Transition to computed radiography can emergency medicine doctors accurately predict the need of film printing to facilitate optimal patient care
Journal Title: World Journal of Emergency Medicine - Year 2011, Vol 2, Issue 1
Abstract
BACKGROUND: This study aimed to evaluate emergency medicine doctors' accuracy in predicting the need of film printing in a simulated setting of computed radiography and assess whether this can facilitate optimal patient care. METHODS: Cross sectional study was conducted from 20 March 2009 to 3 April 2009 in 1334 patients. After clinical assessment of those patients who needed X-ray examination, doctors in the emergency department would indicate whether film printing was necessary for subsequent patient care in a simulated computed radiography setting. The final discharge plan was then retrieved from each patient record. Accuracy of doctors' prediction was calculated by comparing the initial request for radiographic film printing and the final need of film. Doctors with different level of emergency medicine experience would also be analyzed and compared. RESULTS: The sensitivity of predicting fi lm printing was 84.5% and the specifi city of predicting no fi lm printing was 91.2%. Positive predictive value was 88.4% while negative predictive value was 88.2%. The overall accuracy was 88.2%. The accuracy of doctors stratified into groups of fellows, higher trainees and basic trainees were 85.4%, 90.5% and 88.5% respectively (P=0.073). CONCLUSIONS: Our study showed that doctors can reliably predict whether film printing is needed after clinical assessment of patients, before actual image viewing. Advanced indication for film printing at the time of imaging request for selected patients can save time for all parties with minimal wastage.
A comparison of perspectives on costs in emergency care among emergency department patients and residents
BACKGROUND: Costs of care are increasingly important in healthcare policy and, more recently, in clinical care in the emergency department (ED). We compare ED resident and patient perspectives surrounding costs in emerge...
Theoretical knowledge and psychomotor skill acquisition of basic life support training programme among secondary school students
BACKGROUND: People sometimes siphon fuel to fill their tanks. However, this is a potentially dangerous procedure and may cause hydrocarbon pneumonitis. We present the case of a patient with severe hydrocarbon pneumonitis...
Meningitis secondary to Cryptococcus gattii, an emerging pathogen affecting immunocompetent hosts
BACKGROUND: Meningitis continues to be one of the most important infections diagnosed and treated by emergency physicians. Despite the advent of anti-infective therapy, meningitis carries a mortality rate of 20%–40%. In...
An unusual emergency department case: ruptured ectopic pregnancy presenting as chest pain
Ectopic pregnancy occurs at a rate of 1%–2% of all pregnancies, and tends to occur at a higher rate (up to 4%) in patients receiving fertility treatments.[1] Women with ectopic pregnancies are often asymptomatic or may c...
Ventilator management for acute respiratory distress syndrome associated with avian influenza A (H7N9) virus infection: A case series
BACKGROUND: Data on the mechanical ventilation (MV) characteristics and radiologic features for the cases with H7N9-induced ARDS were still lacking. METHODS: We describe the MV characteristics and radiologic features of...