Articles: emergency-department.
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This study sought to determine the prevalence, test characteristics, and severity of illness of pediatric patients with systemic inflammatory response syndrome (SIRS) vital signs among pediatric emergency department (ED) visits. ⋯ Systemic inflammatory response syndrome vital signs are common among medical pediatric patients presenting to an ED, and critical illness is rare. The majority of patients with SIRS vital signs were discharged without IV therapy and without readmission. Patients with SIRS vital signs had a statistically significant increased risk of critical care requirement, ED IV treatment, ED laboratory tests, admission, and readmission. However, SIRS vital sign criteria did not identify the majority of patients with mortality or need for critical care. SIRS vital signs had low sensitivity for critical illness, making it poorly suited for use in isolation in this setting as a test to detect children requiring sepsis resuscitation.
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Journal of physiotherapy · Apr 2015
Observational StudyPrimary-contact physiotherapists manage a minor trauma caseload in the emergency department without misdiagnoses or adverse events: an observational study.
What proportion of people who are managed by a primary-contact physiotherapy service in an emergency department experience adverse events? For people presenting to the emergency department with minor trauma, does the length of stay differ between those managed by the physiotherapy service and those managed by medical staff? For people presenting to the emergency department with minor trauma, is diagnostic imaging ordered as often by the physiotherapy service as it is by medical staff? ⋯ Primary-contact physiotherapists can manage a minor trauma caseload in the emergency department without adverse events. A physiotherapy service in the emergency department may result in a reduced length of stay and fewer requests for imaging. However, potential confounding of the results for length of stay and imaging must be recognised because matching diagnostic codes may not ensure completely equivalent cohorts. [Sutton M, Govier A, Prince S, Morphett M (2015) Primary-contact physiotherapists manage a minor trauma caseload in the emergency department without misdiagnoses or adverse events: an observational study.Journal of Physiotherapy61: 77-80].
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To determine the impact of the GP-led walk-in centre (WIC) in Sheffield (England) on the demand for emergency department (ED) care. ⋯ There was a statistically significant reduction in GP-type daytime attendances at the adult ED after the opening of the GP WIC. Since this reduction was not mirrored in changes in night-time attendances (when the GP WIC was closed), and our survey responses suggested some people were diverted from going to the ED, it is possible that the opening of the GP WIC caused this reduction.