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Decision Making In Emergency Medicine

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10 papers 0 to 25 followers
Jeremiah S Hinson, Michael R Ehmann, Derek M Fine, Elliot K Fishman, Matthew F Toerper, Richard E Rothman, Eili Y Klein
STUDY OBJECTIVE: The study objective was to determine whether intravenous contrast administration for computed tomography (CT) is independently associated with increased risk for acute kidney injury and adverse clinical outcomes. METHODS: This single-center retrospective cohort analysis was performed in a large, urban, academic emergency department with an average census of 62,179 visits per year; 17,934 ED visits for patients who underwent contrast-enhanced, unenhanced, or no CT during a 5-year period (2009 to 2014) were included...
May 2017: Annals of Emergency Medicine
Erik P Hess, Corita R Grudzen, Richard Thomson, Ali S Raja, Christopher R Carpenter
Shared decision-making (SDM), a collaborative process in which patients and providers make health care decisions together, taking into account the best scientific evidence available, as well as the patient's values and preferences, is being increasingly advocated as the optimal approach to decision-making for many health care decisions. The rapidly paced and often chaotic environment of the emergency department (ED), however, is a unique clinical setting that offers many practical and contextual challenges...
July 2015: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Hemal K Kanzaria, Robert H Brook, Marc A Probst, Dustin Harris, Sandra H Berry, Jerome R Hoffman
OBJECTIVES: Despite the potential benefits of shared decision-making (SDM), its integration into emergency care is challenging. Emergency physician (EP) perceptions about the frequency with which they use SDM, its potential to reduce medically unnecessary diagnostic testing, and the barriers to employing SDM in the emergency department (ED) were investigated. METHODS: As part of a larger project examining beliefs on overtesting, questions were posed to EPs about SDM...
April 2015: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Marc Gutenstein
Human psychology, neuroscience and behavioural economics study the human mind, brain and behaviour. Scientific research has discovered a great deal about the factors that influence human perception, judgment and activity in the real world. In this article, I aim to provide an outline of the relationship between decision-making, cognition, emotion and behaviour. I propose that meta-cognition, or thinking-about-thinking, has the potential to inform how we practice emergency medicine. By accommodating human traits rather than trying to defy them, we can ultimately benefit our patients...
June 2014: Emergency Medicine Australasia: EMA
Lisa A Calder, Trevor Arnason, Christian Vaillancourt, Jeffrey J Perry, Ian G Stiell, Alan J Forster
BACKGROUND: One of the most important decisions that emergency department (ED) physicians make is patient disposition (admission vs discharge). OBJECTIVES: To determine how ED physicians perceive their discharge decisions for high-acuity patients and the impact on adverse events (adverse outcomes associated with healthcare management). METHODS: We conducted a real-time survey of staff ED physicians discharging consecutive patients from high-acuity areas of a tertiary care ED...
January 2015: Emergency Medicine Journal: EMJ
Brian Clyne
No abstract text is available yet for this article.
February 2012: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Mike Ardagh
No abstract text is available yet for this article.
October 2011: Emergency Medicine Australasia: EMA
Brendan G Magauran
This article focuses on those times that the emergency physician (EP) and patient do not agree on a treatment option. Attention is placed on the risk management issues relevant to the patient's unexpected choice. Emphasis is placed on determining a patient's competency or capability of making clinical decisions, with particular focus on the EP deciding that patient competency requires a formal evaluation. The EP should have a strategy for assessing clinical decision-making capability and an understanding of what circumstances should act as a trigger for considering such an assessment...
November 2009: Emergency Medicine Clinics of North America
James V Quinn, Ian G Stiell, Daniel A McDermott, Michael A Kohn, George A Wells
OBJECTIVE: To compare a clinical decision rule (San Francisco Syncope Rule [SFSR]) and physician decision making when predicting serious outcomes in patients with syncope. METHODS: In a prospective cohort study, physicians evaluated patients presenting with syncope and predicted the chance (0%-100%) of the patient developing a predefined serious outcome. They were then observed to determine their decision to admit the patient. All patients were followed up to determine whether they had a serious outcome within 7 days of their emergency department visit...
October 2005: American Journal of Emergency Medicine
Pat Croskerry
Clinical decision making is a cornerstone of high-quality care in emergency medicine. The density of decision making is unusually high in this unique milieu, and a combination of strategies has necessarily evolved to manage the load. In addition to the traditional hypothetico-deductive method, emergency physicians use several other approaches, principal among which are heuristics. These cognitive short-cutting strategies are especially adaptive under the time and resource limitations that prevail in many emergency departments (EDs), but occasionally they fail...
November 2002: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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