The American journal of emergency medicine
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Health emergency medical service (HEMS) plays an important role in reducing injuries by providing advanced medical care in the shortest time and reducing the transfer time to advanced treatment centers. In the regions without ground relief coverage, it would be faster to transfer emergency patients to the hospital by a helicopter. In this paper, an integer nonlinear programming model is presented for the integrated locating of helicopter stations and helipads by considering uncertainty in demand points. ⋯ It is also assumed that demands in an area decrease errors in the distances between each two cities. The purpose of this model is to minimize the transfer time from demand points to the hospital by considering different modes. The proposed model is examined in terms of validity and applicability in Lorestan Province and a sensitivity analysis is also conducted on the total allocated budget.
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Observational Study
Adverse event and error of unexpected life-threatening events within 24h of emergency department admission.
Errors and adverse events associated with unexpected life-threatening events including unplanned transfer to the intensive care unit (ICU) and unexpected death after emergency department (ED) hospitalization are not well characterized. We performed this study to investigate the role of unexpected life-threatening events as a trigger to capture errors and adverse events for ED patient safety. ⋯ Unexpected life-threatening events within 24h of admission from the ED could be a useful trigger tool to identify preventable adverse events with serious physical injury in ED.
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To calculate the emergency department (ED)-level Escherichia coli percentage of isolates susceptible to commonly used antibiotics and to determine the risk factors associated with inadequate empiric antibiotic therapy among patients treated for urinary tract infections (UTIs) in our ED. ⋯ Development of ED-level antimicrobial susceptibility data and consideration of patients' clinical characteristics can help better guide selection of empiric antibiotic therapy for the treatment of UTIs.
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Kounis syndrome (KS), described by Kounis and Zavras in 1991, is the manifestation of an allergic reaction preceding and leading to an acute coronary syndrome (ACS). There are three variants of Kounis Syndrome. Here we describe a novel case report of a type 1 variant secondary to Ziprasidone.
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Acute heart failure (AHF) is a leading cause of admission in emergency departments (ED). It is associated with significant in-hospital mortality, suggesting that there is room for improvement of care. Our aims were to investigate clinical patterns, biological characteristics and determinants of 30-day mortality. ⋯ Nt-proBNP level on admission, age and creatinine clearance, are predictive of 30-day mortality in adult patients admitted to ED for AHF.