Articles: emergency-department.
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Emerg Med Australas · Aug 2023
24 hours - Life in the E.R.: A state-wide data linkage analysis of in-patients with prolonged emergency department length of stay in New South Wales, Australia.
Describe the characteristics and predictors of mortality for patients who spend more than 24 h in the ED waiting for an in-patient bed and compare baseline clinical and demographic characteristics between tertiary and non-tertiary hospitals. ⋯ Interventions and models of care to address ED access block need to focus on mental health patients, older patients particularly those with cardiorespiratory illness and oncology and haematology patients for whom risk of mortality is disproportionately higher.
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Emergency departments (EDs) are seeing an increase in patients requiring end-of-life (EOL) care. There is paucity of data of attitudes and knowledge of physicians providing EOL care in the ED both internationally and in Ireland. ⋯ This study has highlighted a lack of awareness and knowledge of EOL care particularly amongst less experienced emergency medicine doctors. Formalized training and education programs in the provision of EOL care in the ED will improve comfort levels and knowledge amongst the emergency medicine doctors and improve the quality of care provided.
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Due to an increasing incidence of new cancer diagnoses in the United States and longer survivorship, a growing number of patients with cancer receive care in emergency departments (EDs). This trend places an increasing burden on already crowded EDs, and experts are concerned these patients do not receive optimal care. The purpose of this study was to describe the experiences of ED physicians and nurses who care for patients with cancer. This information can inform strategies to improve oncology care for patients in ED settings. ⋯ Physicians and nurses experience challenges stemming from three overarching types of factors: illness factors, communication factors, and system-level factors. Solutions for the challenges of providing oncology care in the ED call for new strategies at the levels of the patient, provider, institution, and health care system.
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Eur. J. Clin. Invest. · Aug 2023
Modified Rapid Emergency Medicine Score-Lactate (mREMS-L) performance to screen non-anticipated 30-day related-mortality in Emergency Department.
The aim of this study was to compare the ability to predict 30-day in-hospital mortality of lactate versus the modified Rapid Emergency Medicine Score (mREMS) versus the arithmetic sum of the mREMS plus the numerical value of lactate (mREMS-L). ⋯ The new score generated, mREMS-L, obtained better statistical results than its components (mREMS and lactate) separately.
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Pediatric emergency care · Aug 2023
Observational StudyThe Impact of an Emergency Department Bruising Pathway on Disparities in Child Abuse Evaluation.
Previous research has shown racial, ethnic, and socioeconomic disparities in provider medical evaluations and reporting to child protective services (CPS) and law enforcement (LE) for cases of suspected child physical abuse. Our hospital standardized evaluation and reporting of high-risk bruising using a clinical pathway. We aimed to assess whether standardization impacted disparity. ⋯ A standardized clinical pathway for identification and evaluation of high-risk bruising may help to decrease socioeconomic disparities in reporting high-risk bruising. Larger studies are needed to fully evaluate disparities in assessment and reporting of child abuse.