Articles: hospital-emergency-service.
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NHS England is planning to abolish the long-standing 4-hour target for waits in emergency departments. The target has been criticised as an arbitrary management target that is unrelated to clinical outcomes, but waits much longer than 4 hours in the emergency department cause a notable increase in mortality for admitted patients, suggesting that the 4-hour target is clinically important and should not be abolished.
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Case Reports
Equal incidence of COVID-19 among homeless and non-homeless ED patients when controlling for confounders.
The World Health Organization (WHO) declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) a pandemic in March 2020. Theoretically, homeless patients could have disproportionately worse outcomes from COVID-19, but little research has corroborated this claim. This study aimed to examine the demographics and incidence of COVID-19 in homeless vs non-homeless emergency department (ED) patients. ⋯ Previous literature has indicated that higher disease burden, lack of access to social distancing, and poor hygiene would increase the risk of homeless individuals contracting COVID-19 and experiencing serious morbidity. However, this study found that homelessness was not an independent risk factor for COVID-19 infection.
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Review Meta Analysis
The prognostic value of emergency department measured hypertension: A systematic review and meta-analysis.
The objective was to assess the prognostic value of hypertension detected in the emergency department (ED). ⋯ Hypertension can be measured feasibly in the ED and consequently used in a long-term cardiovascular risk prediction model. There is an opportunity to intervene in targeted individuals, using routinely collected data.
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Critical care medicine · Mar 2022
Randomized Controlled TrialImproving Timeliness of Antibiotic Administration Using a Provider and Pharmacist Facing Sepsis Early Warning System in the Emergency Department Setting: A Randomized Controlled Quality Improvement Initiative.
Results of pre-post intervention studies of sepsis early warning systems have been mixed, and randomized clinical trials showing efficacy in the emergency department setting are lacking. Additionally, early warning systems can be resource-intensive and may cause unintended consequences such as antibiotic or IV fluid overuse. We assessed the impact of a pharmacist and provider facing sepsis early warning systems on timeliness of antibiotic administration and sepsis-related clinical outcomes in our setting. ⋯ In this single-center randomized quality improvement initiative, the display of an electronic health record-based sepsis early warning system-triggered flag combined with electronic health record-based pharmacist notification was associated with shorter time to antibiotic administration without an increase in undesirable or potentially harmful clinical interventions.