Articles: emergency-department.
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Hospital crowding and emergency department (ED) boarding are large and growing problems. To date, there has been a paucity of information regarding the quality of care received by patients boarding in the ED compared with the care received by patients on an inpatient unit. We compared the rate of delays and adverse events at the event level that occur while boarding in the ED vs while on an inpatient unit. ⋯ Compared with inpatient units, ED boarding was associated with more medication-related delays and adverse events but fewer laboratory-related delays. Until we can eliminate ED boarding, it is critical to identify areas for improvement.
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Can J Public Health · Sep 2014
Emergency department visits for asthma in relation to the Air Quality Health Index: a case-crossover study in Windsor, Canada.
In this study, associations of short-term changes in ambient air pollution with emergency department (ED) visits for asthma were examined in hospitals in the area of Windsor, Ontario. Ambient air pollution quality was represented by the Air Quality Health Index(AQHI), calculated using a formula that combines the concentrations and the relative health impacts of three ambient air pollutants: ozone , nitrogen dioxide and fine particulate matter. ⋯ Exposure to ambient air pollution in Windsor increases the risk of ED visits for asthma. When the adverse effects of air pollutants are increased, patient visits to the ED depend on the patient's age.
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Observational Study
Differences in noninvasive thermometer measurements in the adult ED.
Detection of accurate temperature in the emergency department (ED) is integral for assessment, treatment, and disposition. The primary objective was to compare temperature measurements from noninvasive temperature devices in the adult ED. The secondary objective was to evaluate the discrepancy between febrile and afebrile patients. ⋯ There was a statistically significant difference in measured temperatures between oral and TA thermometers and a clinically significant difference in 49% of patients. Febrile patients had a greater discrepancy and variability between noninvasive temperature measurements. Caution should be taken when evaluating temperature measurements with these noninvasive devices.
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Anaphylaxis is a potentially life-threatening allergic reaction that may require emergency medical system (EMS) transport. Fatal anaphylaxis is associated with delayed epinephrine administration. Patient outcome data to assess appropriateness of EMS epinephrine administration are sparse. ⋯ Low rates of epinephrine administration were observed. The association of EMS administration of epinephrine with respiratory symptoms, fulfillment of anaphylaxis diagnostic criteria, and low rate of additional epinephrine administration in the ED suggest that ALS EMS administered epinephrine based on symptom severity. Additional studies of EMS anaphylaxis management including ED management and outcomes are needed.
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Observational Study
Arterial lactate improves the prognostic performance of severity score systems in septic patients in the ED.
To evaluate the prognostic performance of lactate in septic patients in the emergency department (ED) and investigate how to add lactate to the traditional score systems. ⋯ Lactate is a prognostic predictor in septic patients in the ED, and it may improve the performance of APACHE II, SOFA, and MEDS scores in predicting mortality.