Articles: emergency-services.
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Observational Study
Patient assessment of the CAPE: A solution to negative pressure isolation in an emergency department.
The Collapsible Aerosolized Particle Enclosure (CAPE) is a negative pressure patient isolation device designed to protect patients and clinicians from aerosolized infectious particles. The CAPE is intended to provide a safe environment for care receipt and delivery when isolation capacity is limited. The goal of this study was to evaluate the acceptability of receiving care in the CAPE from the emergency department (ED) patient perspective. ⋯ In this pilot, prospective, observational study with adult ED patients, the majority of patients found the CAPE comfortable and safe, providing adequate space, and easily accessed. Use of the CAPE with ED patients was feasible and acceptable in our setting, supporting its use as a promising method for expanding isolation space during times of limited negative pressure capacity.
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The mortality, long-term morbidity, and exacerbated healthcare needs due to firearm injury in the U.S. are significant and growing. However, the relationship between exposure to a nonfatal firearm injury and long-term emergency department (ED) utilization is poorly understood. This study estimates the association between exposure to a nonfatal firearm injury and ED utilization in the subsequent year. ⋯ Nonfatal firearm-related injuries contribute to preventable harm, health inequity, and increased ED utilization.
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Emerg Med Australas · Feb 2025
Prisoners in the emergency department: Lessons from a recent inquest.
The recent coronial finding in Victoria into the death of Joshua (Josh) Kerr highlights some of the challenges of treating patients who are in custody and under the supervision of custodial staff (prison officers or police) in the ED. Issues include ED clinicians' duty of care, roles and responsibilities of ED staff and custodial staff and the need for processes that facilitate collaboration and communication between ED clinicians and custodial staff.
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Emerg Med Australas · Feb 2025
Observational StudyAmbulance offload performance, patient characteristics and disposition for patients offloaded to different areas of the emergency department.
Ambulance transfer of care (TOC) is a key performance indicator for New South Wales EDs, with 90% of ambulances to be offloaded within 30 min of arrival. Nepean Hospital ED has a number of strategies to improve TOC, including ambulatory areas where patients can be offloaded immediately. Offload data are supplied by ambulance and there is no study into its accuracy. The aim is to audit the accuracy of ambulance data of TOC compared to times recorded in the Nepean ED information system, and to examine TOC and patient demographics for different offload destinations. ⋯ Patients arriving by ambulance requiring an acute care bed were likely to be elderly and frail, and suffered substantial ambulance offload delays. Delays to ambulance offload for these patients is likely driven by acute care bed availability and access block.
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Emerg Med Australas · Feb 2025
Observational StudyImpact of the Astra Zeneca COVID-19 vaccine on an emergency department.
To assess the impact of the AstraZeneca (AZ) vaccine roll-out on an ED. Primary outcomes are ED length of stay (LOS), investigation ordering and costs. Secondary measures are compliance with the Thrombosis and Haemostasis Society of Australia and New Zealand (THANZ) Vaccine-Induced Thrombotic Thrombocytopaenia Syndrome (VITT) guidelines. ⋯ A high number of young, low acuity patients presented to the ED with AZ vaccine concerns and were associated with financial and workload implications. The quantity of ED presentations appears to be associated with vaccine administration rates. There was poor compliance with the THANZ guidelines, and they appear to have contributed to the high volume of investigations.