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Emergencies clinical trials

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NCT ID: NCT06331767 Not yet recruiting - HIV Clinical Trials

Development of a Multilevel HIV Prevention Intervention for the Emergency Department

mSYNC
Start date: June 2024
Phase: N/A
Study type: Interventional

The goal of this clinical trial is to pilot test a psychosocial-behavioral mobile health (mHealth) human immunodeficiency virus (HIV) prevention intervention in people who use drugs presenting to the emergency department (ED). The main question the study aims to answer is: is the intervention acceptable and appropriate? Participants will use the mHealth app while waiting in the ED and also at home for 90 days. Participants will be asked to complete surveys at baseline, before leaving the ED, and at 30-, 60-, and 90-day follow up visits.

NCT ID: NCT06330207 Not yet recruiting - Odontalgia Clinical Trials

An Emergency Department (ED) Provider Centered Intervention for Non-Traumatic Dental Condition Management (NTDC)

Start date: August 1, 2025
Phase: N/A
Study type: Interventional

The overall objective of this proposal is to understand the barriers and facilitators to non-traumatic dental condition (NTDC) management in the emergency department (ED) through quantitative and qualitative methods. The first aim will determine the national variation in NTDC prescribing in the ED and subsequent ED/urgent care revisits and hospitalizations within 30-days of an index ED visit. Using national electronic health records and integrated claims datasets and a random effects model, we will identify factors associated with prescribing for NTDC and variation at the patient, provider, hospital and state levels. The second aim identifies ED providers' perceived barriers and facilitators to the management of NTDC in the ED. Using individual in depth interviews, ED providers (physicians, advanced practice providers) will identify the facilitators and barriers to management and prescribing for NTDC in the ED.

NCT ID: NCT06329752 Not yet recruiting - Ankle Fractures Clinical Trials

Sciatic Nerve Block for Ankle and Leg Fracture Manipulation in the Emergency Department

AnkleMan
Start date: May 2024
Phase: N/A
Study type: Interventional

The goal of this feasibility clinical trial is to assess the acceptability of ultrasound-guided sciatic nerve block when performed at Emergency Departments for manipulation and temporary stabilization of distal leg and ankle fractures. The trial aims to assess: - The acceptability of sciatic nerve block - The technical feasibility of sciatic nerve block - The technical success of sciatic nerve block - The analgesic efficacy of sciatic nerve block In addition to that, this study aims to - Describe patient-reported and physician-reported satisfaction - Assess the Adverse Event rate at 48 hours post intervention

NCT ID: NCT06327893 Not yet recruiting - Drowning Clinical Trials

Patients Treated by the Danish Emergency Medical Services Following Non-drowning Water Rescues From 2016 to 2023

RESCUE
Start date: May 1, 2024
Phase:
Study type: Observational

Since 2015, all Danish prehospital EMS have used the nationwide Prehospital Electronic Medical Record (PEMR). In 2023, the investigators developed the Danish Drowning Formula (DDF), a text-search algorithm designed to search the unstructured text fields in the electronic medical records with comprehensive search criteria to identify all potential water-related incidents. This protocol describes the first study to analyse the prehospital data from a nationwide Danish cohort of patients treated by the EMS from 2016 to 2023 following non-drowning aquatic rescues.

NCT ID: NCT06327867 Not yet recruiting - Clinical trials for To Compare the Success Rate of Video Laryngoscopy vs Direct Laryngoscopy for First Pass Oro Tracheal Intubation

Comparison of Video Laryngoscopy Versus Direct Laryngoscopy for Orotracheal Intubation Among Adults in Emergency Department

Start date: May 1, 2024
Phase: N/A
Study type: Interventional

This is an open-label, single center, prospective, randomized, comparative, intervention study. The goal of this study is to compare the success rate of video laryngoscopy vs direct laryngoscopy for first pass oro tracheal intubation. The other question it aims to answer are: 1. To assess the adverse events during video laryngoscopy 2. To assess the adverse events during direct Laryngoscopy 3. To compare the first pass success rate of DL vs VL according to demographic profile (age and sex)

NCT ID: NCT06326424 Not yet recruiting - Dementia Clinical Trials

Delirium Identification in Older Patients With Alzheimer's and Other Related Dementias In the Emergency Department

DELIRIUM
Start date: April 10, 2024
Phase:
Study type: Observational

Delirium is highly prevalent and very bad for patients with dementia. Delirium is a dangerous medical condition that occurs in 6-38% of older Emergency Department patients and 70% of ICU patients. A person who develops delirium in the ED or hospital has a 12 times higher odds of being newly diagnosed with dementia in the next year compared to a similar patient who does not become delirious. Delirium is especially dangerous for persons living with Alzheimer Disease and Related Dementias (AD/ADRD). Persons living with ADRD have an almost 50% chance of developing delirium in the hospital. Clinicians are bad at recognizing delirium. A recent systematic review led by the Geriatric Emergency Care Applied Research network (NIH funded) found that current delirium screening tools are at most 64% sensitive, meaning that physicians can identify some phenotypes of delirium well, but cannot easily rule out delirium in acutely ill older patients. The investigators propose integrating wrist biosensors into the emergency management of older adults with dementia. The investigators will monitor heart rate variability, movement, and electrodermal activity (electrical activity of at the level of the skin) to determine if an array of biosensors more sensitive to delirium than current verbal screening tools.

NCT ID: NCT06322862 Recruiting - Clinical trials for Bowel; Ischemic, Acute

Intraoperative Intestinal Perfusion Assessment by Fluorescence Angiography in Emergency Surgery

Start date: March 5, 2024
Phase: N/A
Study type: Interventional

This is a prospective, multicentre, non-randomized cohort study using real-time intraoperative visualization of bowel perfusion by indocyanine green (ICG) in all-cause bowel ischemia. At intraoperative finding of bowel ischemia, the initial intraoperative plan is noted and resection margins marked with a steril pen. A fluorescence angiography will be performed and the surgeon will note whether the suspected ischemic bowel is perfused, whether there is a change in the resection margins in centimeters, and if the intraoperative plan has changed. If resection is indicated and the strategy of choice is an anastomosis, a renewed fluorescence angiography will be performed to assess anastomotic perfusion.

NCT ID: NCT06322836 Enrolling by invitation - Clinical trials for Emergency Medical Services

A Feasibility Study for Elective Cardioversion of Atrial Fibrillation at Home

Electra-1
Start date: February 7, 2024
Phase: N/A
Study type: Interventional

The goal of this pilot, non-controlled, non-randomised, single centre, prospective intervention feasibility study is to assess the feasibility of a home DC-ECV in the treatment of recurrent symptomatic AF performed by APP in 25 patients. The main question[s] it aims to answer are: Primary objective: In this prospective intervention feasibility study, in 25 patients the primary endpoint is completion of cardioversion to sinus rhythm. (% of study patients with a recurrence of AF in whom a home cardioversion is performed, i.e. to whom at least one DC shock was administered while the patient was under sedation). Feasibility endpoints are ; (a) evaluation of enrolment of participants, (b) evaluation and refinement of data and outcome collection procedures, (c) evaluation of logistics, (d) evaluation of the appropriateness of the intervention and research procedures to manage and implement the intervention, and (e) preliminary evaluation of participant responses to the intervention. Secondary objectives: Safety endpoint: Complications immediately during and one hour after cardioversion (e.g. arrhythmias, changes in the electrocardiogram, hypotension related to sedation and/or vasodilation or skin irritation). A composite of major adverse cardiovascular and cerebrovascular events (MACCE) occurring within 24 hours MACCE occurring during 6 weeks follow-up; any hospitalisation and all-cause mortality during 6 weeks follow-up; number (%) of patients in sinus rhythm at 1 hour in the post-shock observation period; idem at the end of 6 weeks follow-up; inventory of all interventions in the study related to cost-of-care.

NCT ID: NCT06322004 Recruiting - Clinical trials for Communication Barriers

Video-Interpreting in Prehospital Emergency Medicine - Feasibility Study

Start date: February 6, 2023
Phase:
Study type: Observational

50 responsive patients with language barriers will be included in this study. The prehospital emergency physician will start video-interpreting via a tablet. Feasibility, quality of communication, usability as well as changes in diagnosis and treatment will be gathered and analysed.

NCT ID: NCT06320236 Recruiting - Pulmonary Embolism Clinical Trials

Emergency Medicine Pulmonary Embolism Testing Multicentre Study

EMPET
Start date: January 1, 2024
Phase:
Study type: Observational

It is important to diagnose pulmonary embolism in a timely manner to prevent death and long-term disability. More than half a million people (4-5% of emergency department patients) are tested for pulmonary embolism, although positive results are low. Imaging for PE testing exposes patients to radiation, is expensive, adds time to the emergency visit, and can lead to a false positive diagnoses. Existing protocols aimed at reducing unnecessary pulmonary embolism imaging are complex and seldom used by emergency physicians. Too many patients undergo unnecessary pulmonary embolism imaging. We have created a new tool (called Adjust-Unlikely) which could safely reduce pulmonary embolism imaging in Canada. Our research group composed of researchers, emergency physicians, and patients developed the Adjust-Unlikely clinical decision rule: a rule which has been customized for emergency physicians and emergency patients. Adjust-Unlikely is highly sensitive at the bedside, meaning there are very few false negative results. Our study aim is to prospectively validate Adjust-Unlikely pulmonary embolism testing in emergency patients with suspected pulmonary embolism.