The American journal of emergency medicine
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Due to limited community resources for mental health and long travel distances, emergency departments (EDs) serve as the safety net for many rural residents facing crisis mental health care. In 2019, The Leona M. and Harry B. Helmsley Charitable Trust funded a project to establish and implement an ED-based telepsychiatry service for patients with mental health issues in underserved areas. The purpose of this study was to evaluate the implementation of this novel ED-based telepsychiatry service. ⋯ Implementation of a telepsychiatry service in ED settings may be beneficial to the patient, local ED, and the underserved community. In this study, we found that implementing this service alleviated the burden of care during the COVID-19 pandemic, enhanced local site capability, and improved local ability to provide quality and effective care.
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Review Meta Analysis
Delirium prevalence in geriatric emergency department patients: A systematic review and meta-analysis.
In the emergency department, delirium associated with serious adverse outcomes is common in geriatric patients. We performed a meta-analysis and estimated the prevalence of delirium and its related factors among geriatric emergency department patients. ⋯ In the emergency department, delirium is common in geriatric patients. We should pay specific attention to delirium screening, prevention, and treatment in geriatric patients. Overall appropriate interventions should be utilized to reduce the occurrence of delirium and the adverse outcomes.
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Symptoms may differ between frail and non-frail patients presenting to Emergency Departments (ED). However, the association between frailty status and type of presenting symptoms has not been investigated. We aimed to systematically analyse presenting symptoms in frail and non-frail older emergency patients and hypothesized that frailty may be associated with nonspecific complaints (NSC), such as generalised weakness. ⋯ Presenting symptoms differ in frail and non-frail patients. Frailty is associated with generalised weakness at ED presentation.
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Emergency clinicians utilize local anesthetics for a variety of procedures in the emergency department (ED) setting. Local anesthetic systemic toxicity (LAST) is a potentially deadly complication. ⋯ This focused review provides an update for the emergency clinician to manage patients with LAST.