The American journal of emergency medicine
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Patients and their families frequently misclassify female physicians in the Emergency Department (ED) as non-physicians. Physician misidentification impacts the environment of care on multiple levels; including patient satisfaction and physician well-being. Implementing "DOCTOR" badges may be a low-cost tool to rectify these problems. ⋯ Female EM physicians are disproportionately misidentified by patients and their families and are more likely to feel undervalued when clarifying their roles. In only a span of 3 months, we found that the use of "DOCTOR" badges decreased misidentification and improved outcomes that may enhance physician wellness. Having EM physicians wear a "DOCTOR" badge may be a simple and effective long-term solution to this issue.
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Evaluate the impact of an emergency critical care center (EC3) on the admissions of critically ill patients to a critical care medicine unit (CCMU) and their outcomes. ⋯ Following the opening of the EC3, the proportion of CCMU admissions from the ED decreased. The EC3 may be most effective at reducing the admission of lower-acuity patients with GI bleeding and possibly sepsis. The EC3 may be associated with improved survival in ED patients.
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To investigate the influence of Coronavirus Disease 2019 on incidence of acute complex appendicitis and management of acute appendicitis. ⋯ Higher incidence of acute complex appendicitis seemed to occur during COVID-19 outbreak.
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To examine whether and how avoidable emergency department (ED) utilization is associated with ambulatory or primary care (APC) utilization, insurance, and interaction effects. ⋯ The association between APC utilization and avoidable ED utilization varied based on segments of the distribution of ED score and differed significantly by insurance type.
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Upper gastrointestinal bleeding (UGIB) is an important health problem with a potentially life threatening course. Measurement of immature granulocytes percentage (IG %), reflecting the fraction of circulating immature granulocyte (IG), is associated with increased mortality in patients with systemic inflammation, or distress. The aim of this study was to evaluate whether the IG% is an effective predictive marker for estimating the in-hospital mortality for patients with UGIB admitting to the emergency department (ED). ⋯ This study included 149 patients, 94 of whom were men. The mean age of the patients was 64.5 ± 14.2. Twenty patients died during hospitalization and 129 were discharged. IG% was significantly higher in patients who died compared with patients who discharged. In the receiver operating characteristic (ROC) curves analysis to determine the in-hospital mortality, the cut-off value (>1%) for IG% level was found specificity (93.8%), sensitivity (100%), positive predictive value (PPV = 71.43%), negative predictive value (NPV = 100.00%) and area under curve (AUC = 0.98). Univariate logistic regression analysis showed that IG% was predicting in-hospital mortality (odds ratio, OR = 65.6, confidence interval, CI = 2.00-2152.6). CONCLUSıONS: High IG% levels may be used as a predictor of in-hospital mortality in patients with UGIB.