Articles: hospital-emergency-service.
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Randomized Controlled Trial Clinical Trial
Communication across the divide. A trial of structured communication between general practice and emergency departments.
To evaluate the impact of structured form letters for general practitioner to emergency department (ED) communication. ⋯ This study demonstrates that improvements to communication between GPs and EDs are difficult and may require a systemic change within general practice and the hospital. Electronic systems may allow the sort of reciprocal communication required to establish and sustain improvement.
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Randomized Controlled Trial Clinical Trial
A randomized, controlled trial of panic disorder treatment initiation in an emergency department chest pain center.
We examine the effect of a protocol for panic disorder recognition and treatment initiation on medication initiation rates and medication continuation rates at 1- and 3-month follow-up. ⋯ Panic disorder is common and severe in this sample of patients with chest pain. A screening measure and a brief (5-minute) structured interview allowed emergency physicians with no extra training to reliably diagnose panic disorder and initiate pharmacologic treatment.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A randomized, controlled trial of clinical information shared from another institution.
Emergency physicians often must deliver medical care with minimal access to historical clinical information. We demonstrate the feasibility and potential value of increased access to patients' clinical information from another hospital while they are receiving care in the emergency department. ⋯ Our pilot study is the first to demonstrate the feasibility of sharing clinical information between different health care systems. We observed a trend toward cost savings at 1 of 2 hospitals and no differences in the quality measures we studied. Our experience underscores the difficulties inherent in studying the effects of community-wide health care interventions on cost and quality of ED care.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized clinical trial of intravenous magnesium sulfate as an adjunctive medication for emergency department treatment of migraine headache.
We test the hypothesis that intravenous magnesium sulfate is an effective adjunctive medication for treatment of acute migraine. ⋯ Although this result was unexpected, our data suggest that the addition of magnesium to metoclopramide may attenuate the effectiveness of metoclopramide in relieving migraine. Countertherapeutic cerebral vasodilatation caused by magnesium is a plausible, although unproven, explanation for this finding. Because of the preponderance of women in our trial, these data may not be generalizable to men.
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Randomized Controlled Trial Comparative Study Clinical Trial
The epidemiology of the homeless population and its impact on an urban emergency department.
To characterize the homeless adult population of an urban emergency department (ED) and study the medical, psychiatric, and social factors that contribute to homelessness. ⋯ In the study population homelessness was associated with a history of significantly higher rates of infectious disease, ethanol and substance use, psychiatric illness, social isolation, and rates of ED utilization.