Articles: emergency-department.
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I propose a methodology to compare individual emergency physician (EP) work patterns. This is intended to generate discussion within the specialty. A work pattern graph shows individual EP productivity and, assuming the EPs case selection is similar, can be used to compare group activity. Using a simple mathematical model, an averaged calculation can be made of the number of patients needed to be seen by each treating clinician during a standard shift.
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Emergency department (ED)-initiated buprenorphine improves outcomes in patients with opioid use disorder; however, adoption varies widely. To reduce variability, we implemented a nurse-driven triage screening question in the electronic health record to identify patients with opioid use disorder, followed by targeted electronic health record prompts to measure withdrawal and guide next steps in management, including initiation of treatment. Our objective was to assess the impact of screening implementation in 3 urban, academic EDs. ⋯ An ED triage screening and treatment protocol led to increased assessment and treatment of opioid use disorder. Protocols designed to make screening and treatment the default practice have promise in increasing the implementation of evidence-based treatment ED opioid use disorder care.
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Appropriate decision-making is critical for transfusions to prevent unnecessary adverse outcomes; however, transfusion in the emergency department (ED) can only be decided based on sparse evidence in a limited time window. ⋯ In this single-center retrospective study, younger age and higher ED triage scores were associated with the appropriateness of RBC transfusions.
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Low back pain is a common reason for visiting the emergency department (ED), yet little is known about patient motivations for seeking emergency care. The purpose of this study was to explore patient perspectives on visiting the ED for low back pain to inform a more patient-centered approach to emergency care. ⋯ These patient perspectives and resulting themes may be used to inform a more patient-centered emergency care experience and contextualize quantitative research findings on ED care for low back pain.
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Eur J Trauma Emerg Surg · Aug 2023
Refining triage practices by predicting the need for emergent care following major trauma: the experience of a level 1 adult trauma center.
We examined the predictability of selected parameters for establishing the need for urgent care following multi-trauma as a means to warrant the highest level of trauma activation and potentially improve over- and under-triage rates. ⋯ A GCS ≤ 13, systolic BP < 110 mmHg, signs of respiratory distress, and age > 75 years best predicted the need for acute care following multisystem trauma. Prospective studies are warranted to confirm the predictability of these criteria and to assess the extent to which their implementation will refine over- and under-triage rates.