Articles: emergency-department.
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We compared high-sensitivity cardiac troponin T (hs-cTnT) and standard cTnT for acute myocardial infarction (AMI) diagnosis in everyday clinical practice of an emergency department (ED). ⋯ In unselected ED patients the diagnostic performances of hs-cTnT and standard cTnT for AMI diagnosis did not differ significantly. hs-cTnT detected significantly more cardiac diseases. hs-cTnT and standard cTnT were not independent predictors of ED readmissions and mortality from all causes.
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BMJ quality & safety · Jun 2013
Comparative StudyContextual information influences diagnosis accuracy and decision making in simulated emergency medicine emergencies.
It is well documented that adaptations in cognitive processes with increasing skill levels support decision making in multiple domains. We examined skill-based differences in cognitive processes in emergency medicine physicians, and whether performance was significantly influenced by the removal of contextual information related to a patient's medical history. ⋯ Our findings have implications for scenario design and the manipulation of contextual information during simulation training.
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The patient visits to Norwegian emergency departments (EDs) have increased significantly over the last few years. A national evaluation revealed a lack of systematic activity control, resource management and quality improvement. This paper describes some variables in patient visits to an urban Norwegian university hospital. ⋯ The increase in ED visits to the St. Olav's Hospital in recent years follows the same trend as in other countries. The authors see a slightly higher percentage of high level acuity patients compared with international studies due the general practitioner's intended 'gatekeeper' function. The authors also found a high total admission rate and a low ICU admission rate compared with other countries. These differences cannot be explained solely by differences in the healthcare system in Norway. The cultural and traditional organisation of the Norwegian Health Care System needs to change and this creates an excellent opportunity to improve the competence by establishing emergency medicine as a specialty in Norway.
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Bell's palsy is a non-life threatening disorder with important functional and psychosocial effects. While recent research has shown significant benefit from treatment with steroids in adults, there have been no conclusive studies demonstrating benefit in children. This study set out to explore the medium term resolution of symptoms in Bell's palsy presenting to the emergency department (ED). ⋯ The majority of children with Bell's palsy have complete resolution of the facial weakness. Steroid use is highly variable and warrants a placebo controlled randomised trial.
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Observational Study
Humanisation in the emergency department of an Italian hospital: new features and patient satisfaction.
The goal of this study was to describe and analyse interventions performed in the emergency department (ED) of an Italian hospital with the aim of humanising the patient care pathway. The actions taken are described and the changes analysed to determine whether they resulted in an increased level of patient satisfaction. ⋯ The results demonstrate that the interventions implemented in this study, designed to humanise the ED, improved overall patient satisfaction. Interventions may be taken to reduce the depersonalisation of patients in the emergency room.