European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The aim of this study was to describe baseline coagulation in patients presenting to the emergency department (ED) with a ruptured abdominal aortic aneurysm (rAAA) and its effect on survival. ⋯ Although coagulopathy is often present in patients presenting with a rAAA, it does not seem to be associated with a poorer outcome. Our results seem to suggest that altering the current practice of minimal transfusion in the ED to include early transfusion of blood products, such as platelets or fresh frozen plasma, is therefore unlikely to improve outcome.
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The aim of this study was to describe the demographic, social and medical characteristics, and healthcare use of highly frequent users of a university hospital emergency department (ED) in Switzerland. ⋯ Highly frequent users of a Swiss academic ED are a highly vulnerable population. They are in poor health and accumulate several risk factors of being even in poorer health. The small number of patients and their high level of insurance coverage make it particularly feasible to design a specific intervention to approach their needs, in close collaboration with their primary care practitioner. Elaboration of the intervention should focus on social reinsertion and risk-reduction strategies with regard to substance use, hospital admissions and suicide.
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At the time of this study, the Sheba Medical Center Emergency Department (ED) in Israel had no formal triage system in place. To evaluate the interobserver reliability of two triage scales among nurses in our ED, the time-based Australasian Triage Scale (ATS) and the resource-based Emergency Severity Index (ESI), 10 nurses participated in a workshop on ATS and ESI. They then independently assessed 100 simulated triage scenarios taken from actual ED patients, and completed a survey. ⋯ The nurses felt that ESI was slightly easier to use. Using conventional interpretations, the agreement for ATS is considered substantial, whereas that for ESI is considered moderate. Conversely, the nurses found the ESI somewhat easier to use.
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This study attempts to quantify and characterize the patients who leave before being seen (LBBS) by a physician in an urgent care setting. ⋯ The rates of leaving before being seen in urgent care were comparable with the lower end of those reported by emergency departments. Patients who left before being seen in UCC were most likely to be working-age adults during daytime hours. In UCC, LBBS is often related to perceived, rather than actual, long wait times.