European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study
Why do patients with nonurgent conditions present to the Emergency Department despite the availability of alternative services?
The aim of this study was to investigate why nonurgent patients present to the Emergency Department (ED) despite availability of alternative services; also to assess impact of the UK Choose Well Campaign. A convenience sample of nonurgent ED attenders was surveyed in North Wales, UK. More than half of patients sought advice from friends, family, carer or GP before attending ED. ⋯ Twenty per cent of patients reported they would have changed their decision about attending ED if they had known more about alternatives. Only 12% were aware of Choose Well. Analysis suggests that though Choose Well effectively provides information on alternatives, it does not translate into more appropriate attendance.
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Comparative Study
Infection prevention practices in Swedish emergency departments: results from a cross-sectional survey.
Healthcare-associated infections (HAIs) are a leading cause of preventable morbidity and mortality. Emergency departments (EDs) are a potential source of HAIs as they are the site for large volumes of patients in tight quarters and often focus on immediate life threats over prevention. We aimed to estimate the extent to which Swedish EDs have adopted evidence-based measures to prevent HAIs. The second aim was to identify predictors of high hand hygiene compliance. ⋯ A minority of Swedish EDs are participating in projects to address hand hygiene and catheter-associated urinary tract infection. Frequent auditing of hand hygiene compliance may improve compliance rates.
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Sepsis is associated with high mortality. Because early therapy has proven to decrease mortality, a risk stratification tool that quickly and easily quantifies mortality risk of patients will be helpful to guide appropriate treatment. We investigated five scores in terms of (a) predicting 28-day mortality and (b) their feasibility for use in the emergency department (ED). ⋯ The MEDS and CURB-65 scores are the most adequate and feasible tools for the prediction of total 28-day mortality in septic patients presenting at the ED, but they need local recalibration before use in the ED.
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This study was designed to provide an overview of the epidemiology and clinical findings in children presenting to a sports injury clinic with 'low back pain' (LBP). ⋯ No consistent demonstrable association was established between clinical presentation and final diagnosis. It was found that red flags could not be relied upon for the inclusion or the exclusion of a significant radiological finding. This study therefore suggests that, in this population group, a significant diagnosis cannot always be reliably excluded from clinical assessment alone.
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The Mortality in Severe Sepsis in the Emergency Department (MISSED) score was derived to predict in-hospital mortality in septic patients in the emergency department (ED). The present study aimed to validate the MISSED score in patients receiving early goal-directed therapy (EGDT). ⋯ Further studies are required to validate the MISSED score in more diverse patients.