European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Observational Study
Delays in the administration of antimicrobials in the emergency department and the impact of an educational intervention to improve this administration.
The aim of the study was to assess the factors associated with delays in emergency department (ED) antimicrobial administration and to determine whether an educational intervention would reduce the incidence of such delays. ⋯ Older age, multiple agent orders, and dosing ordering pattern showed a significant association with delays in ED antimicrobial administration. An educational intervention to disseminate knowledge of these factors did not result in a reduction in such delays.
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Observational Study
Feasibility of introduction and implementation of the Surviving Sepsis Campaign bundle in a Singapore Emergency Department.
The Surviving Sepsis Campaign has been shown to improve the outcome of patients with severe sepsis or septic shock in Europe and North America. We aim to examine the impact of implementing the severe sepsis resuscitation bundle as part of standard care at the National University Hospital Emergency Department (ED) and assess its feasibility in Singapore. ⋯ There was zero compliance to the severe sepsis resuscitation bundle at baseline. Quality improvement initiatives resulted in better compliance and outcome for patients, showing that such a protocol of management is feasible in a typical Singapore ED.
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Dengue fever is endemic in Malaysia and poses a significant problem to the national health system. Because of its nonspecific clinical features, it creates clinical and administrative uncertainties. We evaluated the role of an emergency department short-stay ward (EDSSW) in the management of dengue fever in the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). ⋯ EDSSW limit the number and burden of dengue patients requiring formal IP admissions while acting as a 'safety net' for inappropriate discharges and unnecessary admissions.
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Comparative Study Observational Study
Diagnosing pulmonary edema: lung ultrasound versus chest radiography.
Diagnosing the underlying cause of acute dyspnea can be challenging. Lung ultrasound may help to identify pulmonary edema as a possible cause. ⋯ Residents were able to more accurately identify pulmonary edema with lung ultrasound than with chest radiograph. Physicians with minimal exposure to lung ultrasound may be able to correctly recognize pulmonary edema on lung ultrasound.
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To assess the impact of improving long-term control medications on quality of life in children with persistent asthma symptoms attended in a paediatric emergency department (PED). ⋯ Children attended for acute asthma in PED where LCTM were initiated or stepped up showed a decrease in asthma persistent symptoms and an improvement in their quality of life.