Articles: emergency-department.
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Pediatric emergency care · Dec 2023
Observational StudySocial Determinants of Health Are Associated With Visits for Ambulatory Care Sensitive Conditions.
Population health experts have described the link between social factors and health, but few studies link specific social needs to disease processes. Nationwide Children's Hospital implemented a universal, annual screener for social determinants of health (SDH) in 2018. Early analyses have shown that patients identifying an SDH need were more likely to have an emergency department (ED) or inpatient stay. The objective of this study is to identify links between SDH and ED presentation for ambulatory care sensitive conditions (ACSCs). ⋯ The odds of ED presentation for ACSCs are higher in patients with expressed social needs. Further delineating the connections between specific SDH and health outcomes can inform timely and appropriate interventions.
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Pediatric emergency care · Dec 2023
Nucleated Red Blood Cells Are Predictive of In-Hospital Mortality for Pediatric Patients.
We sought to establish whether nucleated red blood cells (NRBCs) are predictive of disposition, morbidity, and mortality for pediatric patients presenting to the emergency department (ED). ⋯ The presence of NRBCs is an independent predictor for mortality, including in-hospital mortality, ICU admission, CPR, and readmission within 30 days for children presenting to the ED.
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There are multiple reported injuries associated with cardiopulmonary resuscitation, most of them caused by the force of compressions, like sternal and rib fractures, abdominal organ injuries like splenic rupture, liver lacerations, and injuries to the upper airway and skin. Injuries related to defibrillation and cardioversion are rare, mostly related to skin and muscle injuries on where the defibrillation paddles were placed. ⋯ A 52-year-old man presented to the Emergency Department with crushing chest pain. The patient was suffering from a myocardial infarction, and during percutaneous coronary intervention, had to be defibrillated on the angioplasty table. This resulted in fracture-dislocations on both shoulders. The patient was transferred to our orthopedics clinic and was operated on within 5 days of angioplasty. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Early diagnosis and treatment are important, and can prevent long-term morbidity. However, cardiopulmonary resuscitation and defibrillation are acts that are most commonly performed in the emergency department. Injury prevention by controlling the patient's position, in this case, positions of the shoulders, is an important factor that emergency physicians can control and effect.
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J Coll Physicians Surg Pak · Dec 2023
Developing and Validating a New Model to Predict In-Hospital Mortality in Patients with Acute Myocardial Infarction.
To derive and validate a regression model that can successfully and robustly predict in-hospital mortality of patients who underwent percutaneous coronary intervention (PCI) after admission to the Department of Emergency Medicine (ED) with acute myocardial infarction (AMI). ⋯ Percutaneous coronary intervention, Mortality, In-hospital mortality, Prediction model, Logistic regression.
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Nationally, suicide ideation prevalence is comparable among White, American Indian/Alaska Native, Black, and Hispanic adults experiencing alcohol use disorder. This study examines whether such comparability extends to the probability of receiving a suicide ideation diagnosis when presenting with alcohol use disorder at emergency departments. The probability of hospitalization following such diagnosis is examined as well. ⋯ Diagnosis of suicide ideation, a key step in emergency department suicide prevention care, occurred significantly less often for patients of color with alcohol use disorder than for White counterparts. American Indians/Alaska Natives, the racial/ethnic group known to have the nation's highest suicide rate, had the lowest probability of being hospitalized after a diagnosis of alcohol use disorder plus suicide ideation.