The American journal of emergency medicine
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Due to limited community resources for mental health and long travel distances, emergency departments (EDs) serve as the safety net for many rural residents facing crisis mental health care. In 2019, The Leona M. and Harry B. Helmsley Charitable Trust funded a project to establish and implement an ED-based telepsychiatry service for patients with mental health issues in underserved areas. The purpose of this study was to evaluate the implementation of this novel ED-based telepsychiatry service. ⋯ Implementation of a telepsychiatry service in ED settings may be beneficial to the patient, local ED, and the underserved community. In this study, we found that implementing this service alleviated the burden of care during the COVID-19 pandemic, enhanced local site capability, and improved local ability to provide quality and effective care.
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Review Meta Analysis
Delirium prevalence in geriatric emergency department patients: A systematic review and meta-analysis.
In the emergency department, delirium associated with serious adverse outcomes is common in geriatric patients. We performed a meta-analysis and estimated the prevalence of delirium and its related factors among geriatric emergency department patients. ⋯ In the emergency department, delirium is common in geriatric patients. We should pay specific attention to delirium screening, prevention, and treatment in geriatric patients. Overall appropriate interventions should be utilized to reduce the occurrence of delirium and the adverse outcomes.
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Multicenter Study Observational Study
COVID-19 disease in children presenting to the pediatric emergency department: A multicenter study with 8886 cases from Turkey.
The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population. ⋯ Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups.
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Multicenter Study Observational Study
Hypernatremia is associated with poor long-term neurological outcomes in out-of-hospital cardiac arrest survivors.
Brain oedema after cardiac arrest is strongly associated with poor neurological outcomes. Excessive sodium supplementation may increase serum osmolarity and facilitate brain oedema development in cardiac arrest survivors. We aimed to investigate the association of serum sodium levels with long-term neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors. ⋯ Relatively high Sodium 24H levels showed a strong and independent association with poor long-term neurological outcomes in OHCA survivors. These findings may be applied in therapeutic strategies for improving neurological outcomes in OHCA survivors.
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Randomized Controlled Trial
Ethyl chloride spray, a local anesthetic in arterial blood gas sampling: A randomized, controlled, double-blinded study.
Arterial blood gas sampling provides useful information on respiratory parameters and acid-base balance. However, this procedure is painful and uncomfortable for the patient. Therefore, this study aimed to examine the analgesic efficacy of ethyl chloride spray compared to a placebo during radial artery blood gas sampling. ⋯ Ethyl chloride spray has analgesic efficacy in arterial blood gas sampling. Therefore, the use of this spray provides an analgesic effect on patients during arterial blood gas sampling performed in the emergency department.