Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
To determine the availability and completeness of selected data elements from administrative and clinical sources for emergency department (ED) visits in a national pediatric research network. ⋯ Data elements important in emergency medical care for children are frequently missing in existing administrative and medical record sources; completeness varies widely across EDs. Researchers must be aware of these limitations in the use of existing data when planning studies.
-
Comparative Study
Factors associated with failure of noninvasive positive pressure ventilation in the emergency department.
To determine the factors associated with failure of noninvasive positive pressure ventilation (NPPV) in patients presenting with acute respiratory failure to the emergency department (ED). ⋯ Patients with pH < or = 7.35 and an RR > or =20 min(-1) after one hour of NPPV had an increased risk of subsequent endotracheal intubation.
-
Comparative Study
The paradox of the nested pediatric emergency department.
Nested pediatric emergency departments (nPEDs) are defined as dedicated treatment areas operating during peak pediatric hours within general emergency departments (EDs). This study examined three staffing models for nPEDs and their impact on pediatric encounters. ⋯ Physicians practicing in facilities that include an nPED must dedicate some portion of their practice to the nPED to maintain equivalent pediatric encounters.
-
Comparative Study
Resident efficiency in a pediatric emergency department.
To measure the hourly rate of patients evaluated and treated by resident physicians in an academic pediatric emergency department (PED) and examine differences in the rate by subspecialty and year of training. ⋯ Significant differences in the rate of patients evaluated and treated in the PED exist by resident subspecialty and year of training. Knowing these rates is helpful in evaluation of resident performance, because it allows comparison with peers. Additionally, such information may be useful for residency program evaluators to gauge the amount of patient exposure for residents.
-
On September 18, 2003, Hurricane Isabel made landfall as a category 2 hurricane over the mid-Atlantic region, generating record conditions for the region's 27 years of monitoring. The purpose of this study was to investigate the impact of the hurricane on the number and type of emergency department (ED) patient visits and its impact on hospital admission rate from the day of landfall to day 5 postlandfall. Comparisons were made with a control group, which comprised average daily ED census during the six-month period preceding landfall and the average daily admission rates for the preceding six months. ⋯ A significant overall reduction in ED visits by almost half the typical average volume was noted on the day of landfall (-46%). During the four days immediately following landfall, however, there was a marked increase in the overall ED census, with a particularly high increase on day 1 postlandfall. The largest complaint category increase was minor trauma (+57%). Hospital admission rates were highest on the day of landfall and seemed to return to baseline on day 1 postlandfall. These data may be useful for structuring ED personnel and hospital resource allocation to better serve its community during hurricane preparedness planning.