Emergency department Chlamydia screening through partnership with the public health department.

Background: The emergency department (ED) serves a population that may benefit from numerous screening initiatives but screening in the ED is challenging due to crowding as well as resource and time constraints. One option may be to collect specimens in the ED and then partner with the public health department (PHD) to analyze the specimens off-site and arrange follow-up treatment.

Objectives: The objective was to explore the feasibility of chlamydia screening in females using a partnership model in which the ED is responsible for urine collection and the PHD is responsible for chlamydia testing, notification, and treatment.

Public health considerations in knowledge translation in the emergency department.

Effective preventive and screening interventions have not been widely adopted in emergency departments (EDs). Barriers to knowledge translation of these initiatives include lack of knowledge of current evidence, perceived lack of efficacy, and resource availability. To address this challenge, the Academic Emergency Medicine 2007 Consensus Conference, "Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Uptake," convened a public health focus group.

A single ventilator for multiple simulated patients to meet disaster surge.

Objectives: To determine if a ventilator available in an emergency department could quickly be modified to provide ventilation for four adults simultaneously.

Methods: Using lung simulators, readily available plastic tubing, and ventilators (840 Series Ventilator; Puritan-Bennett), human lung simulators were added in parallel until the ventilator was ventilating the equivalent of four adults. Data collected included peak pressure, positive end-expiratory pressure, total tidal volume, and total minute ventilation.

Are there disparities in emergency care for uninsured, medicaid, and privately insured patients?

Objectives: To determine if there are any differences in proportion of high-acuity care and low-acuity care provided to uninsured, Medicaid-insured, and privately insured emergency department (ED) patients.

Methods: This was a retrospective, observational study using physician level of service provided as a marker for acuity. The study used computerized billing data (2000-2001) from an urban, teaching, Level I trauma center with 75,000 visits per year.

Racial and ethnic disparities in the clinical practice of emergency medicine.

There is convincing evidence that racial and ethnic disparities exist in the provision of health care, including the provision of emergency care; and that stereotyping, biases, and uncertainty on the part of health care providers all contribute to unequal treatment. Situations, such as the emergency department (ED), that are characterized by time pressure, incomplete information, and high demands on attention and cognitive resources increase the likelihood that stereotypes and bias will affect diagnostic and treatment decisions. It is likely that there are many as-yet-undocumented disparities in clinical emergency practice.

Financial impact on emergency physicians for nonreimbursed care for the uninsured.

Study Objective: The financial impact on emergency physicians' reimbursement for uninsured patient care has not been previously evaluated. We conducted this study to estimate the amount of emergency physicians' nonreimbursed care for uninsured patients in Michigan.

Methods: This retrospective observational study used a convenience sample of reimbursement information from 29 hospitals.

Syndromic analysis of computerized emergency department patients' chief complaints: an opportunity for bioterrorism and influenza surveillance.

Study Objective: Emergency department computerized triage logs might be useful for automated ED surveillance and potentially for early identification of bioterrorism events. We describe a Web-based surveillance program and its feasibility for surveillance.

Methods: A Web-based surveillance program that receives computerized chief complaint data daily from a large academic urban teaching hospital and performs syndromic analysis on these data was developed.