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Find video protocols related to scientific articles indexed in Pubmed.
Physiologic field triage criteria for identifying seriously injured older adults.
Prehosp Emerg Care
PUBLISHED: 06-16-2014
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To evaluate the ability of out-of-hospital physiologic measures to predict serious injury for field triage purposes among older adults and potentially reduce the undertriage of seriously injured elders to non-trauma hospitals.
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Addressing the challenges of obtaining functional outcomes in traumatic brain injury research: missing data patterns, timing of follow-up, and three prognostic models.
J. Neurotrauma
PUBLISHED: 05-08-2014
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Traumatic brain injury (TBI) is common and debilitating. Randomized trials of interventions for TBI ideally assess effectiveness by using long-term functional neurological outcomes, but such outcomes are difficult to obtain and costly. If there is little change between functional status at hospital discharge versus 6 months, then shorter-term outcomes may be adequate for use in future clinical trials. Using data from a previously published multi-center, randomized, placebo-controlled TBI clinical trial, we evaluated patterns of missing outcome data, changes in functional status between hospital discharge and 6 months, and three prognostic models to predict long-term functional outcome from covariates available at hospital discharge (functional measures, demographics, and injury characteristics). The Resuscitation Outcomes Consortium Hypertonic Saline trial enrolled 1282 TBI patients, obtaining the primary outcome of 6-month Glasgow Outcome Score Extended (GOSE) for 85% of patients, but missing the primary outcome for the remaining 15%. Patients with missing outcomes had less-severe injuries, higher neurological function at discharge (GOSE), and shorter hospital stays than patients whose GOSE was obtained. Of 1066 (83%) patients whose GOSE was obtained both at hospital discharge and at 6-months, 71% of patients had the same dichotomized functional status (severe disability/death vs. moderate/no disability) after 6 months as at discharge, 28% had an improved functional status, and 1% had worsened. Performance was excellent (C-statistic between 0.88 and 0.91) for all three prognostic models and calibration adequate for two models (p values, 0.22 and 0.85). Our results suggest that multiple imputation of the standard 6-month GOSE may be reasonable in TBI research when the primary outcome cannot be obtained through other means.
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A consensus-based criterion standard for trauma center need.
J Trauma Acute Care Surg
PUBLISHED: 03-26-2014
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In civilian trauma care, field triage is the process applied by prehospital care providers to identify patients who are likely to have severe injuries and immediately need the resources of a trauma center. Studies of the efficacy of field triage have used various measures to define trauma center need because no "criterion standard" exists, making cross-study comparisons difficult. This study aimed to develop a consensus-based functional criterion standard definition of trauma center need.
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From 9-1-1 call to death: evaluating traumatic deaths in seven regions for early recognition of high-risk patients.
J Trauma Acute Care Surg
PUBLISHED: 02-21-2014
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This study aimed to characterize initial clinical presentations of patients served by emergency medical services (EMS) who die following injury, with particular attention to patients with occult ("talk-and-die") presentations.
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Gunshot injuries in children served by emergency services.
Pediatrics
PUBLISHED: 10-14-2013
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To describe the incidence, injury severity, resource use, mortality, and costs for children with gunshot injuries, compared with other injury mechanisms.
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The effect of trauma center care on pediatric injury mortality in California, 1999 to 2011.
J Trauma Acute Care Surg
PUBLISHED: 09-26-2013
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Trauma centers (TCs) have been shown to decrease mortality in adults, but this has not been demonstrated at a population level in all children. We hypothesized that seriously injured children would have increased survival in a TC versus nontrauma center (nTC), but there would be no increased benefit from pediatric-designated versus adult TC care.
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The cost of overtriage: more than one-third of low-risk injured patients were taken to major trauma centers.
Health Aff (Millwood)
PUBLISHED: 09-11-2013
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Regionalized trauma care has been widely implemented in the United States, with field triage by emergency medical services (EMS) playing an important role in identifying seriously injured patients for transport to major trauma centers. In this study we estimated hospital-level differences in the adjusted cost of acute care for injured patients transported by 94 EMS agencies to 122 hospitals in 7 regions, overall and by injury severity. Among 301,214 patients, the average adjusted per episode cost of care was $5,590 higher in a level 1 trauma center than in a nontrauma hospital. We found hospital-level differences in cost among patients with minor, moderate, and serious injuries. Of the 248,342 low-risk patients-those who did not meet field triage guidelines for transport to trauma centers-85,155 (34.3 percent) were still transported to major trauma centers, accounting for up to 40 percent of acute injury costs. Adhering to field triage guidelines that minimize the overtriage of low-risk injured patients to major trauma centers could save up to $136.7 million annually in the seven regions we studied.
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Predicting ambulance time of arrival to the emergency department using global positioning system and google maps.
Prehosp Emerg Care
PUBLISHED: 07-18-2013
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To derive and validate a model that accurately predicts ambulance arrival time that could be implemented as a Google Maps web application.
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Triage of elderly trauma patients: a population-based perspective.
J. Am. Coll. Surg.
PUBLISHED: 06-21-2013
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Elderly patients are frequently undertriaged. However, the associations between triage patterns and outcomes from a population perspective are unknown. We hypothesized that triage patterns would be associated with differences in outcomes.
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End-of-life decision-making for patients admitted through the emergency department: hospital variability, patient demographics, and changes over time.
Acad Emerg Med
PUBLISHED: 05-25-2013
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Early studies suggest that racial, economic, and hospital-based factors influence the do-not-attempt-resuscitation (DNAR) status of admitted patients, although it remains unknown how these factors apply to patients admitted through the emergency department (ED) and whether use is changing over time.
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The trade-offs in field trauma triage: a multiregion assessment of accuracy metrics and volume shifts associated with different triage strategies.
J Trauma Acute Care Surg
PUBLISHED: 04-24-2013
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National benchmarks for trauma triage sensitivity (?95%) and specificity (?50%) have not been rigorously evaluated across broad populations of injured patients. We evaluated the impact of different field triage schemes for identifying seriously injured patients across a range of sensitivity values. Impact metrics included specificity and number of undertriaged and overtriaged patients compared with current triage practices.
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Concordance of Out-of-Hospital and Emergency Department Cardiac Arrest Resuscitation With Documented End-of-Life Choices in Oregon.
Ann Emerg Med
PUBLISHED: 04-21-2013
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Resuscitation measures should be guided by previous patient choices about end-of-life care, when they exist; however, documentation of these choices can be unclear or difficult to access. We evaluate the concordance of a statewide registry of actionable resuscitation orders unique to Oregon with out-of-hospital and emergency department (ED) care provided for patients found by emergency medical services (EMS) in out-of-hospital cardiac arrest.
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Variation in prehospital use and uptake of the national Field Triage Decision Scheme.
Prehosp Emerg Care
PUBLISHED: 03-05-2013
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The Field Triage Decision Scheme is a national guideline that has been implemented widely for prehospital emergency medical services (EMS) and trauma systems. However, little is known about the uptake, modification, or variation in field application of triage criteria between trauma systems.
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Patient choice in the selection of hospitals by 9-1-1 emergency medical services providers in trauma systems.
Acad Emerg Med
PUBLISHED: 01-31-2013
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Reasons for undertriage (transporting seriously injured patients to nontrauma centers) and the apparent lack of benefit of trauma centers among older adults remain unclear; understanding emergency medical services (EMS) provider reasons for selecting certain hospitals in trauma systems may provide insight to these issues. In this study, the authors evaluated reasons cited by EMS providers for selecting specific hospital destinations for injured patients, stratified by age, injury severity, field triage status, and prognosis.
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Why persons choose to opt out of an exception from informed consent cardiac arrest trial.
Resuscitation
PUBLISHED: 01-24-2013
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We sought to characterize persons who requested to opt out of an exception from informed consent (EFIC) cardiac arrest trial and their reasons for opting out.
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Survival in out-of-hospital cardiac arrests with initial asystole or pulseless electrical activity and subsequent shockable rhythms.
Resuscitation
PUBLISHED: 01-16-2013
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Non-shockable arrest rhythms (pulseless electrical activity and asystole) represent an increasing proportion of reported cases of out-of-hospital cardiac arrest (OHCA). The prognostic significance of conversion from non-shockable to shockable rhythms during the course of resuscitation remains unclear.
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Intraosseous line use, complications, and outcomes among a population-based cohort of children presenting to California hospitals.
Pediatr Emerg Care
PUBLISHED: 10-01-2011
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Intraosseous line (IO) use has been described in prehospital settings, with some studies in the emergency department (ED). However, population-based studies describing IO line use across diverse ED and hospital settings are sparse, and the true incidence of complications remains unknown.
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Surrogate markers of transport distance for out-of-hospital cardiac arrest patients.
Prehosp Emerg Care
PUBLISHED: 09-27-2011
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Transport of out-of-hospital cardiac arrest (OHCA) patients expeditiously to appropriately equipped hospitals is of paramount importance.
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Out-of-hospital decision making and factors influencing the regional distribution of injured patients in a trauma system.
J Trauma
PUBLISHED: 08-06-2011
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The decision-making processes used for out-of-hospital trauma triage and hospital selection in regionalized trauma systems remain poorly understood. The objective of this study was to assess the process of field triage decision making in an established trauma system.
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Rural-urban disparities in emergency department intimate partner violence resources.
West J Emerg Med
PUBLISHED: 06-22-2011
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Little is known about availability of resources for managing intimate partner violence (IPV) at rural hospitals. We assessed differences in availability of resources for IPV screening and management between rural and urban emergency departments (EDs) in Oregon.
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Developing a statewide emergency medical services database linked to hospital outcomes: a feasibility study.
Prehosp Emerg Care
PUBLISHED: 05-27-2011
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Statewide emergency medical services (EMS) data linked to outcomes are critical for promoting high-quality emergency care; however, many states do not have such a resource.
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A multisite assessment of the American College of Surgeons Committee on Trauma field triage decision scheme for identifying seriously injured children and adults.
J. Am. Coll. Surg.
PUBLISHED: 04-25-2011
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The American College of Surgeons Committee on Trauma (ACSCOT) has developed and updated field trauma triage protocols for decades, yet the ability to identify major trauma patients remains unclear. We estimate the diagnostic value of the Field Triage Decision Scheme for identifying major trauma patients (Injury Severity Score [ISS] ? 16) in a large and diverse multisite cohort.
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Trauma in the neighborhood: a geospatial analysis and assessment of social determinants of major injury in North America.
Am J Public Health
PUBLISHED: 03-11-2011
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We sought to identify and characterize areas with high rates of major trauma events in 9 diverse cities and counties in the United States and Canada.
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The relationship between out-of-hospital airway management and outcome among trauma patients with Glasgow Coma Scale Scores of 8 or less.
Prehosp Emerg Care
PUBLISHED: 02-10-2011
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Airway management remains a fundamental component of optimal care of the severely injured patient, with endotracheal intubation representing the definitive strategy for airway control. However, multiple studies document an association between out-of-hospital intubation and increased mortality for severe traumatic brain injury.
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Rural-urban disparities in child abuse management resources in the emergency department.
J Rural Health
PUBLISHED: 10-30-2010
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To characterize differences in child abuse management resources between urban and rural emergency departments (EDs).
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Out-of-hospital hypertonic resuscitation following severe traumatic brain injury: a randomized controlled trial.
JAMA
PUBLISHED: 10-07-2010
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Hypertonic fluids restore cerebral perfusion with reduced cerebral edema and modulate inflammatory response to reduce subsequent neuronal injury and thus have potential benefit in resuscitation of patients with traumatic brain injury (TBI).
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The optimum follow-up period for assessing mortality outcomes in injured older adults.
J Am Geriatr Soc
PUBLISHED: 09-09-2010
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To compare mortality rates of hospitalized injured aged 67 and older across commonly used follow-up periods (e.g., in-hospital, 30-day, 1-year) and to determine the postinjury time after which mortality rates stabilize.
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Injury hospitalization as a marker for emergency medical services use in elderly patients.
Prehosp Emerg Care
PUBLISHED: 07-01-2010
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The elderly utilize emergency medical services (EMS) at a higher rate than younger patients, yet little is known about the influence of injury on subsequent EMS utilization and costs.
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Validation of length of hospital stay as a surrogate measure for injury severity and resource use among injury survivors.
Acad Emerg Med
PUBLISHED: 04-08-2010
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While hospital length of stay (LOS) has been used as a surrogate injury outcome when more detailed outcomes are unavailable, it has not been validated. This project sought to validate LOS as a proxy measure of injury severity and resource use in heterogeneous injury populations.
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Effectiveness and safety of fentanyl compared with morphine for out-of-hospital analgesia.
Prehosp Emerg Care
PUBLISHED: 03-05-2010
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Fentanyl has several potential advantages for out-of-hospital analgesia, including rapid onset, short duration, and less histamine release. Objective. To compare the effectiveness and safety of fentanyl with that of morphine.
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A critical assessment of the out-of-hospital trauma triage guidelines for physiologic abnormality.
J Trauma
PUBLISHED: 02-16-2010
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It remains unclear whether the American College of Surgeons Committee on Trauma (ACSCOT) "step 1" field physiologic criteria could be further restricted without substantially sacrificing sensitivity. We assessed whether more restrictive physiologic criteria would improve the specificity of this triage step without missing high-risk patients.
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A geospatial assessment of transport distance and survival to discharge in out of hospital cardiac arrest patients: Implications for resuscitation centers.
Resuscitation
PUBLISHED: 02-01-2010
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National leaders have suggested that patients with an out of hospital cardiac arrest (OOHCA) may benefit from transport to specialized hospitals. We sought to assess the survival of OOHCA patients by transport distance and hospital proximity.
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Geographic cluster analysis of injury severity and hospital resource use in a regional trauma system.
Prehosp Emerg Care
PUBLISHED: 01-26-2010
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To determine clusters of trauma incidents with high injury severity and resource utilization and to test their association with census demographic information.
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Soft tissue infections and emergency department disposition: predicting the need for inpatient admission.
Acad Emerg Med
PUBLISHED: 12-07-2009
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Little empiric evidence exists to guide emergency department (ED) disposition of patients presenting with soft tissue infections. This studys objective was to generate a clinical decision rule to predict the need for greater than 24-hour hospital admission for patients presenting to the ED with soft tissue infection.
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Variation in the type, rate, and selection of patients for out-of-hospital airway procedures among injured children and adults.
Acad Emerg Med
PUBLISHED: 12-07-2009
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The objective was to compare the type, rate, and selection of injured patients for out-of-hospital airway procedures among emergency medical services (EMS) agencies in 10 sites across North America.
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Early neurosurgical procedures enhance survival in blunt head injury: propensity score analysis.
J Emerg Med
PUBLISHED: 10-27-2009
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Studies of trauma systems have identified traumatic brain injury as a frequent cause of death or disability. Due to the heterogeneity of patient presentations, practice variations, and potential for secondary brain injury, the importance of early neurosurgical procedures upon survival remains controversial. Traditional observational outcome studies have been biased because injury severity and clinical prognosis are associated with use of such interventions.
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A population-based survival assessment of categorizing level III and IV rural hospitals as trauma centers.
J Rural Health
PUBLISHED: 09-30-2009
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Patients injured in rural areas are hypothesized to have improved outcomes if statewide trauma systems categorize rural hospitals as Level III and IV trauma centers, though evidence to support this belief is sparse.
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The availability and use of out-of-hospital physiologic information to identify high-risk injured children in a multisite, population-based cohort.
Prehosp Emerg Care
PUBLISHED: 09-05-2009
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The validity of using adult physiologic criteria to triage injured children in the out-of-hospital setting remains unproven. Among children meeting adult field physiologic criteria, we assessed the availability of physiologic information, the incidence of death or prolonged hospitalization, and whether age-specific criteria would improve the specificity of the physiologic triage step.
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Level I versus Level II trauma centers: an outcomes-based assessment.
J Trauma
PUBLISHED: 05-12-2009
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Trauma centers improve outcomes compared with nontrauma centers, although the relative benefit of different levels of major trauma centers (Level I vs. Level II hospitals) remains unclear. We sought to determine whether there was a difference in the patient outcome in trauma victims taken to Level I versus Level II trauma centers.
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Local media influence on opting out from an exception from informed consent trial.
Ann Emerg Med
PUBLISHED: 04-15-2009
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News media are used for community education and notification in exception from informed consent clinical trials, yet their effectiveness as an added safeguard in such research remains unknown. We assessed the number of callers requesting opt-out bracelets after each local media report and described the errors and content within each media report.
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Emergency medical services intervals and survival in trauma: assessment of the "golden hour" in a North American prospective cohort.
Ann Emerg Med
PUBLISHED: 03-13-2009
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The first hour after the onset of out-of-hospital traumatic injury is referred to as the "golden hour," yet the relationship between time and outcome remains unclear. We evaluate the association between emergency medical services (EMS) intervals and mortality among trauma patients with field-based physiologic abnormality.
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A geospatial analysis of persons opting out of an exception from informed consent out-of-hospital clinical trial.
Resuscitation
PUBLISHED: 03-11-2009
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For trials involving exception from informed consent, some IRBs require that community members be allowed to "opt out" prior to enrollment. We tested for geospatial clustering of opt-out requests and the associated census tract characteristics in one study region.
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Establishing an emergency medicine education research network.
Acad Emerg Med
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This project was developed from the research network track at the 2012 Academic Emergency Medicine consensus conference on education research in emergency medicine (EM). Using a combination of consensus techniques, the modified Delphi method, and qualitative research methods, the authors describe multiple aspects of developing, implementing, managing, and growing an EM education research network. A total of 175 conference attendees and 24 small-group participants contributed to discussions regarding an education research network; participants were experts in research networks, education, and education research. This article summarizes relevant conference discussions and expert opinion for recommendations on the structure of an education research network, basic operational framework, site selection, leadership, subcommittees, guidelines for authorship, logistics, and measuring success while growing and maintaining the network.
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Variability of ICU use in adult patients with minor traumatic intracranial hemorrhage.
Ann Emerg Med
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Patients with minor traumatic intracranial hemorrhage are frequently admitted to the ICU, although many never require critical care interventions. To describe ICU resource use in minor traumatic intracranial hemorrhage, we assess (1) the variability of ICU use in a cohort of patients with minor traumatic intracranial hemorrhage across multiple trauma centers, and (2) the proportion of adult patients with traumatic intracranial hemorrhage who are admitted to the ICU and never receive a critical care intervention during hospitalization. In addition, we evaluate the association between ICU admission and key independent variables.
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The impact of early do not resuscitate (DNR) orders on patient care and outcomes following resuscitation from out of hospital cardiac arrest.
Resuscitation
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Among patients successfully resuscitated from out-of-hospital cardiac arrest (OHCA) and admitted to California hospitals, we examined how the placement of a do not resuscitate (DNR) order in the first 24h after admission was associated with patient care, procedures and inhospital survival. We further analyzed hospital and patient demographic factors associated with early DNR placement among patients admitted following OHCA.
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The association between hospital type and mortality among critically ill children in US EDs.
Resuscitation
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Little is known about the setting of care for critically ill children and whether differences in outcomes are related to the presenting hospital type. This study describes the characteristics of hospitals to which critically ill children present and explores the associations between hospital factors and mortality.
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Is futile care in the injured elderly an important target for cost savings?
J Trauma Acute Care Surg
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This study proposes a definition of futile care and quantifies its cost in injured elders.
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Deciphering the use and predictive value of "emergency medical services provider judgment" in out-of-hospital trauma triage: a multisite, mixed methods assessment.
J Trauma Acute Care Surg
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"Emergency medical services (EMS) provider judgment" was recently added as a field triage criterion to the national guidelines, yet its predictive value and real world application remain unclear. We examine the use and independent predictive value of EMS provider judgment in identifying seriously injured persons.
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Evaluating age in the field triage of injured persons.
Ann Emerg Med
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We evaluate trauma undertriage by age group, the association between age and serious injury after accounting for other field triage criteria and confounders, and the potential effect of a mandatory age triage criterion for field triage.
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Evaluating the use of existing data sources, probabilistic linkage, and multiple imputation to build population-based injury databases across phases of trauma care.
Acad Emerg Med
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The objective was to evaluate the process of using existing data sources, probabilistic linkage, and multiple imputation to create large population-based injury databases matched to outcomes.
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The forgotten trauma patient: outcomes for injured patients evaluated by emergency medical services but not transported to the hospital.
J Trauma Acute Care Surg
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Injured patients who are not transported by an ambulance to the hospital are often not included in trauma registries. The outcomes of these patients have until now been unknown. Understanding what happens to nontransports is necessary to better understand triage validity, patient outcomes, and costs associated with injury. We hypothesized that a subset of patients who were not transported from the scene would later present for evaluation and that these patients would have a nonzero mortality rate.
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Association between emergency department resources and diagnosis of intimate partner violence.
Eur J Emerg Med
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There is little information about which intimate partner violence (IPV) policies and services assist in the identification of IPV in the emergency department (ED). The objective of this study was to examine the association between a variety of resources and documented IPV diagnoses.
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Electronic versus manual data processing: evaluating the use of electronic health records in out-of-hospital clinical research.
Acad Emerg Med
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? The objective was to compare case ascertainment, agreement, validity, and missing values for clinical research data obtained, processed, and linked electronically from electronic health records (EHR) compared to "manual" data processing and record abstraction in a cohort of out-of-hospital trauma patients.
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Guidelines for field triage of injured patients: recommendations of the National Expert Panel on Field Triage, 2011.
MMWR Recomm Rep
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In the United States, injury is the leading cause of death for persons aged 1-44 years. In 2008, approximately 30 million injuries were serious enough to require the injured person to visit a hospital emergency department (ED); 5.4 million (18%) of these injured patients were transported by Emergency Medical Services (EMS). On arrival at the scene of an injury, the EMS provider must determine the severity of injury, initiate management of the patients injuries, and decide the most appropriate destination hospital for the individual patient. These destination decisions are made through a process known as "field triage," which involves an assessment not only of the physiology and anatomy of injury but also of the mechanism of the injury and special patient and system considerations. Since 1986, the American College of Surgeons Committee on Trauma (ACS-COT) has provided guidance for the field triage process through its "Field Triage Decision Scheme." This guidance was updated with each version of the decision scheme (published in 1986, 1990, 1993, and 1999). In 2005, CDC, with financial support from the National Highway Traffic Safety Administration, collaborated with ACS-COT to convene the initial meetings of the National Expert Panel on Field Triage (the Panel) to revise the decision scheme; the revised version was published in 2006 by ACS-COT (American College of Surgeons. Resources for the optimal care of the injured patient: 2006. Chicago, IL: American College of Surgeons; 2006). In 2009, CDC published a detailed description of the scientific rationale for revising the field triage criteria (CDC. Guidelines for field triage of injured patients: recommendations of the National Expert Panel on Field Triage. MMWR 2009;58[No. RR-1]). In 2011, CDC reconvened the Panel to review the 2006 Guidelines in the context of recently published literature, assess the experiences of states and local communities working to implement the Guidelines, and recommend any needed changes or modifications to the Guidelines. This report describes the dissemination and impact of the 2006 Guidelines; outlines the methodology used by the Panel for its 2011 review; explains the revisions and modifications to the physiologic, anatomic, mechanism-of-injury, and special considerations criteria; updates the schematic of the 2006 Guidelines; and provides the rationale used by the Panel for these changes. This report is intended to help prehospital-care providers in their daily duties recognize individual injured patients who are most likely to benefit from specialized trauma center resources and is not intended as a mass casualty or disaster triage tool. The Panel anticipates a review of these Guidelines approximately every 5 years.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.