Articles: hospital-emergency-service.
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Randomized Controlled Trial
Intravenous subdissociative-dose ketamine versus morphine for acute geriatric pain in the Emergency Department: A randomized controlled trial.
We compare the analgesic efficacy and safety of subdissociative intravenous-dose ketamine (SDK) versus morphine in geriatric Emergency Department (ED) patients. ⋯ SDK administered at 0.3 mg/kg over 15 min provides analgesic efficacy comparable to morphine for short-term treatment of acute pain in the geriatric ED patients but results in higher rates of psychoperceptual adverse effects. ClinicalTrials.gov Registration #: NCT02673372.
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Randomized Controlled Trial
Effect of a brief motivational intervention in reducing alcohol consumption in the emergency department: a randomized controlled trial.
Introduction to alcohol consumption early in life increases the risk of alcohol dependency and hence motivational interventions are needed in young patients visiting the emergency department (ED). ⋯ We did not observe a significant decrease in alcohol consumption among the youth. Further studies are needed to confirm the positive impact of a brief motivational intervention in the ED.
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Randomized Controlled Trial Multicenter Study
Impact of scribes on emergency medicine doctors' productivity and patient throughput: multicentre randomised trial.
To evaluate the changes in productivity when scribes were used by emergency physicians in emergency departments in Australia and assess the effect of scribes on throughput. ⋯ Scribes improved emergency physicians' productivity, particularly during primary consultations, and decreased patients' length of stay. Further work should evaluate the role of the scribe in countries with health systems similar to Australia's.
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Randomized Controlled Trial
The HEART Pathway Randomized Controlled Trial One-year Outcomes.
The objective was to determine the impact of the HEART Pathway on health care utilization and safety outcomes at 1 year in patients with acute chest pain. ⋯ The HEART Pathway had a 100% NPV for 1-year safety outcomes (MACE) without increasing downstream hospitalizations or ED visits. Reduction in 1-year objective testing was not significant.
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Randomized Controlled Trial Comparative Study
Predicting mortality in patients with suspected sepsis at the Emergency Department; A retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score.
In hospitalized patients, the risk of sepsis-related mortality can be assessed using the quick Sepsis-related Organ Failure Assessment (qSOFA). Currently, different tools that predict deterioration such as the National Early Warning Score (NEWS) have been introduced in clinical practice in Emergency Departments (ED) worldwide. It remains ambiguous which screening tool for mortality at the ED is best. The objective of this study was to evaluate the predictive performance for mortality of two sepsis-based scores (i.e. qSOFA and Systemic Inflammatory Response Syndrome (SIRS)-criteria) compared to the more general NEWS score, in patients with suspected infection directly at presentation to the ED. ⋯ NEWS is more accurate in predicting 10- and 30-day mortality than qSOFA and SIRS in patients presenting to the ED with suspected sepsis.