The American journal of emergency medicine
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Renal colic is generally considered a diagnosis appropriate for discharge home once pain is adequately controlled and no other admission criteria are met. The increasing prevalence of ED observation units (EDOU) represent another disposition option for patients with renal colic. In this study, we sought to describe the rates of 14-day revisits for renal colic among patients placed in an EDOU as compared to those discharged from the ED. ⋯ We did not identify a difference in 14-day revisits or serious revisits for patients with renal colic who were placed in an EDOU compared to those who were discharged from the ED. However, we found that patients placed in the EDOU had higher-risk stone features (size, location, degree of obstruction), and yet despite this, had similar rates for revisits.
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Boarding of admitted patients in the Emergency Department (ED) changes both the setting and teams providing care during the initial phase of admissions. We measured the waiting time from ED door arrival to inpatient floor arrival for 17,944 admissions to internal medicine services over a 5-year period from 2018 to 2023 and propose this as a metric for the total delay in care associated with ED boarding, termed "Door to Floor" (DTF) time. ⋯ The majority of DTF time arises from time in the ED after the disposition decision is made. Determining patterns in boarding time as well as of which phases of care contribute to boarding time can be used inform and track interventions.
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In the United States, on average, every 15 s, someone visits a hospital emergency department (ED) for a dental condition. This commentary summarizes the recommendations from a 2024 clinical practice guideline for the pharmacological management of acute dental pain associated with tooth extractions and toothache applicable to ED settings, hospitals, and urgent care clinics where definitive dental treatment is not immediately available. ⋯ NSAIDs with or without acetaminophen are first-line therapy for managing acute dental pain following tooth extraction(s) and temporarily managing toothache. Opioids should be reserved for clinical situations when first-line therapy is insufficient or contraindications to NSAIDs exist.