Articles: hospital-emergency-service.
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To analyze the possible association between a finding of plasma alkalosis in patients diagnosed with acute heart failure (AHF) in the emergency department (ED) and in-hospital mortality. ⋯ This retrospective analysis of cases in the EAHFE registry found no association between alkalosis and higher in-hospital mortality after AHF. Nor were significant associations found when we analyzed mortality related to probable metabolic vs respiratory alkalosis.
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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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The three-step programme to treat locum addiction locum dependency in rural EDs is a pervasive issue, leading to significant financial strain and impacting clinical care and staff morale. This article outlines a three-step programme to mitigate this dependency. ⋯ Step three emphasises the role of individual hospitals in effective recruitment, highlighting the benefits of rural living and the potential of NPs to provide departmental continuity and reduce turnover. These reforms, although independent, collectively aim to enhance the quality of care in rural EDs and optimise resource allocation.
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Randomized Controlled Trial Comparative Study
Comparing first pass success of Channeled versus Non-channeled KingVision video laryngoscopes in patients presenting to the emergency department - A randomized control study.
In modern times, the emergency physician (EP) has access to a host of video laryngoscopes (VL). There are different makes, models, angulations in the blades provided by different VLs. The blades may be channeled or non-channeled. In busy emergency departments (ED), ease and speed of intubations in managing the emergent airways may impact the outcome for the patient. ⋯ We found the non-channeled blades to have a significantly higher percentage of first pass success. Performance with respect to time to intubate was similar between the two. We recommend using the non-channeled KVVL for intubations in the EDs.
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Caring for older adults in the Emergency Department demands compassion, expertise, and adaptability to address the intricate medical and emotional needs of this vulnerable population. Key geriatric emergency medicine articles from 2023 highlight the evolving landscape of this field: updates to the Beers Criteria for potentially inappropriate medications, medications most implicated in causing delirium, geriatric trauma centers, behavioral problems in persons with dementia, geriatric syndrome detection, and emergency department (ED) process outcomes in geriatric EDs. As healthcare organizations shift to focus on the larger continuum of care that extends beyond the ED visit, we also highlight a novel program from the Veterans Affairs bringing former military medics to the home to improve outcomes after ED discharge. This review highlights practice-changing updates to improve the management of older adults in the ED.