Articles: hospital-emergency-service.
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Multicenter Study Comparative Study
Validation and comparison of triage-based screening strategies for sepsis.
This study sought to externally validate and compare proposed methods for stratifying sepsis risk at emergency department (ED) triage. ⋯ The Predict Sepsis and Borelli scores exhibited improved performance including increased specificity and positive predictive values for sepsis identification at ED triage compared to CTAS and SIRS criteria.
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Vital signs are an essential component of the emergency department (ED) assessment. Vital sign abnormalities are associated with adverse events in the ED setting and may indicate a risk of poor outcomes after ED discharge. ⋯ Based on the available evidence, the specific vital sign abnormality and the number of total abnormalities influence the risk of adverse outcomes after discharge. Vital sign abnormalities at the time of discharge also increase the risk of ED revisit. The most common abnormal vital sign at the time of discharge is tachycardia.
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Airway management including endotracheal intubation (ETI) is a key skill for emergency clinicians. Therefore, it is important for emergency clinicians to be aware of the current evidence regarding the identification and management of patients requiring ETI. ⋯ An understanding of literature updates can improve the ED care of patients requiring emergent intubation.
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Adolescent substance use is a growing public health concern, particularly given rising mortality rates from drug overdose deaths. The emergency department (ED) provides a unique opportunity to screen adolescents for substance use and provide brief interventions and linkage to care. ⋯ ED-based adolescent substance use screening and interventions are necessary, feasible, and acceptable, but understudied. Future studies, focusing on optimizing ED interventions and linkage to care, are important next steps in determining the best care for adolescents with substance use who present to the ED.
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Multicenter Study
Association between multiple intubation attempts and complications during emergency department airway management: A national emergency airway registry study.
Peri-intubation complications are important sequelae of airway management in the emergency department (ED). Our objective was to quantify the increased risk of complications with multiple attempts at emergency airway intubation in the ED. ⋯ We found an independent association between the number of intubation attempts among ED patients undergoing emergency airway intubation and the risk of complications.