Articles: emergency-department.
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Bilateral chemical eye injuries are a common and important problem in the Emergency Department. Irrigation of both eyes can be time-consuming, so we present a novel, simple and cost-effective technique for hands-free bilateral eye irrigation. Modifications of a generic dual-lumen cannula adapter and fixation about the glabella allow sterile irrigation fluid to be delivered directly to the medial canthi of the contaminated eyes in a hands-free fashion. ⋯ Patients regain autonomy of movement to reposition themselves for comfort or to manipulate the eyelids for more effective irrigation. Clinicians are freed to tend to other tasks. By sharing this technique we hope to stimulate discussion on the safest and most effective method of irrigating chemically injured eyes and prompt the generation of comparable outcome data for the benefit of patients.
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Australas Emerg Nurs J · Aug 2014
Shortfalls in residents' transfer documentation: challenges for emergency department staff.
Increasing numbers of residents are transferred from aged care facilities to emergency departments. Frequently, residents arrive with inadequate documentation regarding their presenting complaint or medical history, making it difficult for emergency department staff to make decisions about care. ⋯ Inadequate documentation negatively impacted the resident's journey through the emergency department. There is evidence that inadequate documentation contributes to poor patient outcomes. To minimise the gaps in the transfer documentation regular staff development and quality assurance programs may be required in residential aged care facilities.
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Febrile infants undergoing urethral catheterization (UC) are often not treated for pain and distress. The aim was to evaluate the effectiveness of midazolam premedication. We compared a convenience sample of infants who underwent UC with midazolam with those who did not receive midazolam. ⋯ Serious adverse events were not observed during sedation and at 48 h after discharge. Study participants had longer emergency department length of stay compared with the controls (191.5 vs. 139 min, P<0.017). In this cohort, midazolam significantly reduced the distress associated with UC without causing serious adverse events.
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Variation in hospital admission rates of patients presenting to the emergency department (ED) may represent an opportunity to improve practice. We seek to describe national variation in hospital admission rates from the ED and to determine the degree to which variation is not explained by patient characteristics or hospital factors. ⋯ There was variation in hospital admission rates from the ED in the United States, even after adjusting for patients' sociodemographic and clinical characteristics and accounting for hospital factors. Our findings suggest that suggesting that the likelihood of being admitted from the ED is not only dependent on clinical factors but also at which hospital the patient seeks care.
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Emergency department (ED) crowding is a major international concern that affects patients and providers. ⋯ Return visits impose additional pressure on the ED, because return patients have a significantly longer LOS at the ED. However, the rate of unscheduled return visits and ED crowding was not related. Because this parameter serves as an essential quality assurance tool, we can assume that the studied hospital scores well on this particular parameter.