Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial
Impact of point of care testing on length of stay of patients in the emergency department: a cluster randomized controlled study.
Crowding is a frequent concern in the emergency department (ED). Laboratory point-of-care testing (POCT) has been proposed to decrease patients' length of stay (LOS). Our objective was to determine whether an extended panel of POCT solutions could reduce LOS. ⋯ The implementation of an extended panel of POCT solutions in an ED did not significantly reduce the LOS, but reduced the TTR.
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The Centers for Disease Control and Prevention (CDC) recommend universal human immunodeficiency virus (HIV) screening starting at 13 years, which has been implemented in many general U.S. emergency departments (EDs) but infrequently in pediatric EDs. We aimed to 1) implement a pilot of routine adolescent HIV screening in a pediatric ED and 2) determine the unique barriers to CDC-recommended screening in this region of high HIV prevalence. ⋯ Routine HIV screening in adolescents was able to be implemented in this pediatric ED and led to the identification of early infection in a young adolescent who would have otherwise been undetected at this stage of disease. Addressing the unique barriers to adolescent HIV screening is critical in high-prevalence regions and may lead to earlier diagnosis and treatment in this vulnerable population.
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Observational Study
Association between emergency physician length of stay rankings and patient characteristics.
Emergency physicians are commonly compared by their patients' length of stay (LOS). We test the hypothesis that LOS is associated with patient characteristics and that accounting for these features impacts physician LOS rankings. ⋯ Length of stay was significantly associated with patient characteristics, and accounting for variation in patient characteristics resulted in substantial reordering of relative physician rankings by LOS. Comparisons of emergency physicians by LOS that do not account for patient characteristics should be reconsidered.
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SARS-CoV-2 is a global pandemic associated with significant morbidity and mortality. However, information from United States cohorts is limited. Understanding predictors of admission and critical illness in these patients is essential to guide prevention and risk stratification strategies. ⋯ There are a number of factors associated with hospitalization and critical illness. Clinicians should consider these factors when evaluating patients with COVID-19.