Articles: emergency-department.
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Internal medicine journal · Oct 2013
Impact of emergency access targets on admissions to general medicine: a retrospective cohort study.
Emergency access targets have been implemented Australia-wide following recent retrospective cohort studies linking emergency department (ED) overcrowding and excess mortality. ⋯ Implementation of a 4-h access target has been associated with changes to the characteristics of patients admitted to GM, including higher proportions of younger patients, with fewer comorbid conditions and lower clinical urgency at presentation, although the latter may be explained by a coincidental change in the way that ED patients were triaged, as well as a greater number of these patients presenting to ED overall.
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Emerg Med Australas · Oct 2013
Level of agreement between prehospital and emergency department vital signs in trauma patients.
Describe the level of agreement between prehospital (emergency medical service [EMS]) and ED vital signs in a group of trauma patients transported to an inner city Major Trauma Centre. We also sought to determine factors associated with differences in recorded vital sign measurements. ⋯ Agreement was demonstrated between EMS and ED GCS scores but not RR and SBP recordings. Discrepancies appeared to reflect physiological changes in response to EMS initiated interventions. Trauma triage algorithms and risk models might need to take these measurement differences, and factors associated with them, into account.
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Widespread conservative management of low-risk chest pain has motivated the development of a rapid triage strategy based on CT coronary angiography (CTCA) in the Emergency Department (ED). Recently, three prominent trials using this technology in the ED setting have presented results in support of its routine use. However, these studies fail to show the incremental prognostic value of CTCA over clinical and biomarker-based risk-stratification strategies, demonstrate additional downstream costs and interventions, and result in multiple harms associated with radio-contrast and radiation exposure. Observing the widespread overdiagnosis of pulmonary embolism following availability of CT pulmonary angiogram as a practice pattern parallel, CTCA use for low-risk chest pain in the ED should be advanced only with caution.
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Emerg Med Australas · Oct 2013
Improvement in emergency department length of stay using an early senior medical assessment and streaming model of care: A cohort study.
Australian EDs are required to conform to the National Emergency Access Target (NEAT): patients must be discharged within 4 h of arrival. The aim of the present study was to determine if a model of care called Senior Assessment and Streaming (SAS) would increase the proportion of patients achieving NEAT. ⋯ Through the introduction of SAS, the present study has demonstrated that providing early senior medical assessment can improve an ED's ability to meet NEAT.
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The Journal of pediatrics · Oct 2013
Neurocognitive test performance and symptom reporting in cheerleaders with concussions.
To evaluate neurocognitive test results and symptom reporting after sports-related concussion in a group of female cheerleaders. ⋯ The diagnosis and management of concussion in cheerleaders should not consist solely of self-reported symptoms. Neurocognitive test results represent an important component of the evaluation process and may identify athletes with residual neurocognitive deficits who report being clinically asymptomatic.