Articles: emergency-services.
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Multicenter Study
Safety and efficiency of implementation of high-sensitivity troponin T in the assessment of emergency department patients with cardiac chest pain.
For emergency department (ED) patients with cardiac chest pain, introduction of high-sensitivity troponin (hsTnT) pathways has been associated with reductions in length of stay of less than 1 h. ⋯ Implementation of hsTnT for evaluation of ED chest pain patients was safe and associated with a 3-h decrease in length of stay.
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Pediatric emergency care · Nov 2024
Multicenter StudyThe Use of Point-of-Care Ultrasound in Pediatric Emergency Departments and Intensive Care Units: A Descriptive Study From Turkey.
The aim was to evaluate the current status of point-of-care ultrasound (POCUS), perceptions, education, training, and barriers to using POCUS in pediatric emergency departments (PEDs) and pediatric intensive care units (PICUs) in Turkey. ⋯ Most participants were aware of the need for POCUS. However, lack of education, equipment, manpower, and infrastructure still emerged as barriers to the use of POCUS. To further promote POCUS use, it would be helpful to improve accessibility by ensuring sufficient numbers of ultrasound devices together with sufficient numbers of appointed physicians and by expanding POCUS education in PEDs and PICUs.
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Ultrasound guidance is fundamental to procedural safety and success. For many emergency department (ED) procedures, the use of ultrasound improves first-pass success rate, time-to-completion, and complication rate when compared with traditional landmark-based techniques. Once learned, the general principles of ultrasound guidance may be adapted across a broad range of bedside procedures.
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Multicenter Study Observational Study
Development and validation of a nomogram for assessing comorbidity and frailty in triage: a multicentre observational study.
Assessing patient frailty in the Emergency Department (ED) is crucial; however, triage frailty and comorbidity assessment scores developed in recent years are unsatisfactory. The underlying causes of this phenomenon could reside in the nature of the tools used, which were not designed specifically for the emergency context and, thus, are difficult to adapt to the emergency environment. The objective of this study was to create and internally validate a nomogram for identifying different levels of patient frailty during triage. ⋯ The internal validation of the nomogram reported an area under the receiver operating characteristic of 0.91 (95% CI 0.884-0.937). A nomogram was created for assessing comorbidity and frailty during triage and was demonstrated to be capable of determining comorbidity and frailty in the ED setting. Integrating a tool capable of identifying frail patients at the first triage assessment could improve patient stratification.
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Randomized Controlled Trial
Proactive care management of AI-identified at-risk patients decreases preventable admissions.
We assessed whether proactive care management for artificial intelligence (AI)-identified at-risk patients reduced preventable emergency department (ED) visits and hospital admissions (HAs). ⋯ A care management intervention targeting AI-identified at-risk patients was followed by a onetime, significant, sizable reduction in preventable HA rates. Further exploration is needed to assess the potential of integrating AI and care management in preventing acute hospital encounters.