Articles: emergency-department.
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Timely administration of systemic corticosteroids is a cornerstone of asthma exacerbation treatment, yet little is known regarding potential benefits of prehospital administration by emergency medical services (EMS) clinicians. We examined factors associated with prehospital corticosteroid administration with hospitalization and hospital length of stay (LOS). ⋯ Prehospital systemic corticosteroid administration was not associated with hospitalization or LOS in the overall cohort of asthma patients treated by EMS, though they had a lower probability of admission within Bayesian models. Improved outcomes were noted among subgroups of longer EMS encounters, documented wheezing, and receipt of albuterol.
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Higher trust in healthcare providers has been linked to better health outcomes and satisfaction. Lower trust has been associated with healthcare-based discrimination. ⋯ Patients and caregivers reporting more healthcare-based discrimination were less likely to report high provider trust. Interventions to strengthen trust need structural antiracist components. Increased rapport with patients may be a potential by-product of social screening. Further research is needed on screening and trust.
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Pediatric emergency care · Jul 2024
Impact of a Strategy for Improving Early Management of Acute Pain in the Pediatric Emergency Department.
The objective of this study was to measure the impact of an intervention on pain treatment in a pediatric emergency department (ED). The application of interventions to improve pain management in DE has demonstrated diverse effects so far, most of them successful. ⋯ The application strategies to enhance early pain treatment in the ED can improve analgesia administration. Training strategies aimed at healthcare personnel working in the ED can change the way they work and achieve clear benefits for the patient. The treatment of pain in the ED should begin as soon as possible, and in this objective, the involvement of the nursing staff is a priority, because they are the professional who has the best opportunity for the detection and treatment of pain from the moment of triage.
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Human trafficking is a heinous crime and violation of human rights affecting between 25 and 27 million adults and children globally each year. Current immigration and refugee policy could exacerbate the human trafficking public health crisis. Health care providers working in emergency department and urgent care settings interact with human trafficking victims and provide life-changing care. Research identifies a significant need for coordinated, consistent, and standardized education on human trafficking. The purpose of this study was to determine the effectiveness of online educational training in human trafficking on the knowledge and self-confidence of registered nurses and nurse practitioners working in the emergency department and urgent care settings in New York. ⋯ Results in this study demonstrate the need for increased standardized education regarding HT for frontline health care workers.
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Pediatric emergency care · Jul 2024
Catching Suicide Before It Harms: Universal Suicide Screening in a Pediatric Emergency Department.
Suicide is the second leading cause of death in people aged 10 to 24 years. We aim to assess the effectiveness of universal suicide screening in a pediatric ED. ⋯ Several patients who screened positive for suicide risk did not present with a mental health concern. Nearly half of screen-positive children who were admitted for mental health concerns had been seen in the ED in the year before their visit. Initiation of universal suicide screening in the pediatric ED identified a significant number of children with unrecognized suicide risk.