Annals of emergency medicine
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Editorial Comment
Emergency department crowding 2.0: coping with a dysfunctional system.
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Multicenter Study
Patients with rib fractures do not develop delayed pneumonia: a prospective, multicenter cohort study of minor thoracic injury.
Patients admitted to emergency departments (EDs) for minor thoracic injuries are possibly at risk of delayed pneumonia. We aimed to evaluate the incidence of delayed pneumonia post-minor thoracic injury and the associated risk factors. ⋯ This prospective cohort study of nonhospitalized patients with minor thoracic injuries revealed a low incidence of delayed pneumonia. Nonetheless, our results support tailored follow-up for asthmatic or chronic obstructive pulmonary disease patients with rib fracture.
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In 2005, England implemented a controversial target limiting patient stays in the emergency department (ED) to 4 hours. We determine the effect of the "4-hour target" on quality of care and resource use. ⋯ England's 4-hour target did not appear to have a negative effect on quality or safety of ED care and had little effect on test use.
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We evaluate recent trends in emergency department (ED) crowding and its potential causes by analyzing ED occupancy, a proxy measure for ED crowding. ⋯ Despite repeated calls for action, ED crowding is getting worse. Sociodemographic changes account for some of the increase, but practice intensity is the principal factor driving increasing occupancy levels. Although hospital admission generated longer ED stays than any other factor, it did not influence the steep trend in occupancy.