Articles: emergency-department.
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Emergency department patient boarding is associated with hospital mortality and increased hospital length of stay. The objective of the present study is to describe the impact of deploying an Intensive Care team in the ED and its association with sepsis mortality and ICU length of stay. Patients admitted to ICU through the ED with an ICD-10 CM diagnosis of sepsis were included. ⋯ Septic shock and ED boarding time were associated with prolonged ICU LOS. Compliance with SEP-1 bundle was associated with its reduction. Implementation of an ICU team in the ED for the treatment of septic patients during high volume hospitalizations is not associated with a reduction of mortality or ICU LOS.
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Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. ⋯ These factors contribute to prolonged ED stays and boarding, which negatively affects patient care and ED operations. Strategies to improve care for MBH emergencies, including systems level coordination of care, is therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.
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Multicenter Study Observational Study
High-Risk Criteria for the Physiologically Difficult Paediatric Airway: a Multicenter, Observational Study to Generate Validity Evidence.
Single-center studies have identified risk factors for peri-intubation cardiac arrest in the emergency department (ED). The study objective was to generate validity evidence from a more diverse, multicenter cohort of patients. ⋯ In a multicenter study, we confirmed that meeting at least one high-risk criterion was associated with paediatric peri-intubation cardiac arrest and patient mortality.