The American journal of emergency medicine
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Multicenter Study
Factors influencing the development of antibiotic associated diarrhea in ED patients discharged home: risk of administering intravenous antibiotics.
Antibiotic-associated diarrhea (AAD) and Clostridium difficile infection (CDI) are well-known outcomes from antibiotic administration. Because emergency department (ED) visits frequently result in antibiotic use, we evaluated the frequency of AAD/CDI in adults treated and discharged home with new prescriptions for antibiotics to identify risk factors for acquiring AAD/CDI. ⋯ Intravenous antibiotic therapy administered to ED patients before discharge was associated with higher rates of AAD and with 2 cases of CDI. Care should be taken when deciding to use broad-spectrum IV antibiotics to treat ED patients before discharge home.
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There has been a rise in advanced diagnostic imaging (ADI) use in the emergency department (ED). Increased utilization may contribute to longer length of stay (LOS), but prior reports have not considered improved methods for modeling skewed LOS data. ⋯ Generalized linear model offered an improved modeling approach compared to OLS and quantile regression. Consideration of such techniques may facilitate a more complete view of the effect of ADI on ED LOS.
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We initiated a program to rapidly rule out myocardial infarction and make an appointment (with no co-payment) with a cardiologist within 72 hours for patients with low-risk chest pain. ⋯ This program did not reduce repeat ED visits. Patients with insurance were more likely to keep follow-up appointments.
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To describe a tertiary care pediatric emergency department (PED) experience with bougienage for esophageal coins. ⋯ Esophageal bougienage is safe and highly effective. It is also more time and cost efficient than other treatment options.
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To determine how age and gender impact resource utilization and profitability in patients seen and released from an Emergency Department (ED). ⋯ Resource utilization increased and profitability decreased with increasing age in patients seen and released from an ED. The care of women of childbearing age resulted in higher resource utilization and higher profitability than men of the same age. No differences in resource utilization or profitability by gender were observed in children and adults over 45.