The American journal of emergency medicine
-
Besides clinical signs and imaging, in recent years, biomarkers have proven to be a viable diagnostic resource for acute appendicitis (AA). ⋯ In our validation cohort of patients with acute abdominal pain, the new score can accurately predict which children are at low risk of appendicitis and could be safely managed with close observation.
-
Burnout syndrome (BOS) affects up to 50% of healthcare practitioners. Limited data exist on BOS in paramedics/firstresponders, or others whose practice involves trauma. We sought to assess the impact of BOS in practitioners of rural healthcare systems involved in the provision of trauma care within West Virginia. ⋯ Burnout syndrome impacts rural healthcare practitioners, regardless of discipline. These data highlight a need to address the entire team and implement occupation-specific approaches for prevention and treatment. Further prospective study of these findings is warranted.
-
It has not been investigated whether the quick sepsis-related organ failure assessment score (qSOFA), a new bedside tool for early sepsis detection, may help accelerating antibiotic initiation in ED patients with sepsis. ⋯ A qSOFA-based triage procedure does not improve antibiotic timing and outcomes in patients with sepsis admitted to a high-volume ED. The qSOFA value at triage was poorly sensitive for early sepsis detection. Trial registration (ClinicalTrials.gov): NCT03299894.
-
This study identifies reasons and predictors of LWBS and examines outcomes of patients in a model that uses "point-of-service" (POS) collection for low acuity patients. ⋯ In an ED setting with POS collection for low acuity patients, non-compensable coverage status was the strongest predictor for LWBS. Further studies are needed to assess the outcomes of patients who LWBS in this model of care.
-
The "quick Sequential Organ Failure Assessment" (qSOFA) score is a bedside risk-stratification tool to predict the likelihood of organ dysfunction. This study evaluated the qSOFA score as a prognostic factor for 30-day mortality in emergency department (ED) patients with sepsis identified by the Systemic Inflammatory Response Syndrome (SIRS) criteria. ⋯ Almost one third of the patients with a qSOFA score of ≥2 had died within 30 days and a qSOFA score of ≥2 was independently associated with mortality. This study indicated that qSOFA score of at least two could provide useful prognostic information for septic patients defined by the SIRS criteria.