Articles: emergency-department.
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Atrial fibrillation with rapid ventricular response (Afib/RVR) is a frequent reason for emergency department (ED) visits and can be treated with a variety of pharmacological agents. Magnesium sulfate has been used to prevent and treat postoperative Afib/RVR. We performed a systematic review and meta-analysis to assess the effectiveness of magnesium for treatment of Afib/RVR in the ED. ⋯ Meta-regressions demonstrated that higher maintenance dose (corr. coeff, 0.17; P = 0.01) was positively correlated with HR reductions, respectively. We observed that magnesium infusion can be an effective rate control treatment for patients who presented to the ED with Afib/RVR. Further studies with more standardized forms of control and magnesium dosages are necessary to assess the benefit/risk ratio of magnesium treatment, besides to confirm our observations.
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Randomized Controlled Trial
Oral Aspirin/ketamine versus oral ketamine for emergency department patients with acute musculoskeletal pain.
The purpose of this study is to investigate if an orally administered combination of aspirin and ketamine will provide better analgesia than a ketamine alone in adult patients presenting to the Emergency Department (ED) with acute musculoskeletal pain. ⋯ govRegistration: NCT04860804.
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To examine sex differences in oral anticoagulation management and outcomes among patients with incident nonvalvular atrial fibrillation presenting to the emergency department (ED). ⋯ Females with incident nonvalvular atrial fibrillation discharged from the ED are less likely to receive oral anticoagulants than males. When oral anticoagulant treatment is initiated, females have high adherence to direct oral anticoagulants, and both the sexes have poor warfarin control. At 1 year, females were at a significantly higher risk of developing stroke.
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Review
About time! A scoping review of public-facing emergency department wait time displays in Canada.
Waiting is a common experience for patients during an emergency department (ED) visit. While high acuity patients are seen with little delay, low acuity patients may experience dissatisfaction from prolonged wait times. One strategy to improve patient experience involves changing the perception of the wait by providing realistic expectations of wait times using public-facing wait time displays. The primary objective of this study is to quantify the number of Canadian EDs with online wait time displays and describe the features and type of information provided. ⋯ Currently, there is emerging use of wait time displays in Canada with considerable variability in the information communicated through these tools. Effectiveness of these displays and their content needs to be determined.
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Observational Study
Validity of the Taiwan Triage and Acuity Scale in mainland China: a retrospective observational study.
The Taiwan Triage and Acuity Scale (TTAS), developed for use in EDs, has been shown to be an excellent tool for triaging patients with high predictive performance, with an area under the receiver operating curve (AUROC) of 0.75. TTAS has been widely used in hospitals in Taiwan since 2010, but its utility has not been studied outside of Taiwan. Thus, the aim of this study was to evaluate the validity of using the TTAS in the ED of a tertiary hospital in mainland China to predict patient outcomes. ⋯ The TTAS had good validity in predicting patient outcomes and ED resource utilisation in a tertiary hospital in mainland China. Compared with the performance of the TTAS in Taiwan, our results suggest that the TTAS can usefully be applied outside of Taiwan.