Emergency medicine journal : EMJ
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While studies have reported factors affecting adherence to diabetic care plans from a chronic disease perspective, no studies have addressed issues with post-discharge adherence facing patients with diabetes after an emergency department (ED) presentation for hyperglycaemia. This study's objectives were to describe patient perspectives on their experience during and after an ED visit for hyperglycaemia and to identify factors that influence postdischarge adherence. ⋯ This study describes the patient experience with the communication of discharge instructions, as well as factors affecting adherence post-ED discharge for hyperglycaemia. Our findings suggest four strategies that could improve the patient experience, improve adherence to discharge plans and potentially decrease the frequency of recurrent ED visits for hyperglycaemia.
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Observational Study
Higher clinical acuity and 7-day hospital mortality in non-COVID-19 acute medical admissions: prospective observational study.
To understand the effect of COVID-19 lockdown measures on severity of illness and mortality in non-COVID-19 acute medical admissions. ⋯ These data demonstrate a significant reduction in non-COVID-19 acute medical admissions during the early weeks of lockdown. Patients admitted during this period were of higher clinical acuity with a higher incidence of early inpatient mortality.
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The recommended front of neck access procedure in can't intubate, can't oxygenate scenarios relies on palpation of the cricothyroid membrane (CTM), or dissection of the neck down to the larynx if CTM is impalpable. CTM palpation is particularly challenging in obese patients, most likely due to an increased distance between the skin and the CTM (CTM depth). The aims of this study were to measure the CTM depth in a representative clinical sample, and to quantify the relationship between body mass index (BMI) and CTM depth. ⋯ CTM depth was strongly associated with BMI in a retrospective analysis of patients having clinical CT scans.
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Observational Study
Paediatric emergencies and related mortality in Nicaragua: results from a multi-site paediatric emergency registry.
We aim to describe the characteristics and outcomes of the severe spectrum of paediatric emergency visits using a multi-site registry developed as part of an international cooperation project. ⋯ The mortality rate of urgent-emergency paediatric visits in Nicaragua is high, with younger children being most at risk and the majority of deaths being eventually caused by septic shock or respiratory failure. Our data provide useful information for the development of a Paediatric Emergency Care network to help direct training efforts, resources and logistic/organisational interventions to improve children's health in an emergency setting in Nicaragua.
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UK national newspapers have reported cases of children (and adults) who have got their tongue trapped in a Disney travel mug lid, causing extreme distress to the patients, their parents and ED staff. Potential risks include oral endotracheal intubation necessitating emergency tracheostomy to secure the airway, tongue necrosis and dental trauma. Although Disney has withdrawn their original mug from the global market, the same dangers can occur with other internationally available brands. Our aim was to design, test and present an alternative lid. ⋯ Our lid appears to offer a safer design that can avoid injuries. However, absolute safety remains unproved, as testing did not account for other body parts which may get trapped in the lid, nor did we test a range of tongue substitute sizes, and laboratory testing only was completed.