Articles: emergency-services.
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Emerg Med Australas · Jun 2024
ReviewReview article: Patients who leave before care is completed: What does the legal duty to warn mean for emergency department clinicians?
Patients leave ED for a variety of reasons and at all stages of care. In Australian law, clinicians and health services owe a duty of care to people presenting to the ED for care, even if they have not yet entered a treatment space. ⋯ The form of that warning may vary based on what is known about the patient's condition and the associated risks at the time. Specific documentation of warnings given is essential.
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Emerg Med Australas · Jun 2024
A streamlined Emergency Department approach to moderate risk chest pain in patients with no pre-existing coronary artery disease: A pilot study.
Moderate risk patients with chest pain and no previously diagnosed coronary artery disease (CAD) who present to ED require further risk stratification. We hypothesise that management of these patients by ED physicians can decrease length of stay (LOS), without increasing patient harm. ⋯ Our study suggests that patients with no pre-existing CAD can be safely managed by emergency physicians streamlining their ED management and decreasing LOS. This pathway could be used in other centres following confirmation of the results by a larger study.
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Multicenter Study Observational Study
Concordance between risk scales for venous thromboembolism in patients treated in emergency departments.
To evaluate agreement between risk-assessment models for venous thromboembolism (VTE) in patients hospitalized for medical conditions and to analyze variables associated with the decision to prescribe pharmacological thromboprophylaxis in hospital emergency departments (EDs). Conclusions. ⋯ There is disagreement among the recommended models for predicting risk for VTE in patients hospitalized for medical conditions. The basis for emergency physicians' clinical judgment regarding thromboprophylaxis extends beyond risk scales to include multiple risk factors for VTE and bleeding.
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Ulus Travma Acil Cerrahi Derg · Jun 2024
Comparative StudyComparison of the Kron technique and digital manometry for measuring intra-abdominal pressure in emergency department patients diagnosed with ileus.
Numerous measurement techniques for intra-abdominal pressure have been explored, with the Kron Technique established as the gold standard. Despite its prominence, the search for alternative methods persists due to its lengthy application time, the requirement for additional equipment, and overall impracticality. This study investigated a quicker, more accessible method for effective intra-abdominal pressure measurement in the emergency department. It aimed to compare intra-abdominal pressure measurements in patients diagnosed with ileus using a digital manometer and the Kron Technique. ⋯ We believe that the intra-abdominal pressure measurement technique using a digital manometer is a method that can be effectively employed by healthcare professionals in emergency departments. This technique offers ease of use, requires minimal equipment, provides rapid results, and delivers reliable measurement values compared to the Kron Technique.
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Comparative Study
Comparison of transvaginal ultrasound utilization between radiology and point of care ultrasound in first trimester pregnancy.
Transvaginal (TVUS) and transabdominal ultrasound (TAUS) are both utilized in the evaluation of early pregnancy patients. While many practitioners using point of care ultrasound (POCUS) will generally not pursue TVUS in cases where an intrauterine pregnancy (IUP) is visualized on TAUS, this may not be true in Radiology performed ultrasound. ⋯ POCUS in early pregnancy is associated with a significant reduction in TVUS usage. We suspect that POCUS users elect not to pursue TVUS after an IUP is identified on TAUS, while technicians perform protocol-based TVUS irrespective of TAUS findings. Patients seen by ultrasound trained ED physicians are less likely to receive TVUS.