Articles: emergency-department.
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Comparative Study
Experiences of patients with acute abdominal pain in the ED or acute surgical ward --a qualitative comparative study.
The Danish health care system is currently establishing emergency departments (EDs) with an observation unit nationwide. The aim of the study was to investigate patients with acute abdominal pain and their experiences upon arrival and stay in an acute surgical ward (ASW) versus an ED with an observation unit. A phenomenological-hermeneutic comparative field study with participant observation and interviews was performed. ⋯ In ASW, focus was on assessment by a senior physician, only, and the nurses' interaction with the patients took place after surgical assessment. In all, patients experienced long waiting times. The study shows a need to define the roles of the professionals in units receiving patients with acute abdominal pain in order to fulfil the medical as well as the experienced needs of the acute patient.
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Medication errors are an important cause of preventable morbidity, especially in children in emergency department (ED) settings. Internal use of voluntary incident reporting (IR) is common within hospitals, with little external reporting or sharing of this information across institutions. We describe the analysis of paediatric medication events (ME) reported in 18 EDs in a paediatric research network in 2007-2008. ⋯ ME reporting by the system revealed valuable data across sites on medication categories and potential human factors. Harm was infrequently reported. Our analyses identify trends and latent systems issues, suggesting areas for future interventions to reduce paediatric ED medication errors.
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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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To review clinical indications and demographics of transfusion and the patterns of blood component ordering, transfusion, wastage and traceability, before (2007) and after (2011) implementation of simple improvement strategies. ⋯ Blood component ordering, usage and traceability within the ED have improved significantly since 2007 following implementation of simple strategies. The age of ED transfusion recipients is increasing.
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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.