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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Length of stay is a measure of efficiency of delivery of care and is an important determinant of patient satisfaction in a pediatric emergency department (ED). Although length of stay is affected by many unmodifiable factors, changes in care processes may lead to improvements in throughput. Evaluating the success of such changes, however, requires an understanding of the effect of other determinants. We determine the factors associated with ED length of stay and estimate the effect of an in-room registration process on throughput time. ⋯ In-room registration leads to a statistically significant and practically meaningful improvement in total length of stay in the pediatric ED. Throughput time can be largely explained by a limited number of factors; our predictive model may facilitate the evaluation of other interventions.