Articles: emergency-department.
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Gender-minority youth, whose gender identity differs from their sex assigned at birth, have elevated suicide risk compared to cisgender youth, yet few studies examine their suicide risk in the emergency department (ED). Our objectives were to determine the prevalence of and assess risk and protective factors associated with prior suicide attempt (SA) and recent suicide ideation (SI) among gender-minority adolescents in the ED. ⋯ Among gender-minority ED adolescent patients, one in three experienced a SA prior to the ED visit. One in four endorsed SI within 2 weeks of the ED visit. The identified risk and protective factors among gender-minority adolescents may inform future ED-based efforts to detect and reduce suicide risk.
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Emergency department (ED) visits may serve as opportunities for firearm injury prevention and intervention efforts. Our objective was to determine ED utilization by youth before and after firearm injury. ⋯ Youth have high rates of ED utilization before and after firearm injury. Half of firearm-injured youth receive their emergency care exclusively in general EDs. Implementing firearm injury prevention and intervention efforts in all ED settings is critical.
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Paramedic services face increasing challenges due to delays in patient transfer of care (TOC) at emergency departments (EDs). Prolonged TOC times directly impact paramedic services' ability to provide emergency response, though the patient and clinical factors contributing to these delays remain unclear. We examined TOC times for all transports to the ED and analyzed factors associated with prolonged TOC. ⋯ Prolonged TOC times disproportionately affect older or clinically complex patients, regardless of their acuity or need for paramedic intervention. Our findings highlight the importance for paramedic services, hospitals, and stakeholders to develop targeted care models and collaborations to reduce prolonged TOC.
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Oregon introduced a state policy, HB 3090, on October 6, 2017, which increased requirements on emergency departments (EDs) to improve transitions to outpatient mental health care. The objective of this study was to examine the policy's impact among low-income adolescent patients who face severe barriers to follow-up. ⋯ There was a small increase in short-term outpatient mental health visits after the policy, but the association weakened over time, and other key outcomes did not change. Putting pressure on EDs to perform better in this area is likely to be a minimally effective strategy without accompanying strengthening of mental health resources.