Emergency medicine journal : EMJ
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Multicenter Study
Evaluation of triage methods used to select patients with suspected pandemic influenza for hospital admission.
Prepandemic projections anticipated huge excess attendances and mortality in an influenza pandemic. A number of tools had been suggested for triaging patients with influenza for inpatient and critical care admission, but none had been validated in these patients. The authors aimed to evaluate three potential triage tools--CURB-65, PMEWS and the Department of Health community assessment tool (CAT)--in patients in the first waves of the 2009 H1N1 pandemic. ⋯ Although limited by a paucity of cases, this research shows that current triage methods for suspected pandemic influenza did not reliably discriminate between patients with good and poor outcomes.
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To evaluate the effectiveness of a rapid assessment zone (RAZ) to mitigate emergency department (ED) overcrowding. ⋯ Although the results are consistent, and low acuity patients seem to benefit the most from a RAZ, the available evidence to support its implementation is limited.
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A short-cut review was carried out to establish the sensitivity and specificity of CRP as a tool for diagnosing bacteraemia. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line suggests that CRP is not a useful tool in the initial diagnosis of severe bacterial infection.
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Emergency management is a relatively new research field in China. The severe acute respiratory syndrome epidemic in 2003 caused research and papers on emergency management to increase by leaps and bounds. This review summarises the progress of hospital emergency management research in China, highlights trends and challenges, and discusses likely solutions for research improvement. ⋯ Based on this study we suggest that hospital emergency management research in China should make efforts to (1) establish a universally accepted theory framework and terminology, (2) create a structure for further studies, (3) integrate research of different disciplines, and (4) avoid or minimise confusion. More attention should be paid on the evolvement mechanism of main public health incidents and disasters, and the key functional systems related to hospital's emergency response resiliencies. Focus should also be placed on practical guidelines and tools.