Articles: emergency-department.
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A short-cut review was carried out to establish whether the pulmonary embolism rule-out criteria (PERC) can safely exclude the diagnosis of pulmonary embolism (PE) in the emergency department (ED). One recent systematic review was directly relevant to the question and incorporated all the other relevant evidence identified. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are shown in table 3. The clinical bottom line is that PERC may be safely applied to patients aged 18-49 years presenting to the ED with chest pain and/or dyspnoea providing that the pre-test probability of PE is 7% or less (equivalent to a Wells score of <2).
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Arch Gerontol Geriatr · Jan 2014
Multicenter StudyThe frequency of and reasons for acute hospital transfers of older nursing home residents.
The purpose of the study was to examine the frequency of and reason for transfer from nursing homes to the emergency department (ED), whether these transfers led to admission to a hospital ward, and whether the transfer rate differs as a function of type of nursing home provider and to identify the frequency of avoidable hospitalizations as defined by the Swedish Association of Local Authorities and Regions (SALAR). The design was retrospective, descriptive. Data were collected in a Swedish municipality where 30,000 inhabitants are 65 years or older. ⋯ The frequency of avoidable hospitalizations was 16% among the 375 hospitalizations. The proportion of transfers to the ED ranged widely between nursing homes. The reasons for this finding ought to be explored.
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Comparative Study
Emergency medical admissions, deaths at weekends and the public holiday effect. Cohort study.
To assess whether mortality of patients admitted on weekends and public holidays was higher in a district general hospital whose consultants are present more than 6 h per day on the acute medical unit with no other fixed clinical commitments. ⋯ Patients admitted as emergencies to medicine on public holidays had significantly higher mortality at 7 and 30 days compared with patients admitted on other days of the week.
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Mild to moderate musculoskeletal trauma is a common cause for an emergency room visit, and frequent pain is one of the cardinal symptoms of consultation. The objective of this study is to assess the perception of a single subcutaneous dose of 50 mg tramadol for pain management in patients with mild to moderate musculoskeletal trauma, likewise to appraise the perception of pain by subcutaneous injection. ⋯ We conclude that a single subcutaneous dose of tramadol is a safe and effective option for the management of patients with mild to moderate pain and musculoskeletal disease in the emergency department.
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Little is known about why patients choose emergency departments (EDs) to receive care. ⋯ The majority of patients stated that the most common reason for seeking care in an ED was that they thought their problem was serious. Almost half sought ED care on the advice of a family member, friend, or health care provider, and a sizable minority were actually referred in by a health care provider. PCPs agree that most patients come to EDs because they believe they are too sick to be seen in their office or become sick after office hours.