Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
The reality of emergency health care in the United States today requires new approaches to mental health in the emergency department (ED). Major depression is a disabling condition that disproportionately affects women. ⋯ ED providers rarely addressed depression. Qualitative analysis of significant patient-provider interactions regarding depression found that screening for depression in the ED can be accomplished with minimal expenditure of provider time and effort. Attention to psychosocial risk factors has the potential to improve the quality of ED care and patient satisfaction.
-
To identify the perceptions of emergency physicians (EPs) and hospitalists regarding interservice handoff communication as patients are transferred from the emergency department to the inpatient setting. ⋯ Handoffs between EPs and hospitalists both reflect and contribute to the ambiguity inherent in emergency medicine. Poor handoffs, consisting of faulty communication behaviors and conflicting expectations for information, contribute to patient boarding conditions that can pose safety threats. Pragmatic conclusions are drawn regarding physician-physician communication in patient transfers, and recommendations are offered for medical education.
-
Comparative Study
Characteristics and referral of emergency department patients with elevated blood pressure.
To assess the prevalence, characteristics, and referral to health care of emergency department (ED) patients with elevated blood pressure (BP) and to compare those without a history of hypertension (HTN) with suboptimally controlled, known-hypertensive patients. ⋯ Of ED patients with elevated BP, one third had no prior history, and the remainder were suboptimally controlled hypertensive patients. Both groups were inadequately informed of their elevated BPs, and the group with no prior history of HTN, the population likely to obtain the greatest health benefit, had the lowest referral rate.
-
Ambulance response time is typically reported as the time interval from call dispatch to arrival on-scene. However, the often unmeasured "vertical response time" from arrival on-scene to arrival at the patient's side may be substantial, particularly in urban areas with high-rise buildings or other barriers to access. ⋯ The time from arrival on-scene to the patient's side is an important component of overall response time in large urban areas, particularly in multistory buildings.
-
Comparative Study Clinical Trial
Utility of base deficit for identifying major injury in elder trauma patients.
Early identification of serious injuries is especially important in elders. Base deficit (BD) is an indicator of serious injury in trauma patients. There are limited data to support the utility of BD in elders who have sustained trauma. ⋯ The preliminary data from this study indicate that in trauma patients aged 65 years and older, increased BD at emergency department arrival can predict life-threatening injury.