Articles: emergency-services.
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Multicenter Study Comparative Study
Light intensity of curved laryngoscope blades in Philadelphia emergency departments.
Laryngoscopy and tracheal intubation requires laryngeal exposure and illumination. The objective of this study is to assess variation in laryngoscope lights across different emergency departments (EDs). ⋯ Curved laryngoscope blades in different EDs have marked variation in light intensity. The contribution of luminance to laryngoscopy performance warrants investigation.
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Multicenter Study Comparative Study
Emergency Medical Service (EMS) systems in developed and developing countries.
To compare patient- and injury-related characteristics of trauma victims and pre-hospital trauma care systems among different developed and developing countries. ⋯ This study provides an early look at international variability in patient mix, process of care, and performance of different pre-hospital trauma care systems worldwide. International efforts should be devoted to developing a minimum standard data set for trauma patients.
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Multicenter Study
Improving tetanus prophylaxis in the emergency department: a prospective, double-blind cost-effectiveness study.
The choice of tetanus prophylaxis for patients with wounds depends on obtaining their vaccination history, which has been demonstrated to be unreliable. Use of a rapid immunoassay (Tétanos Quick Stick, the TQS), combined with knowledge of certain demographic characteristics, may improve the evaluation of tetanus immunity and thus help to avoid inadequate prophylactic measures and reduce costs. ⋯ In selected patients, the TQS is a cost-effective tool to evaluate tetanus immunity. An algorithm is proposed for ED assessment of tetanus immunity integrating age and the TQS result.
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Multicenter Study Comparative Study
Comparison of Canadian versus American emergency department visits for acute asthma.
Acute asthma is a common emergency department (ED) presentation in both Canada and the United States. ⋯ Canadian patients with acute asthma have fewer barriers to primary care and are more likely to be on preventive medications, both before the ED visit and following discharge. Admissions rates are higher in the United States; however, relapse after discharge is similar between countries. These findings highlight the influences of preventive practices and heath care systems on ED visits for asthma.
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Multicenter Study
Validation of a diagnostic reminder system in emergency medicine: a multi-centre study.
Diagnostic error is a significant problem in emergency medicine, where initial clinical assessment and decision making is often based on incomplete clinical information. Traditional computerised diagnostic systems have been of limited use in the acute setting, mainly due to the need for lengthy system consultation. We evaluated a novel web-based reminder system, which provides rapid diagnostic advice to users based on free text search terms. ⋯ The Isabel diagnostic aid has been shown to be of potential use in reminding junior doctors of key diagnoses in the emergency department. The effects of its widespread use on decision making and diagnostic error can be clarified by evaluating its impact on routine clinical decision making.