Articles: hospital-emergency-service.
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Mayo Clinic proceedings · Apr 2010
Randomized Controlled TrialComputed tomographic coronary artery calcium assessment for evaluating chest pain in the emergency department: long-term outcome of a prospective blind study.
To determine the long-term outcome of computed tomographic (CT) quantification of coronary artery calcium (CAC) used as a triage tool for patients presenting with chest pain to an emergency department (ED). ⋯ Findings suggest that CT CAC assessment is a powerful adjunct in chest pain evaluation for the population at low-to-intermediate risk. Absent or minimal CAC in this population makes cardiac chest pain extremely unlikely. The absence of CAC suggests an excellent long-term (5-year) prognosis, with no primary or secondary cardiac outcomes occurring in study patients at 5-year follow-up.
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Randomized Controlled Trial
Does end tidal CO2 monitoring during emergency department procedural sedation and analgesia with propofol decrease the incidence of hypoxic events? A randomized, controlled trial.
We determine whether the use of capnography is associated with a decreased incidence of hypoxic events than standard monitoring alone during emergency department (ED) sedation with propofol. ⋯ In adults receiving ED propofol sedation, the addition of capnography to standard monitoring reduced hypoxia and provided advance warning for all hypoxic events.
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Randomized Controlled Trial
Point of care troponin decreases time in the emergency department for patients with possible acute coronary syndrome: a randomised controlled trial.
To determine the effect of cardiac troponin I testing with a point-of-care (POC) device versus central laboratory on length of stay (LOS) in emergency department (ED) patients presenting with possible acute coronary syndromes (ACS). ⋯ POC testing for troponin in the ED tended to reduce the LOS for possible ACS patients. The degree of this benefit is likely to be markedly dependent on its acceptance and uptake by attending personnel, and on the ED setting in which it is used.
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Pediatric emergency care · Feb 2010
Randomized Controlled TrialToward improving the diagnosis and the treatment of adolescent pelvic inflammatory disease in emergency departments: results of a brief, educational intervention.
To assess the utility of an abbreviated teaching tool (ATT) in improving emergency medicine pediatricians' knowledge of the diagnosis and the treatment of pelvic inflammatory disease (PID). ⋯ Although the overall PID knowledge in our sample was low, the physicians with access to a 1-page teaching tool summarizing the CDC treatment recommendations for PID performed significantly better when asked questions involving PID treatment as compared with providers with access to the CDC Web site. Further studies should investigate whether access to a similar tool can improve patient care.
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Randomized Controlled Trial
The Chest Pain Choice trial: a pilot randomized trial of a decision aid for patients with chest pain in the emergency department.
Chest pain is a common presenting complaint in the emergency department (ED). Despite the frequency with which clinicians evaluate patients with chest pain, accurately determining the risk of acute coronary syndrome (ACS) and sharing risk information with patients is challenging. The aims of this study are (1) to develop a decision aid (CHEST PAIN CHOICE) that communicates the short-term risk of ACS and (2) to evaluate the impact of the decision aid on patient participation in decision-making and resource use. ⋯ This pilot randomized trial will develop and evaluate a decision aid for use in ED chest pain patients at low risk for ACS and provide a preliminary estimate of its effect on patient participation in decision-making and resource use.