Articles: emergency-department.
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Scand J Trauma Resus · Apr 2023
Clinical TrialPredicting deterioration of patients with early sepsis at the emergency department using continuous heart rate variability analysis: a model-based approach.
Sepsis is a life-threatening disease with an in-hospital mortality rate of approximately 20%. Physicians at the emergency department (ED) have to estimate the risk of deterioration in the coming hours or days and decide whether the patient should be admitted to the general ward, ICU or can be discharged. Current risk stratification tools are based on measurements of vital parameters at a single timepoint. Here, we performed a time, frequency, and trend analysis on continuous electrocardiograms (ECG) at the ED to try and predict deterioration of septic patients. ⋯ We showed that continuous ECG recordings can be automatically analyzed and used to extract HRV features associated with clinical deterioration in sepsis. The predictive accuracy of our current model based on HRV features derived from the ECG only shows the potential of HRV measurements at the ED. Unlike other risk stratification tools employing multiple vital parameters this does not require manual calculation of the score and can be used on continuous data over time. Trial registration The protocol of this study is published by Quinten et al., 2017.
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Wearing face shields and masks, which used to have very limited public use before the COVID-19 outbreak, has been highly recommended by organizations, such as CDC and WHO, during this pandemic period. ⋯ Although the decrease in systolic blood pressure (SBP) and MAP values is assumed to be caused by increased fatigue due to workload and work pace as well as increase in muscle activity, the increase in PETCO2 levels in the ED healthcare staff working with no breaks between 0 and 4 h should be noted in terms of PPE-induced hypoventilation.
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Emerg Med Australas · Apr 2023
Comment Observational StudyUtilising in situ simulation within translational simulation programmes to evaluate and improve multidisciplinary response to anaphylaxis in the paediatric emergency department.
The prevalence of paediatric anaphylaxis is rising in Australia. Treatment requires timely administration of intramuscular (IM) adrenaline. Study goals included utilising in situ simulation (ISS) within a translational simulation (TS) programme as a diagnostic tool to identify the frequency and cause of IM adrenaline errors in a paediatric ED, and utilising ISS to evaluate multidisciplinary emergency team response to anaphylaxis. ⋯ ISS within TS programmes was successfully utilised as a diagnostic tool in identifying that medication errors were common during anaphylaxis management in the ED. Improving access to adrenaline in dosing boxes and promoting the utilisation of weight-based cognitive aids alongside ISS education will likely reduce errors and improve patient safety.
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JNMA J Nepal Med Assoc · Apr 2023
Road Traffic Accidents among Patients Visiting Department of Emergency of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Road Traffic Accidents, are one of the major neglected global health burdens which are predicted to be the 7th leading cause of global deaths by 2030 as per the World Health Organization hence, seem to be one of the major global threats in near future. Most road traffic accidents affect the most vulnerable age groups in developing countries. The aim of this study was to find out the prevalence of road traffic accidents among patients visiting the Department of Emergency of a tertiary care centre. ⋯ emergencies; prevalence; traffic accidents.
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JNMA J Nepal Med Assoc · Apr 2023
Mean Serum Lactate Levels in Patients with Sepsis Presenting to the Department of Emergency Medicine of a Tertiary Care Center: A Descriptive Cross-sectional Study.
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Serum lactate is useful in predicting the prognosis of critically ill patients. Elevated blood lactate levels as well as delayed clearance have been linked to higher mortality in sepsis. Shock index is a simple and effective bedside assessment means of gauging the degree of shock and is an important predictor of identifying high-risk patients. Monitoring lactate levels may aid clinicians in understanding tissue perfusion and detecting unrecognized shock and making prompt therapy adjustments. This study aimed to find out the mean serum lactate levels in patients with sepsis presenting to the Department of Emergency Medicine of a tertiary care centre. ⋯ emergencies; lactate; sepsis.