Articles: hospital-emergency-service.
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To perform a meta-analysis identifying studies instituting protocolized hemodynamic optimization in the emergency department (ED) for patients with severe sepsis and septic shock. ⋯ Protocolized hemodynamic optimization in the ED for patients with severe sepsis and septic shock appears to reduce mortality.
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Acta Anaesthesiol Scand · Sep 2013
Review Meta AnalysisHandover of patients: a topical review of ambulance crew to emergency department handover.
Handover has major implications for patient care. The handover process between ambulance and emergency department (ED) staff has been sparsely investigated. The purpose of this paper is, based on a literature review, to identify and elaborate on the major factors influencing the ambulance to ED handover, and to bring suggestions on how to optimize this process. ⋯ The handover of patients to the ED has the potential to be improved. Cultural issues and a lack of professional recognition of handover importance need to be approached. Multidisciplinary training in combination with a structured tool may have a potential for changing the culture and improving handover.
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Review Meta Analysis
Adverse outcomes in older adults attending emergency department: systematic review and meta-analysis of the Triage Risk Stratification Tool.
The objective of this study was to assess the predictive ability of the Triage Risk Stratification Tool (TRST) in identifying older adults at risk of adverse outcomes [return to emergency department (ED), hospitalization, or a composite outcome] within 30 and 120 days following discharge from ED. A systematic search was conducted to identify studies validating the TRST in older adults aged at least 65 years discharged from ED. The methodological quality of selected studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. ⋯ There was little heterogeneity across studies. In conclusion, the TRST is limited in its ability to discriminate between older adults with or without an adverse outcome following discharge from ED. The low levels of heterogeneity gives us confidence that the pooled estimates reflect the predictive ability of the TRST in clinical practice.
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Review Meta Analysis
Incidence, etiology and predictors of adverse outcomes in 43,315 patients presenting to the Emergency Department with syncope: an international meta-analysis.
Syncope remains challenging for Emergency Department (ED) physicians due to difficulties in assessing the risk of future adverse outcomes. The aim of this meta-analysis is to establish the incidence and etiology of adverse outcomes as well as the predictors, in patients presenting with syncope to the ED. ⋯ Syncope carries a high risk of death, mainly related to cardiovascular disease. This large study which has established the most powerful predictors of adverse outcomes, may enable care and resources to be better focused at high risk patients.
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J. Am. Coll. Cardiol. · Feb 2013
Meta AnalysisOutcomes after coronary computed tomography angiography in the emergency department: a systematic review and meta-analysis of randomized, controlled trials.
The aim of the study was to systematically review and perform a meta-analysis of randomized, controlled trials of coronary computed tomography angiography (CCTA) versus usual care (UC) triage of acute chest pain in the emergency department (ED). ⋯ Compared with UC, the use of CCTA in the ED is associated with decreased ED cost and length of stay but increased ICA and revascularization.