Articles: emergency-department.
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Southern medical journal · Jun 2022
Association of Referral Source and Substance Use with Hepatitis C Virus Outcomes at a Southern Academic Medical Center.
Therapeutic advances make the cure of chronic hepatitis C virus (HCV) infection achievable for individuals aware of their diagnosis who can access care. Identifying barriers to accessing care is critical to achieve population-level HCV elimination and improve the cascade of care from diagnosis to cure. ⋯ Active substance use, mental health disease, and referral from an emergency department or obstetrics-gynecology provider were associated with a lower odds of presenting for evaluation and initiation of HCV treatment. Innovative models to improve access to care and increase outreach to vulnerable populations will be essential to eliminate HCV.
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Pediatric emergency care · Jun 2022
Use of Outpatient Opioids Prescribed From a Pediatric Acute Care Setting.
Deaths due to prescription opioid overdoses are at record high levels. Limiting the amount of opioid prescribed has been suggested as a prevention strategy, but little is known about how much is needed to adequately treat acutely painful conditions for outpatients. The purpose of this study was to quantify the usage of opioids prescribed from the pediatric emergency departments of a Midwestern tertiary care children's hospital system. ⋯ Prescribed opioid doses exceeded used doses by a factor of 6. Lower extremity fractures required more doses than other acutely painful conditions. We should consider limiting doses prescribed to decrease excess opioids available for misuse and abuse.
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Pediatric emergency care · Jun 2022
External Validation of the PediBIRN Screening Tool for Abusive Head Trauma in Pediatric Emergency Department Settings.
We conducted a retrospective, secondary analysis of an existing, deidentified, prospective data set captured to derive a bruising CDR. Subjects were patients under 3 years with bruising and confirmed acute head trauma. An expert medical panel had previously identified patients with AHT. Measures of the CDR's AHT screening performance (sensitivity, specificity, likelihood ratios) were calculated with 95% confidence intervals (CIs). ⋯ The PediBIRN 4-variable CDR demonstrated AHT screening sensitivity in the pediatric ED equivalent to pediatric intensive care unit and other inpatient settings, but lower specificity. Further study of a simplified 3-variable PediBIRN AHT screening tool for the ED setting is warranted.
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During a multiple-casualty incident, a large casualty caseload adversely affects the quality of care given to patients. From a trauma care perspective, the goal of the hospital emergency department plan is to simultaneously provide severely injured patients with a standard of care that approximates the care given to similar patients under normal conditions. This study highlights the barriers and challenges associated with implementing the emergency plans at the Nasser Medical Complex, Gaza Strip, occupied Palestinian territory, during a multiple-casualty incident, with the aim of facilitating appropriate staff training to address any deficiencies identified. ⋯ None.
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Community-acquired pneumonia (CAP) is one of the most common infectious diseases and is an important cause of mortality and morbidity worldwide. Appropriate management of CAP includes accurate assessment of disease severity at the time of admission, to indicate the optimal intervention. This clinical audit aimed to evaluate the severity assessment and management of patients who presented with CAP to the emergency department at Nasser Hospital, Khan Younis, Gaza Strip, occupied Palestinian territory. ⋯ None.