Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Acute decompensated heart failure (adHF) is the cause of approximately 1 million annual hospital admissions. In some of these, the use of a short-stay emergency department observation unit (EDOU) decreases 90-day ED revisits and 90-day rehospitalizations and, if subsequent hospitalization is required, results in shorter stays. ⋯ These results demonstrate that a BUN level >30 mg/dL is associated with an increased likelihood of admission in patients with adHF. This provides the emergency physician with a practical prognostic tool for disposition planning in congestive heart failure patients.
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To prospectively validate a previously published out-of-hospital clinical decision rule to identify seriously injured children involved in motor vehicle crashes (MVCs). ⋯ Although definitive conclusions are limited by the sample size, the decision rule identified all seriously injured children involved in MVCs and had moderate specificity. The decision rule was less sensitive for identifying children requiring specialized trauma care. Larger validation studies are needed to adequately assess the utility of this rule before implementation.
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Comparative Study
Obese patients with abdominal pain presenting to the emergency department do not require more time or resources for evaluation than nonobese patients.
The authors describe the evaluation of obese and nonobese adult patients with abdominal pain presenting to an emergency department (ED). The hypothesis was that more ED and hospital resources are used to evaluate and treat obese patients. ⋯ In contradiction to the hypothesis, the results suggest that LOS and ED resource use in obese patients with abdominal pain are not increased when compared with nonobese patients.
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The aims of this study were to compare rates of intimate partner violence (IPV) across different medical specialties and health care sites in one metropolitan area, describe demographic characteristics of women with abusive partners, characterize health care provider assessment of IPV, and describe patient characteristics associated with health care assessment for partner violence. ⋯ Using the same instrument and protocol, different rates of IPV and detection of IPV were found across medical departments, with the highest rates in emergency departments and an addiction recovery program. It is especially important for assessment of IPV to include young women who present to medical departments.
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Preparing medical students for residency in emergency medicine involves education in many areas of knowledge and skill, including instruction in advanced emergency procedures. ⋯ These findings support the value of an advanced emergency procedural training course using an unembalmed cadaver-based laboratory and incorporating several teaching modalities.