Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial
Dating aggression and risk behaviors among teenage girls seeking gynecologic care.
The objective was to describe rates of dating aggression and related high-risk behavior among teens presenting to the emergency department (ED) seeking gynecologic care, compared to those seeking care for other reasons. ⋯ Of the teens undergoing gynecologic evaluation in this urban ED, 49% reported dating aggression. These teens also reported higher rates of other sexual risk behaviors compared to their peers. Care providers in urban EDs treating all female teens and particularly those seeking gynecologic care should be aware of this high rate of dating aggression and screen for aggression in dating relationships in this high-risk group.
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Multicenter Study
Emergency department patient flow: the influence of hospital census variables on emergency department length of stay.
The objective was to evaluate the association between hospital census variables and emergency department (ED) length of stay (LOS). This may give insights into future strategies to relieve ED crowding. ⋯ In multiple hospital settings, ED LOS is correlated with the number of admissions and census of the higher acuity nursing units, more so than the number of ED patients each day, particularly in larger hospitals with busier EDs. Streamlining ED admissions and improving availability of inpatient critical care beds may reduce ED LOS.
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Comparative Study
The association between emergency department crowding and adverse cardiovascular outcomes in patients with chest pain.
While emergency department (ED) crowding is a worldwide problem, few studies have demonstrated associations between crowding and outcomes. The authors examined whether ED crowding was associated with adverse cardiovascular outcomes in patients with chest pain syndromes (chest pain or related complaints of possible cardiac origin). ⋯ There was an association between some measures of ED crowding and a higher risk of adverse cardiovascular outcomes in patients with both ACS-related and non-ACS-related chest pain syndrome.
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Overlap of the femoral artery (FA) on the femoral vein (FV) has been shown to occur in pediatric patients. This overlap may increase complications such as arterial puncture and failed insertions of central venous lines (CVLs). Knowledge of the anatomic relationship between the FV and FA may be important in avoiding these complications. ⋯ A significant percentage of children have FAs that overlap their FVs. This overlap may be responsible for complications such as FA puncture with CVL placement. Ultrasound-guided techniques may decrease these risks. Placing children in the frog leg position increases the diameter of the FV visualized on ultrasound.
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The authors assessed the effect of emergency department (ED) crowding on the nontreatment and delay in treatment for analgesia in patients who had acute abdominal pain. ⋯ Emergency department crowding is associated with delays in analgesic treatment from the time of triage in patients presenting with acute abdominal pain.