Clinical Research Directory

Coronary Computed Tomographic Angiography Combined With CT-FFR in Intermediate-Risk Chest Pain Patients.

This study aims to investigate the guiding value of coronary CTA combined with CT-FFR in diagnostic and treatment decision-making for emergency chest pain patients at moderate risk, as well as its impact on clinical outcomes. Through a prospective multicenter randomized controlled trial, this research compares the preventive effects of early application of this technology versus standard care on major adverse cardiovascular and cerebrovascular events (MACCE), with the goal of optimizing the diagnostic and treatment processes for emergency chest pain patients.

ED PLWD/Care Partner Text Messaging

The purpose of this research study is to develop and test a text-messaging intervention for emergency department (ED) discharge care transitions experienced by caregivers of older adults with cognitive impairment.

Modifying the Geriatric Acute & Post-acute Care Coordination Program for Fall Prevention in the Emergency Department for Telehealth

The goal of this clinical trial is to determine the feasibility of eGAPcare, a telehealth modification of the GAPcare fall prevention intervention, in older adults in a community emergency department. The main questions it aims to answer are: * Can telehealth physical therapy and pharmacy consultations be conducted in a community emergency department? * Does the telehealth modification of GAPcare decrease recurrent falls at 6 months? Participants will * Receive telehealth physical therapy and pharmacy consultation while in the emergency department * Participate in follow-up visits over the phone for 6 months following the initial emergency department visit * Complete study questionnaires delivered by study staff.

Universal Test and Connect for HIV Service Delivery in South Africa

The goal of this study is to determine how many patients with HIV or at high risk of getting HIV attend the Emergency Department (ED) in South Africa (SA). The investigators will integrate HIV assessment in the ED and see how many people who would be a candidate for a drug that prevents HIV (PrEP). Universal test and connect (UTC) is a strategy that universally tests all patients and connects patients to long-term care, whether HIV positive or negative, including referrals for PrEP. The investigator's goal is to use UTC across two busy 24-hr EDs in Cape Town, SA.

Aromatherapy to Address Psychological Distress in Emergency Department Patients.

The goal of this clinical trial is to understand the feasibility and acceptability of a brief aromatherapy session for reducing stress, anxiety, and improving patient satisfaction among emergency department patients. The main question the study aims to answer is: Is the intervention acceptable and feasible? Participants in the intervention group will receive a lavender-scented tube and smell it for about 5 minutes. Participants in the control group will receive an unscented tube and follow the same instructions.

Optimization of Medical Time in the Emergency Department: Impact of an AI-Based System on Prescription Entry

Drug-related iatrogenesis is a major public health issue, accounting for a significant proportion of adverse events and hospitalizations in emergency departments. Optimizing prescription management in this context is critical to improve both patient safety and physician efficiency This study aims to evaluate the impact of the POSOS AI-driven device on the medical time required for prescription management in polymedicated patients admitted to emergency departments. The main objective is to establish whether the use of POSOS can reduce transcription time compared to standard electronic management.

The Association Between Post-resuscitation Time Series Management in the Emergency Department and Short-term Outcomes for Out-of-hospital Cardiac Arrest Patients

This study examines the impact of emergency department (ED) management on short-term outcomes of nontraumatic adult out-of-hospital cardiac arrest (OHCA) patients. Conducted by a research team at National Taiwan University Hospital and its affiliated hospitals, including branches in Hsinchu and Yunlin, the study spans from January 2016 to August 2023. It focuses on a sequential population of patients, analyzing data like age, gender, medical history, prehospital care details (e.g., witnessed collapse, bystander CPR), and specifics of ED management. OHCA, with an incidence rate of 50-100 per 100,000 people, presents high mortality and severe complications, leading to significant healthcare expenditures. After resuscitation in the ED, only about one-fifth of patients achieve return of spontaneous circulation (ROSC). The prognosis for these patients remains grim, with a mere 5% experiencing favorable neurological outcomes. Understanding the mechanisms of OHCA, identifying risk factors, effective interventions, and the timing of ED treatments like vasopressors and electrocardiography are crucial. Patients post-OHCA often undergo a postcardiac arrest syndrome (PCAS), marked by cellular hypoxia and a consequential inflammatory response. Stability of vital signs and rapid ED interventions, including identifying OHCA causes and coordinating with specialists, are vital for short-term recovery. This study aims to determine if ED management and time-related factors from ROSC to various interventions (e.g., ECG, CT scans) affect short-term survival rates, including survival to hospital admission and survival after 1, 3, and 7 days. By retrospectively analyzing patient data, including Utstein Style prehospital cardiac arrest registry variables and emergency department management details, the study seeks to shed light on the crucial phase of post-resuscitation care. The ultimate goal is to improve survival rates and neurological outcomes in OHCA patients, emphasizing the need for more comprehensive research in this area

Evaluation of the Quality of Care in the Emergency Department by Studying the Appropriateness of Hospitalizations

The aim of this study is to develop, study and validate a rigorous and sustainable method for assessing the clinical appropriateness of the decision taken in the Emergency Department to admit or not to admit patients.

A New Crowding Indicator in the Emergency Department

Fenice has proposed a new indicator to measure the level of crowding in the ER. The aim of this study is to evaluate, in a national multicenter context, the degree of agreement between the Fenice indicator and the perception of crowding of the ER operators and to compare this agreement with that between NEDOCS and the perception of the operators.

Effects of VR-based Respiratory Training on Motor Reaction Time and Correctness, Stress Levels, Attention, Motor Skills, Postural Stability and Sleep Quality in Shift Healthcare Workers

This study investigates the effects of virtual reality (VR)-based respiratory training on various physiological and cognitive functions in shift-working healthcare professionals, including paramedics and nurses. The research will evaluate how VR-guided breathing exercises influence: stress levels, motor reaction time and accuracy, attention and cognitive performance, motor skills and postural stability, sleep quality Participants will be divided into three groups: VR-based respiratory training group - performing guided breathing exercises in a VR environment. Music-based relaxation group - listening to relaxing music without structured breathing instructions. Control group - no intervention. The findings will help determine whether VR-based respiratory training is an effective method for improving stress resilience, cognitive function, and physical performance in shift-working healthcare professionals.

The Safe Fast Track Study

Emergency departments (ED) internationally are treating an increasing number of patients. Most require hospital services but some could be better cared for on alternative pathways. D-dimer has some unique properties. It is non-specific and is elevated in many acute condi- tions; but conversely remains normal in the absence of significant disease. Previous studies have shown that having a normal D-dimer on arrival to the emergency department is associated with a very low risk of 30-day all-cause mortality. The investigators propose a multicenter randomized controlled trial using D-dimer to identify patients at low risk and test if providing this information will change time to discharge disposition by the treating physician.

Evaluation of the Quality of Care in the Emergency Department by Studying the Appropriateness of Admissions of Patients Accessing the Emergency Department (Fondazione IRCCS Ca' Granda Ospedale Maggione Policlinico)

The aim of this study is to develop, study and validate a rigorous and sustainable method for assessing the clinical appropriateness of the decision taken in the Emergency Department to admit or not to admit patients.