Articles: emergency-services.
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Pediatric emergency care · Feb 2025
ReviewCurrent Evidence on the Care of Young Infants With Hypothermia in the Emergency Department.
The presence of hypothermia among young infants in the emergency department may be a sign of serious or invasive bacterial infections, or invasive herpes simplex viral infection. However, hypothermia may also occur due to a variety of other infectious and noninfectious conditions or environmental exposure. In some settings, hypothermia may represent a protective, energy-conserving response to illness. ⋯ Risk factors for serious bacterial infections in infants with hypothermia, as identified in single-center and multicenter retrospective studies, include lower temperatures, older age, and abnormalities in blood and urine testing. Given the absence of clear guidelines, management of infants with hypothermia relies heavily on clinician judgment and shared decision making, guided by individual patient assessments and risk factors. This review article summarizes existing evidence and identifies gaps in the management of infants (<90 days) with hypothermia in the emergency department.
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Scand J Trauma Resus · Jan 2025
ReviewKey performance indicators in emergency department simulation: a scoping review.
One way to measure emergency department (ED) performance is using key performance indicators (KPIs). Thus, identifying reliable KPIs can be critical in appraising ED performance. This study aims to introduce and classify the KPIs related to ED in simulations through the Balanced Scorecard (BSC) framework. ⋯ The study findings have collected a comprehensive set of KPIs to measure ED performance in simulations. These results can assist policymakers, managers, and researchers in measuring ED performance and help improve ED performance through a holistic view.
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The number 1 reason children 15 years of age and younger present to the emergency department is fever. To successfully address this common chief complaint, a consistent message must be sent by all health care team members. ⋯ In addition, treatment of fever must be evidence based with a goal of comfort rather than normothermia. Nurses must address caregivers' concerns and consider the age, medical history, and clinical presentation of the child with fever when determining the appropriate triage level and management.
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Review
Interventions to improve equity in emergency departments for Indigenous people: A scoping review.
Disparities in health outcomes, including increased chronic disease prevalence and decreased life expectancy for Indigenous people, have been shown across settings affected by white settler colonialism including Canada, the United States, Australia, and New Zealand. Emergency departments (EDs) represent a unique setting in which urgent patient need and provider strain interact to amplify inequities within society. The aim of this scoping review was to map the ED-based interventions aimed at improving equity in care for Indigenous patients in EDs. ⋯ Relatively few interventions for improving equity in care were identified. We found that a minority of interventions are aimed at creating organizational-level change and suggest that future interventions could benefit from targeting system-level changes as opposed to or in addition to incorporating new roles in EDs.
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Multicenter Study
Assessment of Prognostic Scores for Emergency Department Patients With Upper Gastrointestinal Bleeding.
Early prognostic stratification could optimize the management of patients with upper gastrointestinal bleeding and reduce unnecessary hospitalizations. The aim of this study was to assess and compare the performance of existing prognostic scores in predicting therapeutic intervention and death. ⋯ The GBS and the modified GBS are the 2 best performing scores because they achieve both key objectives: stratifying patients based on their risk of therapeutic intervention and/or death and identifying low-risk patients who may qualify for outpatient management.