Annals of emergency medicine
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WHAT IS ALREADY KNOWN ON THIS TOPIC: Emergency department (ED) crowding may result in delays in the administration of medication such as antibiotics for pneumonia. WHAT QUESTION THIS STUDY ADDRESSED: Does crowding cause delays in treatment for pain? WHAT THIS STUDY ADDS TO OUR KNOWLEDGE: In this retrospective analysis of 13,578 patients treated at a single inner-city ED, patients with severe pain were slightly less likely to receive pain medications quickly when the ED volume increased. HOW THIS MIGHT CHANGE CLINICAL PRACTICE: Crowding may delay the administration of pain medication in some patients. Standing orders for the administration of pain medication might mitigate such delays.
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Review Comparative Study
Management of emergency department patients with primary spontaneous pneumothorax: needle aspiration or tube thoracostomy?
The emergency management of primary spontaneous pneumothorax is controversial. This evidence-based emergency medicine review evaluates the existing evidence about the efficacy and safety of needle aspiration in comparison to tube thoracostomy for management of primary spontaneous pneumothorax. ⋯ The existing evidence indicates that needle aspiration is at least as safe and effective as tube thoracostomy for management of primary spontaneous pneumothorax. Additionally, needle aspiration carries the benefit of fewer hospital admissions and shorter length of hospital stay.
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Emergency department patient preferences for boarding locations when hospitals are at full capacity.
Admitted patients are frequently boarded in emergency departments (EDs) when hospitals are at full capacity, which lessens the ED's ability to treat new patients. One alternative is to board admitted patients in inpatient hallways. We assess ED patient preferences for boarding location. ⋯ When hospitals are at full capacity, patients would rather board in inpatient hallways than ED hallways.
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We explore perceptions surrounding use of portable inhalers and holding chambers (spacers) for delivery of beta-agonist respiratory medications to children in the emergency department (ED) and factors influencing practice change. ⋯ Findings from this study could be used to inform a change program to close the gap between evidence and practice with respect to use of inhalers and holding chambers in the ED.