Articles: hospital-emergency-service.
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Bmc Health Serv Res · Jan 2009
Randomized Controlled Trial Multicenter Study Comparative StudyScreening and brief interventions for hazardous alcohol use in accident and emergency departments: a randomised controlled trial protocol.
There is a wealth of evidence regarding the detrimental impact of excessive alcohol consumption on the physical, psychological and social health of the population. There also exists a substantial evidence base for the efficacy of brief interventions aimed at reducing alcohol consumption across a range of healthcare settings. Primary research conducted in emergency departments has reinforced the current evidence regarding the potential effectiveness and cost-effectiveness. Within this body of evidence there is marked variation in the intensity of brief intervention delivered, from very minimal interventions to more intensive behavioural or lifestyle counselling approaches. Further the majority of primary research has been conducted in single centre and there is little evidence of the wider issues of generalisability and implementation of brief interventions across emergency departments. ⋯ This paper presents a protocol for a large multi-centre pragmatic factorial cluster randomised trial to evaluate the effectiveness and cost-effectiveness of screening and brief interventions for hazardous alcohol users attending emergency departments.
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Randomized Controlled Trial Comparative Study
Baseline hospital performance and the impact of medical emergency teams: modelling vs. conventional subgroup analysis.
To compare two approaches to the statistical analysis of the relationship between the baseline incidence of adverse events and the effect of medical emergency teams (METs). ⋯ Our study showed that, in the MERIT study, when there was dependence of treatment effect on baseline performance, an approach based on regression modelling helped illustrate the nature and magnitude of such dependence while sub-group analysis did not. The ability to assess the nature and magnitude of such dependence may have policy implications. Regression technique may thus prove useful in analysing data when there is a conditional treatment effect.
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Randomized Controlled Trial Comparative Study
Oral versus intravenous opioid dosing for the initial treatment of acute musculoskeletal pain in the emergency department.
The objective was to compare the time to medication administration, the side effects, and the analgesic effect at sequential time points after medication administration of an oral treatment strategy using oxycodone solution with an intravenous (IV) treatment strategy using morphine sulfate for the initial treatment of musculoskeletal pain in emergency department (ED) patients. ⋯ The oral loading strategy was associated with delayed onset of analgesia and decreased patient satisfaction, but a shorter time to administration. The oral loading strategy using an oxycodone solution provided similar pain relief to the IV strategy using morphine 30 minutes after administration of the drug. Oral 0.125 mg/kg oxycodone represents a feasible alternative to 0.1 mg/kg IV morphine in the treatment of severe acute musculoskeletal pain when difficult or delayed IV placement greater than 30 minutes presents a barrier to treatment.
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Randomized Controlled Trial
A smoking cessation intervention plus proactive quitline referral in the pediatric emergency department: a pilot study.
The prevalence of adult tobacco users who utilize the emergency department as patients or parents is disproportionately higher than the national average rates of tobacco use. Thus, it is advised that the emergency department be utilized as a venue for providing tobacco cessation counseling to adult tobacco users. Using a randomized control trial design, this pilot study evaluated the effect of a brief tobacco cessation intervention for tobacco using parents of children brought to a pediatric emergency department. ⋯ Quitline counselors were unable to reach 54% of participants. Our results reveal increased intentions to quit and trends toward quitting, however we experienced difficulties with participant retention. Suggestions for improvements in point prevalence and retention are given.
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Arch Pediatr Adolesc Med · Oct 2008
Randomized Controlled TrialCost-effectiveness analysis of anesthetic agents during peripheral intravenous cannulation in the pediatric emergency department.
To conduct a cost-effectiveness analysis of anesthetic agents to reduce the pain of peripheral intravenous cannulation in an emergency department (ED) setting. ⋯ Currently, the needle-free jet injection of lidocaine device and injection of buffered lidocaine appear to provide the most cost-effective alternatives to pediatric ED physicians.