Articles: emergency-services.
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Persons experiencing homelessness (PEH) are vulnerable emergency department (ED) patients due to high rates of multi-comorbidity and mortality, as well as a lack of follow up care. Communication of test results pending at discharge (TPAD) is an important area of post-ED follow up care. We examined phone access, successful contact, and change in treatment among PEH and non-PEH with TPAD from the ED. ⋯ PEH are less likely to have phone access and be successfully contacted regarding TPAD, resulting in untreated or improperly treated infectious disease. Thus, EDs and hospital systems should explore innovative communication solutions, such as shared responsibility models and partnerships with shelters and healthcare for the homeless clinics to improve successful contact with PEH regarding TPAD.
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Given the increasing proportion of patients and caregivers who use languages other than English (LOE) at our institution and across the U.S, we evaluated key workflow and outcome measures in our emergency department (ED) for patients and caregivers who use LOE. ⋯ These results highlight the need for better language documentation and understanding of factors contributing to extended stays and increased revisits for pediatric patients and caregivers who use LOE.
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Observational Study
Droperidol administration among emergency department patients with abdominal pain, nausea, and vomiting.
The primary objective of this study was to examine the common usage patterns of droperidol in the relatively unrestricted environment of an urban, academic medical center. We focused specifically on the most common use of droperidol in our department: patients with a chief complaint of abdominal pain, nausea, and/or vomiting. ⋯ At one institution, droperidol is being used commonly for the chief complaints of abdominal pain, nausea, and/or vomiting. The preferred dosing is nearly universally below the 2.5 mg IV dose for which the FDA warning applies. Similar to previous studies, identification of adverse events was rare, and no major adverse outcomes such as dysrhythmia or death were identified.
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Trauma-informed care has been posited as a framework to optimize patient care and engagement, but there is a paucity of data on patient-level outcomes after trauma-informed care training in health care settings. We sought to measure patient-level outcomes after a painful procedure after implementation of trauma-informed care training for ED staff. ⋯ Our trauma-informed care training did not seem to have a significant effect on our selected patient outcomes. This may be caused by the training itself or the challenges in measurement of the patient-level impact of trauma-informed care training owing to the study design, setting, and lack of standardized tools. Recommendations for future study of trauma-informed care training and measuring its direct impact on patients in the ED setting are discussed.
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Despite advancements in antimicrobial therapies, bacteremia remains a life-threatening condition. Appropriate antimicrobials must be promptly administered to ensure patient survival. However, diagnosing bacteremia based on blood cultures is time-consuming and not something emergency department (ED) personnel are routinely trained to do. ⋯ The ML models developed effectively predicted bacteremia among febrile or hypothermic patients in the ED, with all models demonstrating high AUROC values and rapid processing times. The findings suggest that ED clinicians can effectively utilize ML techniques to develop predictive models for addressing clinical challenges.