Emergency medicine journal : EMJ
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The ABCD scoring system has been described as a simple way of predicting stroke in the first 7 days after a transient ischaemic attack (TIA). The aims of our pilot study were to find out if emergency department (ED) doctors could use the scoring system effectively and if this system would influence admission rates and patient selection. ⋯ The ABCD scoring system for identifying high-risk patients after TIA is a useful aid in determining which patients require admission from the ED. Its use results in a significant reduction in the number of admissions without any inappropriate discharges.
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To evaluate the effects of change of ambient temperature on emergency department (ED) patient visits. ⋯ Our study demonstrated that ambient temperature had differential effects on ED patient visits of different specialties and severities.
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To identify collaborative instances and hindrances and to produce a model of collaborative practice. ⋯ The final model of collaborative practice suggests that ECPs are having an impact on patient care, but that improvements can be made. We recommend the appointment of ECP clinical leads, degree level clinically focussed multi-professional education, communication skills training, clinical supervision and multi-professional ECP appointments.
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Multicenter Study
Improving tetanus prophylaxis in the emergency department: a prospective, double-blind cost-effectiveness study.
The choice of tetanus prophylaxis for patients with wounds depends on obtaining their vaccination history, which has been demonstrated to be unreliable. Use of a rapid immunoassay (Tétanos Quick Stick, the TQS), combined with knowledge of certain demographic characteristics, may improve the evaluation of tetanus immunity and thus help to avoid inadequate prophylactic measures and reduce costs. ⋯ In selected patients, the TQS is a cost-effective tool to evaluate tetanus immunity. An algorithm is proposed for ED assessment of tetanus immunity integrating age and the TQS result.
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Multicenter Study
Validation of a diagnostic reminder system in emergency medicine: a multi-centre study.
Diagnostic error is a significant problem in emergency medicine, where initial clinical assessment and decision making is often based on incomplete clinical information. Traditional computerised diagnostic systems have been of limited use in the acute setting, mainly due to the need for lengthy system consultation. We evaluated a novel web-based reminder system, which provides rapid diagnostic advice to users based on free text search terms. ⋯ The Isabel diagnostic aid has been shown to be of potential use in reminding junior doctors of key diagnoses in the emergency department. The effects of its widespread use on decision making and diagnostic error can be clarified by evaluating its impact on routine clinical decision making.