Articles: emergency-department.
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Eur J Trauma Emerg Surg · Dec 2022
Ways to improve guideline adherence in the emergency department: an interview study on the management of traumatic brain injuries.
The aim was to explore factors affecting guideline adherence among doctors in the emergency department and to explore the general perception about local guidelines for traumatic brain injuries. ⋯ The participants believed that guideline adherence would increase by facilitating guideline availability, by providing concise, easy-to-understand, and well-illustrated guidelines available in printed form, as well as establishing a culture that promotes guideline use. The local guidelines for traumatic brain injuries were appreciated, but could be improved.
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Pediatric emergency care · Dec 2022
The Cost of a Learner in the Pediatric Emergency Department: A Comparison Across Two Pediatric Emergency Departments.
Experimental learning is a foundation of medical education, but a learner in the pediatric emergency department impacts utilization, time and disposition metrics. Our study sought to compare the effect of a resident learner on metrics between 2 pediatric emergency departments. ⋯ Residents see sicker patients and tend to order more ancillary tests, which ultimately leads to increased relative value unit generation. We hypothesize that the difference in metrics seen could be explained by the training background of residents, as well as efficiencies of the department as a whole.
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Forearm fractures in children often require closed reduction in the emergency setting. The choice of anaesthesia influences the degree of pain relief, which determines the success of reduction. Main methods of anaesthesia include procedural sedation and analgesia, haematoma block, intravenous regional anaesthesia (IVRA) and regional nerve blocks. However, their comparative effectiveness is unclear. This study aims to synthesise peer-reviewed evidence and identify the most effective, in terms of pain reduction, and safest anaesthetic method. ⋯ Few randomised controlled trials compared anaesthetic methods in the closed reduction of paediatric forearm fractures. High heterogeneity precluded meta-analysis. Overall, current data are insufficient to guide the choice of anaesthetic method in emergency settings. More adequately powered trials, conducted using standardised methods, are required.