Articles: emergency-department.
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Observational Study
A study of hypothermic patients presenting to a Mediterranean emergency department.
A retrospective chart review was carried out in the adult Emergency Department of Mater Dei Hospital in the 'sunny warm Mediterranean island' Malta, on patients admitted with a rectal temperature of less than 35°C during the two consecutive winters of 2010-2011 and 2011-2012. ⋯ This showed that warm Malta also has its fair share of patients suffering from hypothermia during its winters. The minimum recorded temperatures ranged from +3.8 to +14.2°C in winter 1 and +3.6 to +13.1°C in winter 2. The majority of patients were suffering from either mild or moderate hypothermia, in roughly equal numbers. However, 4% of hypothermic admissions in the first winter and 7% in the colder second winter had severe hypothermia. Hypothermic admissions were most common among patients in their late seventies. Survival rates in primary hypothermia were better than in secondary hypothermia. The type of residence of the patient did not significantly affect the admission rate.
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In this study, the objective was to characterize emergency department (ED) transfer relationships and study the factors that predict the stability of those relationships. A metric is derived for ED transfer relationships that may be useful in assessing emergency care regionalization and as a resource for future emergency medicine research. ⋯ United States EDs that transfer patients to other hospitals often have multiple transfer partners. The stability of the transfer relationship, assessed by the transfer instability index, differs by condition. Less stable transfer relationships (i.e., hospitals with greater numbers of transfer partners) were more common in EDs with higher proportions of publicly insured patients.
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Observational Study
Acute testicular pain in children: collaboration in timely management.
Acute scrotal pain in a child is a urological emergency. Surgeons should be involved early and exclude torsion promptly, often by surgical exploration. This short report compares the time taken by different medical practitioners [Emergency Department (ED) doctors and surgeons] to assess children presenting to the ED with acute scrotal pain. ⋯ Surgeons reviewed patients with testicular pain quicker than ED doctors when they were referred directly from triage (P=0.019). Overall, review by a surgeon was more timely if the patient was referred directly from triage rather than after referral by the ED doctor (P<0.0001). A direct fast-track referral system to surgeons is needed in the ED to prevent unnecessary delays in definitive management of patients with testicular pain.
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Observational Study
Prevalence of Clostridium difficile infection presenting to US EDs.
The objective of the study is to determine the prevalence of Clostridium difficile infection (CDI) presenting to emergency departments (EDs) in the United States. Secondary objectives included defining the burden of CDI. ⋯ The prevalence of CDI presenting to EDs increased each year from 2006 to 2010; however, the rate of increase slowed from each year to the next. The mortality rate increased from 2006 to 2009 and decreased significantly from 2009 to 2010. C difficile infection visits presenting to EDs occurred more frequently with older individuals, females, and in the northeast.