Annals of emergency medicine
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Review Practice Guideline Guideline
Clinical policy: procedural sedation and analgesia in the emergency department.
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There is a high prevalence of unmet substance abuse treatment need among adult hospital emergency department (ED) patients. We examine the association between this unmet need and excess utilization of health services and estimate costs. ⋯ ED patients with unmet substance abuse treatment need generated much higher hospital and ED charges than patients without such need. Given potential savings from avoidable health care costs, the future burden of substance-associated ED visits and hospitalizations may be reduced through programs that screen and, as appropriate, provide brief interventions or treatment options to these patients.
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Multicenter Study
Emergency department visits for outpatient adverse drug events: demonstration for a national surveillance system.
This project demonstrates the operational feasibility and epidemiologic usefulness of modifying a national injury surveillance system for active surveillance of outpatient adverse drug events treated in hospital emergency departments (EDs). ⋯ Active surveillance for outpatient adverse drug events using the National Electronic Injury Surveillance System-All Injury Program is feasible. Ongoing, population-based ED surveillance can help characterize the burden of outpatient adverse drug events, prioritize areas for further research and intervention, and monitor progress on adverse drug event prevention.
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We assess the feasibility of activated charcoal provided by emergency medical services (EMS). ⋯ Out-of-hospital activated charcoal administration by EMS is feasible, even in severe poisonings. Adverse events were rare.
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We determined the additional cost of an extended emergency department (ED) length of stay for chest pain patients awaiting non-ICU, monitored (telemetry) beds. ⋯ Extended ED length of stay demonstrated no association with total hospital costs or revenues or total hospital length of stay but imposed substantial ED opportunity costs, with decreased potential revenue. Interventions that reduce ED delays in hospital admissions have the potential to significantly increase hospital revenues.