Articles: emergency-department.
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Hand (New York, N.Y.) · Mar 2012
The epidemiology of upper extremity injuries presenting to the emergency department in the United States.
The epidemiology of upper extremity injuries presenting to emergency departments in the USA is not well studied. The purpose of this investigation was to estimate the incidence rates of upper extremity injuries presenting to emergency departments. ⋯ The NEISS provides estimates of the incidences of upper extremity injuries that may be useful for public health initiatives.
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Immigrants with language barriers are at high risk of having poor access to health care services. However, several studies have indicated that immigrants tend to use emergency departments (EDs) as their primary source of care at the expense of primary care. This may place an additional burden on already overcrowded EDs and lead to a low level of patient satisfaction with ED care. The study was to review if immigrants utilize ED care differently from host populations and to assess immigrants' satisfaction with ED care. ⋯ Immigrants might use ED care differently from host populations due to language and cultural barriers. There is sparse Australian literature regarding immigrants' access to health care including ED care. To ensure equity, further research is needed to inform policy when planning health care provision to immigrants.
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Patients who receive care in an emergency department (ED), are usually unattended while waiting in queues. ⋯ Application of queuing theory analysis can improve movement and reduce the waiting times of patients in bottlenecks within the ED throughput.
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Open Access Emerg Med · Jan 2012
ReviewManagement of critically ill patients receiving noninvasive and invasive mechanical ventilation in the emergency department.
Patients requiring noninvasive and invasive ventilation frequently present to emergency departments, and may remain for prolonged periods due to constrained critical care services. Emergency clinicians often do not receive the same education on management of mechanical ventilation or have similar exposure to these patients as do their critical care colleagues. The aim of this review was to synthesize the evidence on management of patients requiring noninvasive and invasive ventilation in the emergency department including indications, clinical applications, monitoring priorities, and potential complications. ⋯ Lung-protective ventilation with low tidal volumes based on determination of predicted body weight and control of plateau pressure has been shown to reduce mortality in patients with acute respiratory distress syndrome, and some evidence exists to suggest this strategy should be used in patients without lung injury. Monitoring of the invasively ventilated patient should focus on assessing response to mechanical ventilation and other interventions, and avoiding complications, such as ventilator-associated pneumonia. Several key aspects of management of noninvasive and invasively ventilated patients are discussed, with a particular emphasis on initiation and ongoing monitoring priorities focused on maintaining patient safety and improving patient outcomes.
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J Emerg Trauma Shock · Jan 2012
Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians.
Patients require procedural sedation and analgesia (PSA) for the treatment of acute traumatic injuries. PSA has complications. Ultrasound (US) guided peripheral nerve block is a safe alternative. ⋯ Ultrasound-guided nerve blocks can be safely and effectively performed for upper and lower limb emergencies by emergency physicians with adequate training.