European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Multicenter Study
Determinants of self-rated health in older adults before and 3 months after an emergency department visit: a prospective study.
Self-rated health (SRH) is an important patient-reported outcome, but little is known about SRH after a visit to the emergency department (ED). We investigated the determinants of decline in SRH during 3 months after an ED visit in older patients. ⋯ Decline in SRH after an ED visit in older patients is at least partly dependent on factors of functional capacity and functional decline. Preventive interventions to maintain functional status may be the solution to maintain SRH, but more research is needed to further improve and firmly establish the clinical usability of these findings.
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Multicenter Study
Medically unexplained physical symptoms in patients visiting the emergency department: an international multicentre retrospective study.
The objective of this study was to assess the incidence and characteristics of patients presenting with physical symptoms that remain medically unexplained at the emergency department (ED). ⋯ Physical symptoms remain unexplained in a significant number of patients at the time of ED assessment.
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Multicenter Study Observational Study
Optimising emergency weight estimation in underweight and obese children: the accuracy of estimations of total body weight and ideal body weight.
During medical emergencies, underweight and obese children are at a higher risk of weight-estimation errors than 'average' children, which may lead to poorer outcomes. In obese children, optimum drug dosing requires a measure of both total body weight (TBW) and ideal body weight (IBW) for appropriate scaling. We evaluated the ability of the Broselow tape, the Mercy method and the PAWPER XL tape to estimate TBW and IBW in obese and underweight children. ⋯ The Broselow tape predicted IBW, but not TBW, accurately. The Mercy method estimated TBW very accurately, but not IBW. The PAWPER XL tape estimated both TBW and IBW accurately. The PAWPER XL tape should be considered when choosing a weight-estimation strategy for obese and underweight children.
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In 2018 the Surviving Sepsis Campaign issued new guidance with a revised version of their sepsis bundle. Instead of the 2016 3-hour sepsis bundle, the Surviving Sepsis Campaign now recommends that blood cultures, lactate measurement, broad-spectrum antibiotic therapy and 30 ml/kg crystalloid fluid administration should be initiated within 1 hour after triage. The European Society of Emergency Medicine wishes to express its concerns regarding the low level of evidence that underlies this guidance, and the potential implications from an emergency physician point of view.
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Twenty-one new Danish emergency departments (EDs) were established following a 2007 policy reform that included ED autonomy to self-organize. The aim of this study was to describe the organization of the 21 departments and their organizational challenges. ⋯ We identified three organizational ED models (virtual, hybrid, and independent). Nineteen EDs used more than one organizational model depending on the time of day or day of the week.