Articles: emergency-department.
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There is mounting evidence of racial and ethnic discrimination in the Canadian health care system. Patient level race and ethnicity data are required to identify potential disparities in clinical outcomes and access to health care. However, it is not known what patient race, ethnicity, and language data are collected by Canadian hospitals. This gap limits opportunities to identify and address inequalities in the health care system. The emergency department (ED) is a major point of contact for many patients accessing the health care system, and is therefore a reasonable place to conduct analysis of patient data collection. This study aims to quantify the proportion of Canadian EDs that collect patient race, ethnicity, and primary language data. ⋯ The majority of Canadian EDs do not collect patient race, ethnicity, and language data. This gap limits our ability to identify inequalities in health outcomes or access to health care. Lack of race, ethnicity, and language data also hinders our ability to develop and evaluate programs and interventions that aim to correct these inequalities.
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RATIONALE, AIMS AND OBJECTIVES: Emergency department (ED) clinicians account for approximately 13% of all opioid prescriptions to opioid-naïve patients and variability in the rates of prescribing have been noted among individual clinicians and different EDs. This study elucidates the amount of variability within a unified health system (the U.S. Military Health System [MHS]) with the expectation that understanding the sources of variability will enable health system leaders to improve the quality of decision making. ⋯ Among ED encounters of Army soldiers at military treatment facilities, there was substantial variation among providers in prescribing opioid prescriptions that were not explained by patient case-mix. These results suggest that programmes and protocols to address less than optimal prescribing in the ED should be initiated to improve the quality of care.
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We sought to evaluate the effect of adult procedural sedation on cerebral oxygenation measured by near-infrared spectroscopy (rSo2 levels), and to assess whether respiratory depression occurring during procedural sedation was associated with decreases in cerebral oxygenation. ⋯ Cerebral oximetry may represent a useful tool for procedural sedation safety research to detect potential subclinical changes that may be associated with risk, but appears neither sensitive nor specific for routine use in clinical practice.
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Emerg Med Australas · Dec 2022
Evaluating Stroke Code Activation Pathway in Emergency Departments study.
To describe the clinical characteristics and outcomes of Code Stroke activations in an ED and determine predictors of a final diagnosis of stroke or transient ischemic attack (TIA) diagnosis. ⋯ In a cohort of patients requiring Code Stroke activation in an ED, increased age, systolic blood pressure and weakness and speech impairment increased the risk of stroke. Prehospital notification was associated with lower door to needle times for patients undergoing thrombolysis.
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Southern medical journal · Dec 2022
Impact of Benzodiazepine Use on Length of Stay and 30-Day ED Visits among Hospitalized Hematopoietic Stem Cell Transplant Recipients.
This study assesses the impact of benzodiazepine (BNZ) use on length of stay (LOS) and 30-day emergency department (ED) visits after hematopoietic stem cell transplant (HSCT). ⋯ BNZ use resulted in increased 30-day ED visits after autologous HSCT. BNZ-naïve recipients were less likely to use BNZs during hospital stays; if they required BNZs, then it was in lower dosages.