The American journal of emergency medicine
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US emergency departments are facing a number of operational challenges related to chronic shortages of registered nurses. Many of the tasks done by registered nurses can be safely and successfully delegated to the emergency department technician (EDT), particularly if a hospital's nursing and administrative leadership are affirmatively engaged in a process to professionalize and train their EDT workforce. This paper examines the state, Joint Commission on Accreditation of Healthcare Organizations, and Centers for Medicare & Medicaid Services regulatory landscape for the EDT, reviews the literature on how hospital's utilize EDT's, discusses approaches to skills training, and examines the need for profession standardization that enables job role expansion.
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Assessing the right ventricular function in patients with submassive pulmonary embolism (PE) is pivotal when determining the appropriate treatment pathway. We describe two cases of submassive PE requiring systemic thrombolysis, in which intravenous saline contrast demonstrated a noticeable lack of forward flow in the right ventricle. This technique potentially may indicate impending right ventricular functional collapse and the need for more aggressive intervention.
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Since providing timely care is the primary concern of emergency departments (EDs), long waiting times increase patient dissatisfaction and adverse outcomes. Especially in overcrowded ED environments, emergency care quality can be significantly improved by developing predictive models of patients' waiting and treatment times to use in ED operations planning. ⋯ By predicting patients' waiting and treatment times, ED workloads can be assessed instantly. This enables ED personnel to be scheduled to better manage demand supply deficiencies, increase patient satisfaction by informing patients and relatives about expected waiting times, and evaluate performances to improve ED operations and emergency care quality.
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Study objective: To estimate the frequency of clinically relevant adverse cardiac events (CRACE) in patients admitted to the hospital for chest pain with an intermediate HEART score (4, 5, 6), non-diagnostic EKG, and a negative initial troponin. ⋯ In this cohort of admitted patients with a documented intermediate-risk HEART score, nonischemic EKG, and negative initial troponin, the occurrence of CRACE during the index hospitalization was 0.5%.
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Bed bugs are hematophagous insects that can be problematic in some urban emergency departments. The objective was to determine if red blood cell (RBC) and coagulation indices of bed bug-infested emergency department (ED) patients differed from those of noninfested control patients. ⋯ Bed bug infestated patients in the ED are associated with anemia.