Articles: emergency-department.
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Acute HIV infection is a clinical diagnosis aided by technology. Detecting the highly infectious acute stage of HIV infection is critical to reducing transmission and improving long-term outcomes. The Maricopa Integrated Health System implemented nontargeted, opt-out HIV screening with a fourth-generation antigen/antibody combination HIV assay test in our adult emergency department (ED) at Maricopa Medical Center to assess the prevalence of both acute and chronic unrecognized HIV. ⋯ HIV testing with a fourth-generation antigen/antibody laboratory test producing rapid results is feasible in an ED. Unexpectedly, nearly one fourth of patients with undiagnosed HIV had acute infections, which would have been more difficult to detect with previous testing technology.
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Paediatr Perinat Epidemiol · Nov 2014
Gestational age-specific associations between infantile acute bronchiolitis and asthma after age five.
Infantile acute bronchiolitis (AB) is a risk factor for the development of paediatric asthma. The associations might differ according to gestational age. ⋯ A positive association was observed between ED visits for AB and subsequent asthma ED visits after age 5; associations did not vary meaningfully by gestational age. Sensitivity analyses did not suggest large biases due to differences in ED utilisation across sociodemographic groups or loss to follow-up from residential migration.
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Contemp Clin Trials · Nov 2014
Randomized Controlled TrialDischarge information and support for veterans Receiving Outpatient Care in the Emergency Department: study design and methods.
An explicit goal of Patient Aligned Care Teams (PACTs) within the Veterans Health Administration is to promote continuity of care in primary care clinics and thereby reduce Emergency Department (ED) utilization; however, there has been little research to guide PACTs on how to accomplish this. ⋯ The results of this randomized, controlled trial with an Effectiveness-Implementation Type I Hybrid design will be directly relevant to the care of more than 500,000 high risk patients seen in Veterans' Affairs Medical Center (VAMC) EDs annually. Results will also be informative to health systems outside VA aiming to reduce ED use through accountable care organizations.
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The value of electrocardiogram (ECG) overreads of emergency department (ED) tracings have been questioned in the literature. This review was designed to assess the validity of this criticism. ⋯ Official cardiology overreads seldom affect the clinical outcome of patient care delivered in the ED setting.
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The American Heart Association/American Stroke Association guidelines recommend all patients presenting to emergency departments (EDs) with a potential stroke be seen within 10 minutes of arrival, although this may not be achieved in all patients. We sought to identify factors associated with delayed evaluation of ED patients with potential stroke. ⋯ In this national sample of patients presenting with strokes to US EDs, patient visits to metropolitan statistical area hospitals and those triaged to less urgent categories were associated with delayed evaluation.