Articles: hospital-emergency-service.
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Emerg Med Australas · Feb 2025
ReviewReview article: Somatization Disorders in emergency department: A critical overview of current challenges and future directions.
Individuals with Somatization Disorders present frequently to the ED with non-cardiac chest pain, non-specific abdominal pain, headaches and a range of other non-specific symptoms. Somatization Disorder presentations are ubiquitous within the healthcare system. ⋯ The current review explores the scope of the problem and, the challenges inherent in diagnosing and treating these disorders in ED environments. Based on available evidence and the essential character of these disorders, future directions are suggested for more effective emergency management and possible referral from ED.
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Patients with suspected infections account for 15% to 35% of hospital emergency department (ED) caseloads in Spain and Latin America. The main objective of this systematic review was to compare evidence supporting the safety and efficacy of early (3 hours after triage) vs deferred ($ 3-6 hours) antibiotic therapy prescribed in EDs for adults with serious infections or sepsis. Efficacy and improved clinical course were defined by reduced progression to septic shock and short- and long-term mortality. ⋯ Early initiation of antibiotic therapy, preferably within 3 hours of triage, can be recommended in cases of serious infection (sepsis or serious sepsis that do not meet the criteria for septic shock). In fact, based on a tendency for higher short- and long-term mortality associated with delay and a higher probability of developing septic shock with each hour of delay, therapy should start as soon as possible if infection is confirmed or suspected in the absence of an alternative diagnosis.
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Emerg Med Australas · Feb 2025
ReviewReview article: Scoping review of interventions that reduce mechanical restraint in the emergency department.
Mechanical restraints are known to be associated with many undesirable outcomes in clinical settings. Our objective was to examine the current literature to explore possible interventions that would reduce the use of mechanical restraints in the ED. ⋯ Evidence supports further exploration of interventions that include: designing an agitation guideline; training staff in assessment, attitudinal and de-escalation skills; addition of a crisis team; and environmental changes in the form of adding a dedicated clinical space. Although these strategies may reduce mechanical restraint in the ED setting, further high-quality studies are needed before definitive conclusions may be drawn.
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Pediatric emergency care · Feb 2025
ReviewCurrent Evidence on the Care of Young Infants With Hypothermia in the Emergency Department.
The presence of hypothermia among young infants in the emergency department may be a sign of serious or invasive bacterial infections, or invasive herpes simplex viral infection. However, hypothermia may also occur due to a variety of other infectious and noninfectious conditions or environmental exposure. In some settings, hypothermia may represent a protective, energy-conserving response to illness. ⋯ Risk factors for serious bacterial infections in infants with hypothermia, as identified in single-center and multicenter retrospective studies, include lower temperatures, older age, and abnormalities in blood and urine testing. Given the absence of clear guidelines, management of infants with hypothermia relies heavily on clinician judgment and shared decision making, guided by individual patient assessments and risk factors. This review article summarizes existing evidence and identifies gaps in the management of infants (<90 days) with hypothermia in the emergency department.
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People who use substances increasingly access healthcare primarily through emergency medical services (EMS) and emergency departments (EDs). To meet the needs of these patients, EMS and EDs have become access points for medications for opioid use disorder (OUD), specifically buprenorphine. This systematic review aimed to quantify the efficacy of these programs, examining retention in treatment for OUD, rates of re-presentation to ED or EMS, and rates of precipitated withdrawal, as well as summarise clinician and patient perspectives on buprenorphine initiation in these settings. ⋯ The initiation of buprenorphine in the ED setting is associated with higher odds of short and medium-term treatment engagement. Further research is required into EMS-initiated buprenorphine, as well as patient perspectives of ED- and EMS-initiated buprenorphine.