Annals of emergency medicine
-
Over the past decade, there has been a dramatic increase in pediatric emergency department (PED) visits seeking mental and behavioral health care. We aimed to determine the relationship between hours of care devoted to patients with mental and behavioral health complaints and markers of PED throughput and timeliness. ⋯ In our single-center study, the increase in mental and behavioral health visits and hours of care was associated with significantly worsened PED throughput and timeliness of care metrics. This relationship highlights the challenges that PEDs face in caring for mental and behavioral health patients while simultaneously providing high-quality care to patients with acute nonmental and behavioral health emergencies.
-
Addition of illicitly manufactured fentanyl to the opioid and nonopioid illicit drug supply has exacerbated the drug overdose crisis in the United States. People who use drugs are often unaware that their drugs contain fentanyl. Awareness about fentanyl adulteration may be protective against fatal overdose. ⋯ Many drug-related ED visits involved fentanyl exposure, even when individuals did not believe they were using fentanyl. Knowledge of fentanyl adulteration can inform people who intend to use opioid and/or nonopioid drugs about harm reduction approaches, such as distribution of fentanyl test strips and educational interventions.
-
To evaluate the cost-effectiveness of implementation facilitation compared with a standard educational strategy to promote emergency department (ED)-initiated buprenorphine with linkage to ongoing opioid use disorder care in the community, from a health care-sector perspective. ⋯ Implementation facilitation, relative to a standard educational strategy, has a moderate-to-high likelihood of being considered cost-effective from a health care-sector perspective, depending on decisionmakers' willingness to pay for units of effectiveness.
-
The primary objective of our study was to compare the effectiveness of oral cephalosporins versus fluroquinolones and trimethoprim/sulfamethoxazole (TMP-SMX) for the treatment of pyelonephritis in patients discharged home from the emergency department (ED). ⋯ Oral cephalosporins were associated with similar treatment failure rates compared with Infectious Diseases Society of America guideline-endorsed treatments for the treatment of pyelonephritis in ED patients discharged home.