Articles: emergency-department.
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Thrombosis research · Oct 2013
Observational StudyThe role of soluble thrombomodulin in the risk stratification and prognosis evaluation of septic patients in the emergency department.
Soluble thrombomodulin (sTM) is a sensitive marker of endothelial damage. In this study we investigated the role of sTM in the evaluation of the severity and prognosis of septic patients in the emergency department (ED). ⋯ sTM is a valuable biomarker in the risk stratification and prognosis evaluation of ED sepsis. Furthermore, sTM can enhance the ability of the MEDS score in prediction of severe sepsis and 30-day mortality.
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Int J Gynaecol Obstet · Oct 2013
Assessing the extent of provision of comprehensive medical care management for female sexual assault patients in US hospital emergency departments.
To describe medical services provided to sexual assault patients in US emergency departments and to identify the percentage of hospitals always providing the 10 elements of comprehensive medical care management (CMCM). ⋯ Less than one-fifth of US hospitals provide comprehensive services to sexual assault patients. A national program incorporating clinical guidelines, checklists, and funding for sexual assault forensic/nurse examiner programs could improve the standard of care provided in emergency departments-the primary point of contact for acute care of sexual assault survivors.
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Understanding the cause of patients' symptoms usually involves identification of a pathological diagnosis. Anecdotal reports suggest that emergency department (ED) providers do not prioritise giving pathological diagnoses, and often reiterate the patient's symptom as the discharge 'diagnosis'. Our pilot study sought to identify the proportion of patients at a large teaching hospital who receive a symptomatic versus pathological diagnosis at ED discharge. ⋯ According to our pilot study, most patients are discharged from the ED without a pathological diagnosis that explains the likely cause of their symptoms. Future studies will investigate whether this finding is consistent across institutions, and whether provision of a pathological diagnosis affects clinical outcomes and patient satisfaction.
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The requirement for guidance regarding ambulance crews pre-alerting patients into hospital emergency departments (ED) has been well established, but a clear guidance tool that supports a decision to pre-alert a receiving hospital is lacking. ⋯ The pre-alert guidance tool shows face validity and superior ability to advise a pre-alert than ambulance crew decisions. It supplements a practitioners' clinical decision-making and has been regarded as having a positive impact on ED triage and utilisation of resources. Further levels of validity are expected to be achieved with continued audit and ongoing use of this tool.
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Carbon monoxide (CO) is the most common cause of fatal poisoning worldwide. Therapeutic red cell exchange (TREX) has been used in the treatment of many different diseases. Therefore, we aimed to evaluate the efficacy of TREX on the clinical status, outcome, and discharge of patients with severe CO poisoning. ⋯ TREX may be an alternative treatment method for reducing mortality and morbidity in cases of severe CO poisoning.