The American journal of emergency medicine
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Multicenter Study Comparative Study
The impact of COVID-19 lockdown measures on ED visits in Lebanon.
As the COVID-19 pandemic spread globally, emergency departments (ED) around the world began to report significant drops in volumes and changes in disease patterns. During the early COVID-19 period, Lebanon followed an aggressive containment approach to halt the spread of the disease. ⋯ ED visits dropped significantly during the COVID-19 containment period. Understanding the trends of changes in disease entities is important for ED staffing purposes during the pandemic and the varying containment efforts. While stringent lockdown measures were associated with drops in ED visits, understanding the reason behind these drops, specifically whether behavioral or related to true drops in disease prevalence, needs further exploration.
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Multicenter Study
First-to-second antibiotic delay and hospital mortality among emergency department patients with suspected sepsis.
To evaluate whether delay between the first and second antibiotic administered for suspected sepsis is associated with hospital mortality. ⋯ First-to-second antibiotic delay of greater than one hour was associated with an increased risk of hospital death among patients meeting criteria for septic shock but not all patients with suspected sepsis. Tracking and improving first-to-second antibiotic delays may be considered in septic shock.
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Nucleated red blood cells (NRBCs) are immature erythrocytes that are not normally detected in the blood of healthy adults. The detection of these cells in peripheral blood is associated with increased mortality and poor prognosis. In this study, we aimed to investigate whether NRBCs predict for all causes of death in patients admitted to the emergency department (ED). ⋯ A total of 204 patients (119 male) were included in the study. The mean age of the patients was 66.7 ± 14.6 years. NRBC value was higher in those who died (678.43 ± 655.16/ μl) compared to the control group (22.55 ± 57.86/ μl) (P < 0.001). According to receiver operating characteristic curve analysis (ROC) performed for the prediction all cause mortality in the ED, the best cut-off point for NRBC was >0 /μl (sensitivity 94,12%, specificity 82,35%, Area Under Curve (AUC) =0.97). In the multivariate logistic regression analysis, the NRBC was associated with all-cause mortality in the ED (odds ratio,OR = 1.020, confidence interval, CI = 1.012-1.028). CONCLUSıONS: High blood levels of nucleated red blood cells at admission to the emergency department may be associated with increased mortality.
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Lack of mental health resources, such as inpatient psychiatric beds, has increased frequency and duration of boarding for mental health patients presenting to U.S. emergency departments (EDs). The purpose of this study is to describe characteristics of mental health patients with an ED length of stay of one week or longer and to identify barriers to their disposition. ⋯ In this study of mental health patients with prolonged ED stays, the primary barrier to disposition was the lack of patient acceptance to inpatient psychiatric hospitals, community settings, or other housing. Early identification of potential prolonged boarding, quality treatment and care for those patients, and effective case management, may resolve the ongoing challenges of boarding within the ED.