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{
    "pk": 11506,
    "title": "Emergency Department Time Course for Mild Traumatic Brain Injury Workup",
    "subtitle": null,
    "abstract": "Introduction:\n Mild traumatic brain injury (mTBI) is a common cause for visits to the emergency department (ED). The actual time required for an ED workup of a patient with mTBI in the United States is not well known. National emergency medicine organizations have recommended reducing unnecessary testing, including head computed tomography (CT) for these patients.10\nMethods:\n To examine this issue, we developed a care map that included each step of evaluation of mTBI (Glasgow Coma Scale Score 13-15) – from initial presentation to the ED to discharge. Time spent at each step was estimated by a panel of United States emergency physicians and nurses. We subsequently validated time estimates using retrospectively collected, real-time data at two EDs. Length of stay (LOS) time differences between admission and discharged patients were calculated for patients being evaluated for mTBI.\nResults:\n Evaluation for mTBI was estimated at 401 minutes (6.6 hours) in EDs. Time related to head CT comprised about one-half of the total LOS. Real-time data from two sites corroborated the estimate of median time difference between ED admission and discharge, at 6.3 hours for mTBI.\nConclusion:\n Limiting use of head CT as part of the workup of mTBI to more serious cases may reduce time spent in the ED and potentially improve overall ED throughput.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "mTBI, Time, workup"
        }
    ],
    "section": "Trauma",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/4sr349qd",
    "frozenauthors": [
        {
            "first_name": "Edward",
            "middle_name": "A.",
            "last_name": "Michelson",
            "name_suffix": "",
            "institution": "Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, Department of Emergency Medicine, El Paso, Texas",
            "department": "None"
        },
        {
            "first_name": "J.",
            "middle_name": "Stephen",
            "last_name": "Huff",
            "name_suffix": "",
            "institution": "University of Virginia Health System, Department of Emergency Medicine, Charlottesville, Virginia",
            "department": "None"
        },
        {
            "first_name": "Mae",
            "middle_name": "",
            "last_name": "Loparo",
            "name_suffix": "",
            "institution": "University Hospitals Cleveland Medical Center, Department of Emergency Medicine, Cleveland, Ohio",
            "department": "None"
        },
        {
            "first_name": "Rosanne",
            "middle_name": "S.",
            "last_name": "Naunheim",
            "name_suffix": "",
            "institution": "Washington University School of Medicine, Department of Emergency Medicine, St. Louis, Missouri",
            "department": "None"
        },
        {
            "first_name": "Andrew",
            "middle_name": "",
            "last_name": "Perron",
            "name_suffix": "",
            "institution": "Maine Medical Center, Department of Emergency Medicine, Portland, Maine",
            "department": "None"
        },
        {
            "first_name": "Martha",
            "middle_name": "",
            "last_name": "Rahm",
            "name_suffix": "",
            "institution": "Barnes Jewish Hospital, Department of Emergency Medicine, St. Louis, Missouri",
            "department": "None"
        },
        {
            "first_name": "David",
            "middle_name": "W.",
            "last_name": "Smith",
            "name_suffix": "",
            "institution": "Integris Baptist Medical Center, Department of Emergency Medicine, Oklahoma City, Oklahoma",
            "department": "None"
        },
        {
            "first_name": "Joseph",
            "middle_name": "A",
            "last_name": "Stone",
            "name_suffix": "",
            "institution": "Evidera, INC",
            "department": "None"
        },
        {
            "first_name": "Ariel",
            "middle_name": "",
            "last_name": "Berger",
            "name_suffix": "",
            "institution": "Evidera, Bethesda, Maryland",
            "department": "None"
        }
    ],
    "date_submitted": "2017-12-14T02:17:45Z",
    "date_accepted": "2017-12-14T02:17:45Z",
    "date_published": "2018-06-13T17:08:21Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/11506/galley/6209/download/"
        }
    ]
}