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Emergencies clinical trials

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NCT ID: NCT02237391 Completed - Chronic Pain Clinical Trials

Evaluation of a Interdisciplinary Pain Program Among Patients With Chronic Pain and Frequent Emergency Department Visits

CIPAP
Start date: December 2014
Phase: N/A
Study type: Interventional

While significant advances in pain management have occurred in the last 20 years, the majority of patients with chronic pain (CP) are unable to access evidence-based treatment at either the primary or tertiary care level. Moreover, research has shown that unrelieved CP and the lack of available expertise contribute to emergency department (ED) visits and hospital admissions. At The Ottawa Hospital (TOH), close to 18,000 ED visits per year are related to CP (12.9%). Among high frequency visitors (HFV; >= 8 visits per year), a small number of patients with CP use an inordinate amount of acute care resources. The investigators study will use a randomized controlled (RCT) design to conduct a pilot evaluation of the impact of a Complex Interdisciplinary Pain Assessment Program (CIPAP) linked with primary care physicians (PCP) compared to a treatment as usual (TAU) control arm. The investigators hypothesis is that implementing a CIPAP will increase health care value through improved patient outcomes and reduced costs in HFV with chronic pain (CP-HFV). The investigators believe that a CIPAP will provide CP-HFV patients long-term pain management solutions, ED visits for CP will be reduced, and hospital admissions for CP will be prevented. This pilot RCT study will inform a larger-scale RCT study to be conducted in the future.

NCT ID: NCT02236494 Completed - Alcohol Abuse Clinical Trials

Study of an Emergency Department-based Intervention to Reduce Alcohol Misuse in Older Adults

Start date: October 2014
Phase: N/A
Study type: Interventional

This is a randomized trial to assess the value of an emergency department-based intervention to reduce hazardous alcohol use among older adults. We hypothesize that the intervention will result in a 25% reduction in the prevalence of hazardous alcohol use while the control group will only have a 5% reduction.

NCT ID: NCT02236442 Completed - Cephalalgia Clinical Trials

Protocol to Ease Acute Cephalalgia in Emergency-department

PEACE
Start date: October 2014
Phase: N/A
Study type: Interventional

The purpose of this study is to determine if the use of a therapeutic and global protocol to relieve cephalalgia is helpful in the emergency department of Grenoble University Hospital.

NCT ID: NCT02230813 Completed - Cellulitis Clinical Trials

Predictors of Oral Antibiotic Treatment Failure in Emergency Department Patients With Cellulitis

Start date: March 2015
Phase: N/A
Study type: Observational

The term cellulitis is a medical term describing a bacterial infection of the skin and tissues beneath the skin. Although it is usually easily treated with antibiotics given either orally or through a vein (intravenously), knowing which route of antibiotic treatment to prescribe to a person attending an Emergency Department with cellulitis is not clear. A Clinical Prediction rule (CPR) is a decision-making tool that comes from original research as opposed to the opinion of experts. We intend to create a preliminary CPR to decide which patients require oral and which patients require intravenous antibiotics for cellulitis from their first visit to an emergency department. The aim of this is to provide safer care by reducing the risk of a patient returning to the hospital with a worsening infection. It will also promote more cost-effective care by reducing hospital re-attendance rates and wasted antibiotics. Patients attending the department with cellulitis who are suitable for oral antibiotic treatment will be enrolled into this study. A separate doctor will re-examine at least 10% of study participants in order to reduce bias. A set of physical signs and symptoms will be recorded from each patient in order to determine which ones are associated with them "failing" prescribed oral treatment. A study investigator will then phone the patient after 14 days to see whether they are better or whether they required intravenous antibiotics to get better.

NCT ID: NCT02228317 Completed - Acutely Ill Clinical Trials

Emergency Medical Technician Treat-and-leave Patients Receiving Telemedicine Consultation With Emergency Medical Dispatch Physician - a Controlled Before and After Pilot-study

Start date: September 2014
Phase: N/A
Study type: Interventional

A large part of acutely ill patient's access to the health care system starts by calling the emergency number 1-1-2 and thereby getting in touch with the emergency medical dispatch center (EMDC). In most cases an ambulance is dispatched and the patient is brought to the hospital. These patients are not referred by a physician (eg. a GP) and represent an unselected subpopulation of the acutely ill patients. At present, all non-critically ill patients not evaluated by a pre-hospital physician are normally be transported to hospital as category 2 (without activated emergency lightning and sirens).A part of this patient population, however, is not critically ill and a proportion of these may not need hospital admittance . Emergency medical technicians (EM) are not allowed to treat - and- leave patients without a physician's involvement. If the EMT had 24/7 online access to medical control i.e. in form of a physician present in the EMDC , the number of patients transported to hospital for assessment may be reduced as well as response times for patients actually needing ambulance transportation. This could potentially reduce the workload on the whole healthcare system involved in the management of these patients - thereby potentially reducing costs. The objective of this study is to evaluate if a systematic telemedical assessment by an EMDC-physician of all patients who receive an ambulance but are not critically ill and would have a category 2 transport to hospital can reduce the number of the patients that are transported to hospital and save costs and time.

NCT ID: NCT02223689 Completed - Wounds Clinical Trials

Evaluation of Skin Affix in the Emergency Room

Start date: July 2014
Phase: Phase 4
Study type: Interventional

Effectiveness of a surgical adhesive on wounds found in Emergency Medicine.

NCT ID: NCT02223676 Completed - Clinical trials for Medication Reconciliation

Clinical Pharmacists in the Emergency Department

Start date: October 2013
Phase: N/A
Study type: Interventional

The purpose of this study is to investigate the effect of implementing clinical pharmacists in the Emergency Department Team at Randers Regional Hospital. The clinical pharmacists conduct medication history, make medical interaction screenings, -reconciliations and -reviews on unscheduled patients admitted to the Emergency Department during daytime.

NCT ID: NCT02217059 Completed - Hypertension Clinical Trials

Emergency Department Home Blood Pressure Monitoring and BpTRU Study

Start date: August 2014
Phase: N/A
Study type: Observational

The purpose of this study is to evaluate the Congruence of Emergency Department (ED) Attendings' Predictions of Hypertension with Results of Home Blood Pressure Monitoring.

NCT ID: NCT02190981 Completed - Clinical trials for Small Bowel Obstruction

Point of Care Ultrasound for Suspected Small Bowel Obstruction in the Emergency Department

Start date: July 2014
Phase:
Study type: Observational

The primary purpose of this study is to determine the accuracy of ultrasound in diagnosing small bowel obstruction in emergency department patients, as compared to the criterion standards of computed tomography, operative reports, or discharge diagnosis. The secondary purposes of the study include evaluation of the effect of ultrasound for small bowel obstruction on the patient length of stay in the emergency department and the diagnostic utility of specific ultrasound findings in the diagnosis of small bowel obstruction. The study will also examine the inter-rater agreement between point-of-care sonographers' interpretation and blinded reviewers' interpretation of the ultrasound images.

NCT ID: NCT02188966 Completed - Clinical trials for All Acutely Ill or Injured Patients

Application of Geographical Information System Data in the Emergency Department, Effect on Trauma Team and Medical Emergency Team Wait

Start date: May 2014
Phase: N/A
Study type: Interventional

In the Emergency Department Regional Hospital Horsens a monitor will display Geographical Information System data (GIS data) for all ambulances with the hospital as final destination. The location, estimated time of arrival (ETA) and urgency code for the ambulances will be showed. Furthermore the patient's name, personal identification number and the primary message received by the emergency medical dispatch center resulting in ambulance dispatch will be displayed. This may enable the coordinating nurse to optimize timing of the ad hoc trauma team and medical emergency team activation. The teams are activated if the patient's condition is assessed to be of the highest urgency and/or severity - triage 1 or "red". The coordinating nurse makes this assessment on the basis of information from the ambulance personnel and makes the decision to activate the team and when to do it. In this study the investigators want to examine if the availability of GIS data in the emergency department results in reduced waiting time for the members of the trauma team and medical emergency team. The study will be conducted as a before and after study.