Articles: hospital-emergency-service.
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As more healthcare is provided in non-hospital settings, it is essential to support clinicians in recognising early signs of clinical deterioration to enable prompt intervention and treatment. There are intuitive reasons why the use of the National Early Warning Score 2 (NEWS2) in out-of-hospital settings may enhance the community response to acute illness by using a common language across healthcare. An additional advantage of the use of NEWS2 in community settings is that it is not disease specific and requires no expensive technology or great expertise to take a full set of observations that can be an indicator of clinical acuity. However, concerns have been expressed as NEWS2 was developed in acute hospital settings that it may not be applicable in community settings; this review shares some of the practical ways that NEWS2 can support clinical practice along with the emerging published evidence.
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Existing evidence suggest the emergence of palliative care (PC) services in the emergency department (ED). To gain insight into the nature of these services and provide direction to future actions, there is a need for a comprehensive review that ascertains the components of these services, integration models, and outcomes. ⋯ PC implementation in the ED may potentially improve patient and family outcomes. More studies are needed, however, to standardize trigger or screening tools. More prospective studies are also needed to test PC interventions in the ED.
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Pediatric emergency care · Nov 2022
Emergency Medical Services Provider Acceptance of and Attitudes About Pediatric SimBox Simulations.
SimBox simulations allow for high-frequency open-access health care education, overcoming cost and resource barriers. Prehospital paramedics and emergency medical technician (EMT) care for children infrequently. In this study, prehospital providers evaluated pediatric SimBox simulations. ⋯ SimBox simulations are associated with improved self-efficacy of prehospital care providers for care of acutely ill or injured children. The majority promotes SimBox as a learning tool.
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We identify patient demographic and emergency department (ED) characteristics associated with rooming prioritization decisions among ED patients who are assigned the same triage acuity score. ⋯ Among ED patients with a similar triage acuity (ESI 3), we identified patient age and patient race as characteristics that were associated with deviation from a FCFS prioritization in ED rooming decisions. These findings suggest that there may be patient demographic disparities in ED rooming decisions after adjusting for clinical and ED operational characteristics.
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Preventive medicine · Nov 2022
The association between vacant housing demolition and safety and health in Baltimore, MD.
We measured the association between vacant housing demolitions and changes in crime and emergency department (ED) visits in Baltimore, MD. We included 646 block groups in Baltimore, 224 of which experienced at least one demolition from 2012 to 2019. The exposure was the number of demolitions completed in a block group during the previous quarter. ⋯ Demolitions were associated with a small decrease in total ED visits (difference = -0.068 per 1000 people from the previous quarter to the current quarter, 95% CI -0.119, -0.018) but no significant change in crime. For each demolition, the rate of total child ED visits was 0.452 lower compared to the previous quarter (95% CI -0.777, -0.127). Demolitions were associated with small decreases in adult injury-related ED visits in the short term.