Articles: hospital-emergency-service.
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Emerg Med Australas · Dec 2024
Emergency department staff opinion on newly introduced phlebotomy services in the department. A cross-sectional study incorporating thematic analysis.
The demand for ED services, both in terms of patient numbers and complexity has risen over the past decades. According to reports, there has been an increase in the ED patient presentation rate from 330 per 1000 to 334 per 1000 between 2018-2019 and 2022-2023. Consequently, new care models have been introduced to address this surge in demand, mitigate associated risks and improve overall safety. Among these models is the concept of 'front loading' clinical care, involving the initiation of interventions at the point of arrival. The present study evaluates the impact of introducing phlebotomists at triage. ⋯ Staff expressed satisfaction that patient care now begins in the waiting room, especially after extended waiting periods prior to cubicle allocation. They assert that this improvement significantly enhances timely treatment and disposition decisions, as well as overall patient satisfaction.
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Fear of enacted stigma (fear of discrimination or being treated unfairly) is associated with decreased health care-seeking behaviors among patients with opioid use disorder (OUD). We sought to describe the prevalence of fear of enacted stigma among patients presenting to the emergency department (ED) with OUD and to test whether experiencing greater compassion from ED staff is associated with lower fear of enacted stigma. ⋯ Among ED patients with OUD, fear of enacted stigma is common. Patient experience of compassion from ED staff is associated with lower fear of enacted stigma. Future research is warranted to test if interventions aimed at increasing compassion from ED staff reduce patient fear of enacted stigma among patients with OUD.
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Hidden infections and late diagnoses are currently the main challenges of the HIV pandemic. Emergency departments (EDs) are one of the health care system's key resources addressing these challenges. In 2020, the Spanish Society of Emergency Medicine (SEMES) published recommendations for ordering HIV serology testing for patients with certain health conditions, and in 2021 SEMES launched the "Leave Your Mark" (Deja tu Huella - DTH) program to facilitate implementing the recommendations during emergency care. ⋯ One out of every 5 new HIV diagnoses in Spain is now made in an ED, but there is still room for improvement. To that end, this paper contributes 7 concrete proposals: 1) update the DTH program's criteria for ordering serology by including unexplained thrombocytopenia, fever with no focus of infection, and former residence in a country with endemic HIV infection; 2) include serology for hepatitis C virus infection at the time HIV testing is ordered; 3) reinforce the importance of obtaining the patient's informed consent for testing, meeting the obligation to respect the individual's rights; 4) implement educational programs; 5) develop decision-making tools (forms for ordering tests, alerts in patients' histories); 6) involve nurses in the DTH process and value their contributions; and 7) monitor quality markers to evaluate implementation of the program in all participating hospitals. The ultimate goal is to improve the DTH program and ensure its sustainability over time.
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This cross-sectional analysis of 86,111 visits for sickle cell disease and vaso-occlusive episodes (VOE) in U.S. pediatric emergency departments between 2013 and 2023 shows increased use of NSAIDs, ketamine, and acetaminophen, with unchanged opioid use. Hospitals with a higher volume of VOE visits more frequently administered opioids. ⋯ Over the past decade, the use of NSAIDs, acetaminophen, and ketamine has increased in the management of VOE in pediatric SCD patients, while opioid use remains consistent. The co-administration of NSAIDs and opioids has also increased, reflecting guideline adherence. Variations in analgesia practices across hospitals underscore the need for standardizing pain management strategies in this population.
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There is a paucity of data describing the frequency and complications of body piercing injuries (BPI) in the United States. ⋯ BPI is a common problem in children, adolescents, and youth. Age and body piercing location significantly impact rates of BPI, infection, and hospitalization/transfer. Further study should identify the total number of annual body piercings in the United States. This could generate targeted counseling and risk reduction interventions aimed at specific groups, especially older children who appear to be at increased risk.