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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In helicopter emergency medical services, HEMS, coagulopathy presents both in trauma (e.g. consumption of coagulation factors) and non-trauma cases (e.g. anticoagulant use). Therefore, in HEMS coagulation measurements appear promising and Prothrombin Time (PT) and derived INR are attractive variables herein. We tested the feasibility of prehospital PT/INR coagulation measurements in HEMS. ⋯ PT/INR measurements (n = 15) were performed on hemodiluted blood, and both trauma and non-trauma patients. The PT/INR results confirmed effects of hemodilution and anticoagulation, however, most measurement results were in the normal INR-range (0.9-1.2). We conclude that prehospital PT/INR measurements, although with limitations, are feasible in HEMS operations.
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Acute myocardial damage is detected in a significant portion of patients with coronavirus 2019 disease (COVID-19) infection, with a reported prevalence of 7-28%. The aim of this study was to investigate the relationship between electrocardiographic findings and the indicators of the severity of COVID-19 detected on electrocardiography (ECG). ⋯ ST depression, T-wave inversion, ST-T changes, and the presence of fQRS on admission ECG are closely associated with the severity of COVID-19 infection.
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Conventional vital signs alone have limitations in determining the physiological status. Age-adjusted shock-index (SIPA), a comprehensive physiological variable, defined as the ratio of heart rate (HR) and systolic blood pressure (SBP) may be better at predicting hemodynamic stability and outcome than vital signs. ⋯ SIPA performs better than conventional vital-signs in recognising higher-level-of-care and early mortality.
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During a novel virus pandemic, predicting emergency department (ED) volume is crucial for arranging the limited medical resources of hospitals for balancing the daily patient- and epidemic-related tasks in EDs. The goal of the current study was to detect specific patterns of change in ED volume and severity during a pandemic which would help to arrange medical staff and utilize facilities and resources in EDs in advance in the event of a future pandemic. ⋯ A significant reduction in ED volume during the COVID-19 pandemic was noted and a predictable pattern was found. This specific change in pattern in the ED volume may be useful for performing adjustments in EDs in the future during a novel virus pandemic. The severity of patients visiting the ED during epidemic periods was inconclusive.