emergency admission rates.
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Multicenter Study Comparative Study
Validation of the Full Outline of Unresponsiveness (FOUR) Scale for conscious state in the emergency department: comparison against the Glasgow Coma Scale.
To determine (a) the inter-rater reliability of pairs of emergency doctors' and/or nurses' ratings of the Glasgow Coma Scale (GCS) and the Full Outline of Unresponsiveness (FOUR) Scale in emergency department (ED) patients, (b) the concurrent validity of the FOUR Scale using the GCS as the reference scale and (c) doctors' and nurses' knowledge and attitudes towards the GCS and FOUR Scale. ⋯ The FOUR Scale showed greater reliability than the GCS in ED patients using ED clinicians as raters. A larger study of ED patients is warranted to determine the predictive validity of the FOUR Scale and to further examine the reliability of the scale in various patient populations.
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Randomized Controlled Trial Multicenter Study Comparative Study
Health utility and survival after hospital admission with acute cardiogenic pulmonary oedema.
The aim of this study was to measure health utility and survival in patients with acute cardiogenic pulmonary oedema (ACPO), identify predictors of outcome and determine the effect of initial treatment with non-invasive ventilation (NIV) upon outcomes. ⋯ Patients with ACPO have high mortality and reduced health utility. Initial treatment with CPAP or NIPPV does not alter subsequent survival or health utility.
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Multicenter Study Comparative Study
Predicting influenza A and 2009 H1N1 influenza in patients admitted to hospital with acute respiratory illness.
To create a clinical decision tool for suspected influenza A (including 2009 H1N1) to facilitate treatment and isolation decisions for patients admitted to hospital with an acute respiratory illness from the emergency department (ED) during a 2009 H1N1 pandemic. ⋯ A clinical prediction tool was developed that may be able to assist in making appropriate isolation decisions during future 2009 H1N1 outbreaks.
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Randomized Controlled Trial Multicenter Study Comparative Study
Patient satisfaction with chest pain unit care: findings from the Effectiveness and Safety of Chest Pain Assessment to Prevent Emergency Admissions (ESCAPE) cluster randomised trial.
Chest pain attendances at the emergency department (ED) in the UK are continuing to rise. Chest pain units (CPU) provide nurse-led, protocol-driven care for patients attending the ED with acute chest pain. The ESCAPE trial evaluated the effectiveness, cost-effectiveness and acceptability of CPU care in the NHS. This paper reports the quantitative evaluation of acceptability: patient satisfaction with CPU and routine care. ⋯ No evidence was found that improvements in patient satisfaction associated with CPU care in previous single-centre trials were reproduced in this multicentre study.