Emergency medicine clinics of North America
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Patients presenting to the emergency department with certain traumatic conditions can be managed in observation units. The evidence base supporting the use of observation units to manage injured patients is smaller than the evidence base supporting the management of medical conditions in observation units. The conditions that are eligible for management in an observation unit are not limited to those described in this article, and investigators should continue to identify types of conditions that may benefit from this type of health care delivery.
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Emerg. Med. Clin. North Am. · Aug 2017
ReviewCare of Metabolic and Endocrine Conditions in the Observation Unit.
Accelerated therapeutic protocols targeting metabolic conditions are ideal for observation unit care. Because many conditions, such as hypokalemia and hyperglycemia, have little to no diagnostic uncertainty, the care in the unit is often straightforward. ⋯ Hence, this discussion focuses resource utilization and management considerations for the purposes of matching the level of care to the severity of the conditions. When carefully selected candidates are cared for in the observation unit, hospital resources can enable a safe, efficient hospital stay.
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Emerg. Med. Clin. North Am. · Aug 2017
ReviewCare of the Patient with Chest Pain in the Observation Unit.
Care of the patient presenting to an emergency department (ED) with chest pain remains a common yet challenging aspect of emergency medicine. Acute coronary syndrome presents in nonspecific fashion. ⋯ Furthermore, there are several provocative testing modalities to help assess for coronary artery disease. This article serves to describe and discuss the modern ED-based observation unit approach to patients with chest pain and/or angina equivalents presenting to an ED.
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Emerg. Med. Clin. North Am. · Aug 2017
ReviewThe Establishment and Management of an Observation Unit.
The current health care landscape and evidence support the establishment of observation units (OUs) for safe and efficient care for observation patients. Careful attention is required in the design of OU process, location, and layout to enable optimal care and finances. ⋯ OU management requires a strong, collaborative leadership model, appropriate staffing, and a robust monitoring system for quality, safety, and finances. With a better understanding of these principles of OU establishment and management, hospital leaders can generate and sustain service excellence.
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Emerg. Med. Clin. North Am. · Aug 2017
ReviewCare of Acute Gastrointestinal Conditions in the Observation Unit.
The Emergency Department Observation Unit (EDOU) provides a viable alternative to inpatient admission for the management of many acute gastrointestinal conditions with additional opportunities of reducing resource utilization and reducing radiation exposure. Using available evidence-based criteria to determine appropriate patient selection, evaluation, and treatment provides higher-quality medical care and improved patient satisfaction. Discussions of factors involved in creating an EDOU capable of caring for acute gastrointestinal conditions and clinical protocol examples of acute appendicitis, gastrointestinal hemorrhage, and acute pancreatitis provide a framework from which a successful EDOU can be built.