Articles: emergency-department.
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Brain injury : [BI] · Jan 2014
Multicenter Study Comparative StudySustained outcomes following mild traumatic brain injury: results of a five-emergency department longitudinal study.
To report on the occurrence of sustained outcomes including post-concussion symptoms, health services used and indicators of social disruption following a mild traumatic brain injury (MTBI). ⋯ These findings argue that some with an MTBI suffer real complaints and they are sustained from 3 to at least 6 months. More effort should be given toward specificity of these symptoms from those reported by members of the comparison group.
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Pediatric emergency care · Jan 2014
Multicenter StudySynovial Fluid Findings in Children With Knee Monoarthritis in Lyme Disease Endemic Areas.
Although Lyme and septic arthritis of the knee may have similar clinical presentations, septic arthritis requires prompt identification and treatment to avoid joint destruction. We sought to determine whether synovial fluid cell counts alone can discriminate between Lyme, septic, and other inflammatory arthritis. ⋯ In Lyme endemic areas, synovial fluid results alone do not differentiate septic from Lyme arthritis. Therefore, other clinical or laboratory indicators are needed to direct the care of patients with knee monoarthritis.
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Eur. J. Intern. Med. · Jan 2014
Risk factors associated with adverse drug events among older adults in emergency department.
Little is known about the emergency department (ED) visits from drug-related injury among older adults in Taiwan. This study seeks to identify risk factors associated with adverse drug events (ADEs) leading to ED visits. ⋯ This study suggests that prevention efforts should be focused on older patients with renal insufficiency and polypharmacy who are using high risk medications such as anticoagulants, diuretics, cardiovascular agents, analgesics, and anti-diabetic agents.
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Observational Study
Medication errors in psychiatric patients boarded in the emergency department.
Patients boarded in the emergency department (ED) with psychiatric complaints may be at risk for medication errors. However, no studies exist to characterize the types of errors and risk factors for errors in these patients. ⋯ Psychiatric patients boarded in the ED commonly have medication errors that require intervention.
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Multicenter Study
The emergency department "carousel": an ethnographically-derived model of the dynamics of patient flow.
Emergency department (ED) overcrowding reduces efficiency and increases the risk of medical error leading to adverse events. Technical solutions and models have done little to redress this. A full year's worth of ethnographic observations of patient flow were undertaken, which involved making hand-written field-notes of the communication and activities of emergency clinicians (doctors and nurses), in two EDs in Sydney, Australia. ⋯ The carousel model uniquely integrates diagnosis, treatment and transfer of individual patients with the intellectual labour of leading and coordinating the department. The latter involves managing staff skill mix and the allocation of patients to particular ED sub-departments. The model extends traditional patient flow representations and underlines the importance of valuing ethnographic methods in health services research, in order to foster organisational learning, and generate creative practical and policy alternatives that may, for example, reduce or ameliorate access block and ED overcrowding.