Articles: emergency-department.
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Artificial intelligence (AI) in healthcare is the ability of a computer to perform tasks typically associated with clinical care (e.g. medical decision-making and documentation). AI will soon be integrated into an increasing number of healthcare applications, including elements of emergency department (ED) care. Here, we describe the basics of AI, various categories of its functions (including machine learning and natural language processing) and review emerging and potential future use-cases for emergency care. ⋯ AI could also help provide focused summaries of charts, summarize encounters for hand-offs, and create discharge instructions with an appropriate language and reading level. Additional use cases include medical decision making for decision rules, real-time models that predict clinical deterioration or sepsis, and efficient extraction of unstructured data for coding, billing, research, and quality initiatives. We discuss the potential transformative benefits of AI, as well as the concerns regarding its use (e.g. privacy, data accuracy, and the potential for changing the doctor-patient relationship).
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A previously healthy 55-year-old male patient presented repeatedly to the emergency department with severe episodic periumbilical abdominal pain. After an extensive diagnostic work-up and subsequent clinical deterioration, appendiceal diverticulitis was diagnosed. We identified a correlation of white blood cell counts and possibly faecal calprotectin with the clinical presentation. We suggest that appendiceal diverticulitis should be considered in middle-aged patients with recurrent episodes of abdominal pain that correlate with laboratory markers of inflammation.
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The updated 2021 CDC treatment guidelines recommend a single dose of 500 mg intramuscular ceftriaxone for Neisseria gonorrhea and doxycycline 100 mg by mouth twice daily for 7 days for Chlamydia trachomatis coinfection. However, there is a significant public health concern regarding patient non-adherence to the 7-day course of doxycycline. To date, there are no studies assessing this concern. Therefore, the objective of this study was to evaluate a patient's adherence to doxycycline for chlamydial infections after discharge from the Emergency Department (ED). ⋯ For patients with a positive chlamydia infection who were discharged from the ED on doxycycline, an 18% non-adherence rate was found and a 3.6-fold higher likelihood of returning to the ED with the same chief complaint if the prescription was not picked up.
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Bariatric surgery is becoming increasingly common and postoperative patients often present to the emergency department (ED) with complications. We sought to describe the presenting complaints, management, and outcomes of postoperative bariatric surgery patients seen in the ED. ⋯ This is the first detailed health records review of postoperative bariatric patients seen in the ED in the emergency medicine literature. Those presenting with abdominal pain were more likely to undergo CT abdomen and a surgical procedure. Similarly, those presenting within 30 days of surgery were more likely to have significant CT findings and require hospital admission. Others presenting with primarily nausea and vomiting may improve with ED symptom management and be discharged home with bariatric team follow-up.