Articles: emergency-department.
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Ambulance ramping, the delay to transfer of a patient arriving at an ED by ambulance into an ED treatment space and handover of care to ED clinicians, is a problem in all Australian states and territories and New Zealand. It is a symptom of ED overcrowding and access block and has been associated with adverse health outcomes for some patient groups. The questions arise, who might be legally responsible for the care of patients who are ramped and does their physical location matter? The short answers are 'everyone' and 'no', however, whether there will be a breach of duty depends on the reasonableness of responses and resource allocation considerations.
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J. Korean Med. Sci. · Dec 2024
Using Large Language Models to Extract Core Injury Information From Emergency Department Notes.
Injuries pose a significant global health challenge due to their high incidence and mortality rates. Although injury surveillance is essential for prevention, it is resource-intensive. This study aimed to develop and validate locally deployable large language models (LLMs) to extract core injury-related information from Emergency Department (ED) clinical notes. ⋯ Locally deployable LLMs, trained to extract core injury-related information from free-text ED clinical notes, demonstrated good performance. Generative LLMs can serve as versatile solutions for various injury-related information extraction tasks.
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Patients living with social deprivation, and those with experiences of violence, substance misuse, mental ill-health and homelessness are known to use emergency departments (EDs) more often. It is not known whether a programme of social support initiated during ED attendance may lead to a reduction in healthcare use. ⋯ The Navigator programme was associated with reduced emergency and acute healthcare use in the year following intervention, with increased scheduled outpatient care. There is the potential for a social support programme, delivered from the ED, to change patterns of healthcare use, and future work should consider prospectively assessing the impact of such an intervention.
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Randomized Controlled Trial
Magnesium Sulfate Versus Lidocaine as an Adjunct for Renal Colic in the Emergency Department: A Randomized, Double-Blind Controlled Trial.
We wished to determine whether the addition of magnesium sulfate (MgSO4) or lidocaine to diclofenac could improve the analgesic efficacy in emergency department (ED) patients with acute renal colic. ⋯ Adding intravenous MgSO4, but not lidocaine, to IM diclofenac offered superior pain relief but at levels below accepted thresholds for clinical importance.