Articles: emergency-department.
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Emerg Med Australas · Aug 2022
Diagnoses and trends in use of imaging for low back pain in four Australian emergency departments between 2012 and 2019.
We aimed to determine, in those who present to the ED with low back pain (LBP): (i) the prevalence of four key diagnostic categories, (ii) trends in lumbar imaging from 2015 to 2019 and (iii) the effect of a new model of care on lumbar imaging in the ED. ⋯ Most presentations to the ED for LBP are for non-specific LBP. Around 2% will have specific spinal pathology. Use of imaging in those diagnosed with non-specific LBP remains high and was unaffected by implementation of a state-wide model of care.
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Pediatric emergency care · Aug 2022
Physician Perspectives on Acupuncture Use in the Pediatric Emergency Department.
Acupuncture is a nonpharmalogical treatment modality that is used to treat pain. Prior research demonstrates that pediatric patients tolerate acupuncture well and patients may experience significant pain relief. The objectives of this study were to (1) explore the experiences of pediatric emergency department (ED) physicians as they used 2 acupuncture procedures, Battlefield Acupuncture and Four Gates procedures, and (2) describe factors impacting the feasibility of acupuncture implementation in the pediatric ED setting. ⋯ Participants overall had positive experiences with ED acupuncture. Although multilevel barriers to use of acupuncture were noted, these may be mitigated by several strategies suggested by participants. Future research is needed to further explore the potential impact of these strategies, as well as examine clinical outcomes of acupuncture implementation in the pediatric ED setting.
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Emerg Med Australas · Aug 2022
Profile and outcomes of emergency department presentations based on mode of arrival: A state-wide retrospective cohort study.
Understanding how people arrive to the ED assists in planning health services' response to fluctuating ED demand. The present study aimed to describe and compare demographics, clinical characteristics and health service outcomes of adult ED patient presentations based on mode of arrival: brought in by police (BIBP)/brought in by ambulance (BIBA)/privately arranged transport (PAT). ⋯ Presentations BIBA and BIBP encountered a longer ED LOS and higher admission rates than PAT, suggesting more complex care needs than those from PAT. Clinical care pathways for specific modes of arrival that support pre-hospital providers and patients and are considerate of the throughput and output stages of ED care may be needed.
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Pediatric emergency care · Aug 2022
Predictors of Emergency Department Opioid Use Among Adolescents and Young Adults.
It is well established that adolescents and young adults are increasingly vulnerable to the effects of early opioid exposures, with the emergency department (ED) playing a critical role in such introduction. Our objective was to identify predictors of ED opioid administration (ED-RX) and prescribing at discharge (DC-RX) among adolescent and young adults using a machine learning approach. ⋯ Machine learning methodologies were able to identify predictors of ED-RX and DC-RX, which can be used to inform ED prescribing guidelines and risk mitigation efforts among adolescents and young adults.
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It is well documented that disparities in patient care based on race and ethnicity are prevalent in the emergency medical care setting. In most cases these evaluations are patient focused and outcome based. The timeliness of patient treatment in the emergency department (ED) is correlated with patient outcomes. In this study, we sought to evaluate whether the timeliness of care for patients with chest pain across stages of care was impacted by patient race. ⋯ Black patients have longer wait times for resident physician evaluation, advanced practice provider evaluation, attending physician evaluation, and ED disposition when presenting to the ED with chest pain.