J Emerg Med
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Emergency medical services (EMS) contribute to the vital role of providing health care to an individual by delivering time-sensitive, episodic treatment to patients with acute illnesses. Understanding which factors impact EMS utilization can help guide policies and allocate resources more effectively. Increasing primary care access has often been touted to decrease unnecessary emergency care utilization. ⋯ Insurance coverage can play an important role in decreasing EMS utilization and may also impact the effect of increased primary care physician availability on EMS utilization in a region.
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Criteria for trauma determination evolves. We developed/evaluated a Rapid Trauma Evaluation (RTE) process for a trauma patient subset not meeting preestablished trauma criteria. ⋯ Patients > 65 years with a ground level fall or in a MCC arriving via EMS not meeting ACS trauma criteria may benefit from RTE.
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Mayo Clinic's virtual hybrid hospital-at-home program, Advanced Care at Home (ACH) monitors acute and post-acute patients for signs of deterioration and institutes a rapid response (RR) system if detected. ⋯ The use of an ACH RR team was effective at limiting both escalations back to an ED and hospital readmissions, as 83% of deteriorating patients were successfully stabilized and managed in their homes. Implementing a hospital-at-home RR team can reduce the need for ED use by providing critical resources and carrying out required interventions to stabilize the patient's condition.
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Observational Study
Exploratory Descriptive Analysis of Smart Speaker Utilization in the Emergency Department During the COVID-19 Pandemic.
In March 2020, the U.S. Department of Health and Human Services Office for Civil Rights stated that they would use discretion when enforcing the Health Insurance Portability and Accountability Act regarding remote communication technologies that promoted telehealth delivery during the COVID-19 pandemic. This was in an effort to protect patients, clinicians, and staff. More recently, smart speakers-voice-activated, hands-free devices-are being proposed as productivity tools within hospitals. ⋯ Smart speakers showed notable engagement, primarily being used for patient communication and entertainment. Future studies should examine content of patient care conversations using these devices, effects on frontline staff wellbeing, productivity, patient satisfaction, and even explore opportunities for "smart" hospital rooms.
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Spit restraint devices, also referred to as spit hoods, spit masks, or spit socks, are used by law enforcement and medical personnel to minimize transmission of communicable disease from bodily fluids from agitated individuals. Several lawsuits have implicated spit restraint devices as contributing to the death of individuals who are physically restrained by means of asphyxiation due to saturation of the mesh restraint device with saliva. ⋯ In healthy adult subjects, there were no statistically or clinically significant differences in ventilatory or circulatory parameters while wearing the saturated spit restraint.