B.Tilman Jolly

Simplification of Emergency Department Discharge Instructions Improves Patient Comprehension

STUDY OBJECTIVE Emergency department patients have been shown to have difficulty understanding written discharge instructions. We attempted to determine whether improvements in comprehension can be achieved by simplification of available materials. DESIGN We have previously tested patient understanding of standard discharge instructions. For this study, we simplified the standard instructions. Patients were given one of two simplified instruction sets. After reading the instructions, each patient was asked to answer five specific written questions about them. Results were compared with those from the original study. SETTING ED of a large inner-city university hospital. PARTICIPANTS Four hundred twenty-three adult ED patients who presented on randomly selected days. RESULTS The current and original groups were well matched for demographic variables. Each subjects responses were analyzed for overall success and for success with individual questions. The mean score for the current group was significantly improved over that of the original group. A trend toward improvement was demonstrated in all demographic groups with use of the simplified instructions. CONCLUSION Simplified written materials may help patients who do not understand current standard materials. Health care providers should simplify written materials to make them understandable to the greatest number of patients.

MOTOR VEHICLE SAFETY: CURRENT CONCEPTS AND CHALLENGES FOR EMERGENCY PHYSICIANS

Motor vehicle travel is the primary means of transportation in the United States, providing freedom in travel and enterprise for many people. Motor vehicle crashes are the leading cause of death for the young and contribute to a high degree of morbidity and mortality for all ages. Motor vehicle crashes produce an enormous burden for society in terms of suffering, disability, death, and costs. Motor vehicle crash injury prevention is developing as a focused discipline to implement proven interventions involving technology and behavior known to prevent or reduce the severity of motor vehicle crash injury. Emergency physicians have an important role in advocating motor vehicle safety and injury prevention, both in the emergency department and within the community.

Loiasis. A Case of an Unusual Ocular Foreign Body

Loiasis is a parasitic illness that is endemic in parts of Central and West Africa. In the United States, infection with Loa loa is seen in natives from that region of Africa and in those who have traveled to the area, often in the distant past. There can be significant differences in clinical manifestations between the two groups. We present a case of loiasis in an African native as well as a discussion of Loa loa infection in natives and non-natives and current treatment strategies.

Rhabdomyolysis secondary to keyboard overuse: Occupational hazard of the computer age

A 33-year-old man presented with rhabdomyolysis with bilateral forearm pain and a profoundly elevated creatine phosphokinase. The cause of his illness appears to be computer keyboard overuse soon after a viral illness. This is the first case report directly linking rhabdomyolysis with keyboard overuse.

Commentary: Bigger is Better, but not for Everyone

Abstract [Jolly BT: NHTSA Notes commentary: Bigger is better, but not for everyone. Ann Emerg Med August 1997;30:225-226.]

National Conference on Medical Indication for Air Bag Disconnection—July 16-18, 1997☆

[National Highway Traffic Safety Administration: National Conference on Medical Indication for Air Bag Disconnection-July 16-18, 1997. Ann Emerg Med June 1998;31:782-783.].

Building a Smarter Car: Visions of the Future at NHTSA

Abstract [Jolly BT: Building a smarter car: Visions of the future at NHTSA. Ann Emerg Med June 1997;29:813-814.]