Emergency medicine journal : EMJ
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Multicenter Study
The impact of consultation on length of stay in tertiary care emergency departments.
Consultations in the emergency department (ED) are infrequently studied. This study quantifies the contribution of consultations to ED length of stay (LOS) and examines patient and consultation characteristics associated with prolonged ED LOS. ⋯ Consultation decision time contributes significantly to ED LOS. Further efforts are needed to validate these results in other ED settings and improve this aspect of ED throughput.
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A short cut review was carried out to establish whether over the counter cough and cold medicines were associated with unexpected deaths in childhood. 115 papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of those best papers are tabulated. It is concluded that while over the counter cough and cold medications may be associated with unexpected paediatric deaths, the degree of risk is not clear.
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The primary objective of this study was to compare the analgesic response to morphine in non-obese, obese and morbidly obese patients for acute pain. ⋯ Obesity status did not influence analgesic response to a fixed dose of morphine. This suggests that obese and morbidly obese patients do not require a higher dose of morphine for acute pain reduction compared to non-obese patients.
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We examined if croup presentations to the emergency department (ED) were associated with weather changes in a warm temperate climate. We collected data on all 729 cases with an ED discharge or admission diagnosis of croup over a 798 day time period. We obtained detailed climatic records from the New South Wales Meteorological Office for the same time period. ⋯ There was a stronger correlation (-0.426; 95% CI -0.684 to -0.072) between the calculated mean monthly temperature and the monthly number of croup admissions. Even in this milder climate, croup is associated with cooler weather. We are unable to conclude that hospital attendances for croup are caused by changes in temperature alone, as other factors such as the prevalence of viral illness also follow a seasonal, and therefore, temperature-related pattern.
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Emergency department (ED) triage systems aim to direct the best clinical assistance to those who are in the greatest urgency and guarantee that resources are efficiently applied. The study's purpose was to determine whether the Manchester Triage System (MTS) second version is a useful instrument for determining the risk of hospital admission, intrahospital death and resource utilisation in ED and to compare it with the MTS first version. This was a prospective study of patients that attended the ED at a large hospital. ⋯ The MTS had an inconsistent association relative to the utilisation of x-ray, while it seemed to portray a consistent association between ECG and laboratory utilisation and MTS cluster. There were no differences between medical and surgical specialities risk of admission. This suggests that improvements were made in the second version of MTS, particularly in the discriminators of patients triaged to surgical specialties, because this was not true for the first version of MTS.