Articles: emergency-department.
-
The use of ketorolac for analgesia in the emergency department is a common practice for pediatric patients. There is a lack of guidance on optimal dosing to limit the risk of side effects especially in pediatric patients. The standard dosing is weight based with a cap at 30 mg, a dose which is higher than the typical max used for adult patients. The objective of this study is to compare the analgesic effect of intravenous ketorolac at doses of 15 mg versus doses greater than 15 mg. ⋯ This retrospective review demonstrates an association of similar analgesic effects using a capped dose of 15 mg of IV ketorolac as compared to larger doses in pediatric patients admitted to the ED.
-
Chronic kidney disease (CKD) patients with chest pain (CP) should receive special attention in the emergency department (ED). Evaluating troponin levels is highly confusing. This study aims to compare Cystatin C (CysC) and creatinine on troponin results in CKD patients with CP in ED. ⋯ CysC can be preferable in CKD patients with CP due to the stage change and the decisive effect of CysC on troponin compared to creatinine in patients with and without ACS.
-
Patients with end-of-life care (EoLC) needs present to the emergency departments (ED) frequently and at times, it can be difficult to provide a high standard of care. Within the Irish setting, there is limited literature on the provision of EoLC in EDs and this study, therefore, aimed to evaluate the perceptions of emergency medicine (EM) clinicians regarding the provision of EoLC in EDs in Ireland. ⋯ EM clinicians agree that they are comfortable breaking bad news and discussing EoLC with patients and families, but disagree that adequate resources and infrastructure are in place to provide a high standard of EoLC in Irish EDs. Challenges exist centred on training and infrastructure and addressing these may lead to enhanced EoLC in the future.
-
Emergency Medical Services (EMS) patient care reports (PCRs) are an important component for the transfer of patient care from EMS systems to hospitals and a foundational element of EMS quality improvement (QI). The PCR may serve as the only objective source of information for EMS patient presentation. Surprisingly little data, either objective or anecdotal, exists regarding the reliability of this process. Our objective is to describe the frequency of missing PCRs and the time of their receipt following EMS transport to hospital emergency departments (EDs). ⋯ Many PCRs are missing after EMS transport, with marked variation in submission rates and time to upload by agency and hospital. Many PCRs were infrequently available for use in a timely manner. Further assessment is needed to quantify the degree to which the lack of transfer of documentation of EMS patient care exists across emergency care systems.