The American journal of emergency medicine
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The global increase in neonatal visits to Pediatric Emergency Departments (PEDs) underscores the need to better understand the factors driving these visits and their implications. The often vague and nonspecific symptoms of neonates pose significant challenges for clinicians and caregivers in determining the appropriate level of care, impacting the frequency of return visits and overall effectiveness of discharge education. ⋯ This study identified specific complaints that were most likely to result in hospital admissions and return visits to the ED. This can guide targeted educational interventions for caregivers and ED providers and refinement of triage protocols to ensure that neonates receive the most appropriate and efficient care.
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Band neutrophil count greater than 10 % of the white blood cell differential (bandemia) has been associated with severe infections in emergency department (ED) patients. In January 2023, our ED instituted a critical alert for bandemia. We performed a retrospective chart review of two cohorts of emergency department patients, before and after initiation of critical alert. After critical alert initiation for bandemia, there was a 4.6-fold higher incidence of bandemia with similar baseline patient characteristics.
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The burden of acute bacterial skin and skin structure infections (ABSSSI) continue to plague the healthcare system. One approach to managing moderate-to-severe ABSSSI in low-risk patients involves use of a single dose lipoglycopeptide (LGP), dalbavancin or oritavancin, in the emergency department (ED) and discharge to home with follow-up care. Limited ED studies indicate decreased hospital stays, ED revisits, readmissions, and healthcare costs, as well as improved patient satisfaction with use of these antibiotics. ⋯ Moreover, there is lack of research on the impact of LGPs on organizational productivity, patient quality of life, and utility in indications beyond ABSSSI. This review focuses on the role of long-acting LGPs in the ED setting for select patients presenting with ABSSSI, aiming to avoid hospitalizations, expedite patient discharge, and prevent readmissions while acknowledging potential limitations of therapy. Additionally, it provides insights into strategies and considerations specifically relevant to implementing this therapeutic approach in the ED.