Articles: emergency-department.
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Point-of-care ultrasound (POCUS) is a central component of emergency medical care. However, clinicians often fail to adequately document their examinations, causing problems for downstream clinicians and quality assurance processes as well as loss of revenue. The objective of this study was to evaluate the impact of a user-centered POCUS documentation workflow system for examination ordering, documentation, selective archival, and billing on POCUS documentation in a large academic emergency department (ED). ⋯ In this single-center study, POCUS documentation increased by more than 60% following the implementation of a user-centered POCUS workflow that reduced the burden on the clinician by automating data entry, improving data flow between ultrasound machines and the EHR and integrating billing.
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Although appendicitis is the most common pediatric surgical emergency, the path to diagnosis remains equivocal, with utilization of imaging modalities largely institution dependent. ⋯ The negative appendectomy rates of transfer and primary patients were not significantly different despite more frequent CT use at nonpediatric facilities. It may be valuable to encourage US utilization at adult facilities given the potential to safely reduce CT use in the evaluation of suspected pediatric appendicitis.
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Pediatric emergency care · Mar 2023
A Qualitative Systematic Review of Pediatric Patient and Caregiver Perspectives on Pain Management for Vaso-Occlusive Episodes in the Emergency Department.
The primary objective of this study is to describe the experiences of pediatric patients with sickle cell disease (SCD) and their caregivers who have presented to the emergency department (ED) for management of vaso-occlusive pain events. ⋯ There are multiple opportunities to improve management for vaso-occlusive pain events in the ED, including education of health care providers about SCD and complications, partnership between patients/caregivers and providers, and efforts to reduce the impact of systemic racism on health care delivery.
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The purpose of this study was to assess if implementing a code role delineation intervention in an emergency department would improve the times to defibrillation and medication administration and improve the nurse perception of teamwork. ⋯ Implementation of code role delineation identifiers is an effective method of improving teamwork in a code in an emergency department setting.
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Arch Orthop Trauma Surg · Mar 2023
Effect of coronavirus (COVID-19) pandemic on orthopedic trauma patients presenting in the emergency department of a maximum care hospital and level 1 trauma center.
While overcrowding of emergency departments was often reported in the recent years, during the early phase of the pandemic, a reduction in patient numbers was seen. The aim of the current study was to describe the orthopedic trauma patient cohort presenting to the emergency department (ED) during the early pandemic period as compared to the cohort from the analogue time period 2019. ⋯ The present study shows a significant decline in the number of patients treated in the ED during the pandemic period but at the same time almost identical numbers of patients with fractures or diagnoses requiring surgical treatment. In the context of an overall decline in patient numbers, a stronger concentration on level 1 trauma centers seems to be evident during the pandemic.