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Mashup Score: 0Cessation of Smoking Trial in the Emergency Department (COSTED): a multicentre randomised controlled trial - 2 month(s) ago
Background Supporting people to quit smoking is one of the most powerful interventions to improve health. The Emergency Department (ED) represents a potentially valuable opportunity to deliver a smoking cessation intervention if it is sufficiently resourced. The objective of this trial was to determine whether an opportunistic ED-based smoking cessation intervention can help people to quit smoking. Methods In this multicentre, parallel-group, randomised controlled superiority trial conducted between January and August 2022, adults who smoked daily and attended one of six UK EDs were randomised to intervention (brief advice, e-cigarette starter kit and referral to stop smoking services) or control (written information on stop smoking services). The primary outcome was biochemically validated abstinence at 6 months. Results An intention-to-treat analysis included 972 of 1443 people screened for inclusion (484 in the intervention group, 488 in the control group). Of 975 participants rando
Source: emj.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 0
Psychedelic drugs such as lysergic acid diethylamide (LSD) and psilocybin (‘magic mushrooms’) induce hallucinations and distort thought-processes. The intensity of a psychedelic ‘trip’ can cause distress, agitation, and even psychosis. A recent report showed that at least 8.4% of drug-related presentations to European emergency departments involve psychedelics.1 This proportion may increase as the clinical use of these agents expands.2 There are multiple ways to control a ‘bad trip’ and avoid hospitalisation. One is to take psychedelics under the supervision of a ‘trip-sitter’—a non-intoxicated friend who can provide psychological support. Another is to use additional psychoactive drugs—‘trip-killers’—to attenuate or prematurely end the psychedelic experience. Trip-killers are not new, but have received increased attention on social media in recent years.3 Information on trip-killers is not available through drug advice services, despite the probable risks they pose. To our knowledge,
Source: emj.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 5
“Black Swans”, originally described as an economic theory, are unexpected events whose potential to occur only becomes apparent after they have happened. The concept is very relevant to the practice of Emergency Medicine and this article explores how black swans impact on emergency care and how staff unconsciously aim to mitigate against them.
Source: emj.bmj.comCategories: General Medicine News, Hem/OncsTweet
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Mashup Score: 1Randomised trial comparing the recording ability of a novel, electronic emergency documentation system with the AHA paper cardiac arrest record - 6 month(s) ago
Objective To evaluate the ability of an electronic system created at the University of Washington to accurately document prerecorded VF and pulseless electrical activity (PEA) cardiac arrest scenarios compared with the American Heart Association paper cardiac arrest record. Methods 16 anaesthesiology residents were randomly assigned to view one of two prerecorded, simulated VF and PEA scenarios and asked to document the event with either the paper or electronic system. Each subject then repeated the process with the other video and documentation method. Five types of documentation errors were defined: (1) omission, (2) specification, (3) timing, (4) commission and (5) noise. The mean difference in errors between the paper and electronic methods was analysed using a single factor repeated measures ANOVA model. Results Compared with paper records, the electronic system omitted 6.3 fewer events (95% CI −10.1 to −2.5, p=0.003), which represents a 28% reduction in omission errors. Users rec
Source: emj.bmj.comCategories: General Medicine News, NeurologyTweet-
@MassGenBrigham @American_Heart Which report is correct? #Simulation studies suggest real-time EHR documentation captures more info during code events with higher temporal fidelity (improved discrepancy in time to defib doc from 73s in paper record to 1s in EHR). https://t.co/o4MY7MlBqe https://t.co/fONnYfn1Um
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Mashup Score: 0
Background Health coaching services could help to reduce emergency healthcare utilisation for patients targeted proactively by a clinical prediction model (CPM) predicting patient likelihood of future hospitalisations. Such interventions are designed to empower patients to confidently manage their own health and effectively utilise wider resources. Using CPMs to identify patients, rather than prespecified criteria, accommodates for the dynamic hospital user population and for sufficient time to provide preventative support. However, it is unclear how this care model would negatively impact survival. Methods Emergency Department (ED) attenders and hospital inpatients between 2015 and 2019 were automatically screened for their risk of hospitalisation within 6 months of discharge using a locally trained CPM on routine data. Those considered at risk and screened as suitable for the intervention were contacted for consent and randomised to one-to-one telephone health coaching for 4–6 months
Source: emj.bmj.comCategories: Hem/Oncs, Latest HeadlinesTweet
An emergency department 'stop smoking' service, comprising of advice by a trained professional, an e-cigarette starter kit, and referral to a local stop-smoking service, can help smokers to quit, finds research published in @EmergencyMedBMJ #quitsmoking https://t.co/CeS87xgKo4 https://t.co/PMd01W8lZp