Articles: emergency-department.
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Observational Study
EMS Provider Compliance with Infection Control Recommendations Is Suboptimal.
Standard precautions are disease transmission prevention strategies recommended by both the World Health Organization (WHO) and by the Centers for Disease Control and Prevention (CDC). Emergency medical services (EMS) personnel are expected to utilize standard precautions. ⋯ EMS provider compliance with standard precautions and equipment disinfection recommendations is suboptimal. Strategies must be developed to improve EMS provider compliance with internationally recognized infection control guidelines. Key words: Emergency medical services, hand washing, hygiene, disinfection, disease prevention.
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Geriatric patients are more likely than younger patients to be admitted to the hospital when they present to the emergency department (ED). Identifying trends in geriatric short-stay admission may inform the development of interventions designed to improve acute care for the elderly. ⋯ For all elderly patients, short-stay admissions represented a growing proportion of total admissions, regardless of the definition of short stay. These trends were identified despite the NHDS exclusion of observation status hospitalizations. The increase in short-stay admissions was the most pronounced in the extreme elderly (age ≥ 85 years). Future research is needed to optimize treatment for geriatric patients presenting to the ED, some of whom, with brief observation and appropriate follow-up, may be better cared for without hospitalization.
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Emerg Med Australas · Apr 2014
Limited utility of exercise stress testing in the evaluation of suspected acute coronary syndrome in patients aged less than 40 years with intermediate risk features.
National guidelines for management of intermediate risk patients with suspected acute coronary syndrome, in whom AMI has been excluded, advocate provocative testing to final risk stratify these patients into low risk (negative testing) or high risk (positive testing suggestive of unstable angina). Adults less than 40 years have a low pretest probability of acute coronary syndrome. The utility of exercise stress testing in young adults with chest pain suspected of acute coronary syndrome who have National Heart Foundation intermediate risk features was evaluated. ⋯ Routine exercise stress testing has limited value in the risk stratification of adults less than 40 years with suspected intermediate risk of acute coronary syndrome.
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Crimean-Congo haemorrhagic fever (CCHF) is a tick-borne disease endemic in Turkey since 2002. Çorum is one of the leading five cities in Turkey in which CCHF disease is seen most. We studied characteristics of the patients with tick bites in our emergency department (ED) and determined the fatality rate of the disease in city of Çorum for the first time. We retrospectively analysed the characteristics of the patients admitted to our ED from the medical files of 21,680 patients in a 5-year period. ⋯ Our results demonstrated that the fatality rate of CCHF in Çorum is 6.78%. Among 21,680 patients, blood samples of 970 patients were sent to an advanced centre in Ankara for polymerase chain reaction (PCR) testing. Results of 560 patients were reported to be PCR (+) and 38 of them have died.
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Observational Study
Effectiveness of Emergency Medicine Wards in reducing length of stay and overcrowding in emergency departments.
This study aims to evaluate the effectiveness of an Emergency Medicine Ward (EMW) in reducing the length of stay (LOS) in the emergency department, length of hospitalization, emergency medical admission rate, and the hospital bed occupancy rate. ⋯ EMWs effectively reduce both the LOS during in-patient hospitalization and the avoidable medical admission rate.