Ensayos clínicos

The primary purpose of this study is to understand the effect of educating patients and encouraging shared decision making on rates of CT scanning in head injured patients by using an already developed app and observing the effect on the health care provider

The purpose of this study is to determine the utility of physical therapy services in the Emergency Department through a prospective satisfaction survey of both providers and patients with physical therapy provided in the emergency department.

The purpose of this study is to study the length of the QTc interval in patients receiving the standard of care dose of intravenous droperidol for headache or migraine, nausea, pain, and indications other than agitation over 30 minutes.

Almost one-half million people suffer venous thromboembolism annually in the United States, and one-third die from this disease. Massive bleeding from injury accounts for half of early deaths after trauma. This study aims to prevent the deaths and suffering associated with venous thromboembolism and bleeding by identifying the individual person at high risk of these complications in order to take preventive measures.

The purpose of this study is to evaluate the utilization patterns and satisfaction of telemedicine on the sideline, and to evaluate the effect of sideline telemedicine on reducing unnecessary emergency department visits.

The purpose of this study is to evaluate whether DDP3 identifies patients at early risk of cardiogenic shock presenting with STEMI in order to benefit from more aggressive cardiology scrutiny.

Intravascular catheterization is a common procedure in critically ill patients to enable measurement of hemodynamic variables, delivery of medications and nutritional support. Ultrasound-guided central venous catherization (CVC) placement has been shown to significantly reduce the number of procedural complications in comparison to the traditional landmark technique. The standard ultrasound-scanning includes two different approaches, an out-of-plane and in-plane approach. Using the out-of-plane approach could affect visualization of the needle tip during CVC placement. Complications such as posterior wall puncturing of the target vein or artery and pneumothorax can occur. When using the in-plane approach, the entire needle including the tip may be visualized, but it is technically more difficult to align the ultrasound transducer perfectly with the target vessel as well as the needle during cannulation. A novel 4D needle position technology utilizing magnetic field induction is able to detect the needle position and trajectory in both in- and out-of-plane approaches. This could potentially invaluable, especially for novice proceduralists and lead to improve procedural success and further decrease in complication rates. We hypothesize that 4D needle position ultrasound technology will lead to a significant increase in the first attempt success rate in simulated central venous catheter placement using a low-fidelity simulator . The study will be conducted in the multidisciplinary Simulation-Center, Mayo Clinic, Rochester. We will record participants’ characteristics (including demographics (gender, age), prior experience with CVC placement, prior experience with use of ultrasound, prior experience in video gaming, and assessment of spatial ability using the 24 item - Mental Rotation Test by Peters (MRT) (Peters)). Participants will be given a short tutorial to explain the procedure. CVC placement will use the low-fidelity simulator (Gen II Ultrasound Central Line Training Model, CAE Healthcare). All placements will be video recorded.

The purpose of this study is to establish a registry that will address the data gap regarding the course of NSTEMI (Non-ST-Elevation Myocardial Infarction) between ED (Emergency Department) arrival and diagnostic angiography in detail, by characterizing and following the ED and peri-ED use of advanced OAP (Oral Anti-Platelet) agents. In addition to exploring ED treatment patterns and success of both ischemic and bleeding risk stratification prior to definition of the coronary anatomy, data generated via the UPSTREAM registry will allow plausible attribution of ischemic and bleeding outcomes to pre-catheterization antiplatelet therapy in the management of NSTEMI. This registry further seeks to demonstrate that contemporary use of upstream ticagrelor is associated with an economically-sound utilization of hospital resources, and smooth transition of care into the outpatient, secondary prevention setting for the first 30 days after hospitalization. Finally, it will allow characterization of patient selection factors and processes for ticagrelor vs alternative OAP agents, carrying out that descriptive comparison through discharge. Patients transferred in to an UPSTREAM hospital are eligible for inclusion, but the timing for OAP agent administration and diagnostic catheterization begin with ED care at the first hospital.

The objectives of this study are to evaluate utilization of chest pain risk stratification tools in a community hospital emergency department, to evaluate the effect on utilization of inpatient and outpatient resources for chest pain patients when HEART pathway risk stratification is utilized, and to compare the differences in the above outcomes before and after change from 4th to 5th generation Troponin T assays (which occurs in July 2018), in the midst of our study period.

The purpose of this study is to develop an evidenced-based guideline for pediatric opioid prescribing guideline from the emergency department for long bone fractures to more closely tailor pain management to abuse potential.