Articles: emergency-department.
-
Marked differences have been described between women and men in disease prevalence, clinical presentation, response to treatment and outcomes. However, such data are scarce in the acutely ill. An awareness of differences related to biological sex is essential for the success of clinical care and outcomes in patients presenting with acute dyspnea, the most frequent cause of emergency department (ED) admission. ⋯ Women have better 1-year survival than men after the initial ED presentation for acute dyspnea. Understanding the biological sex-related differences should lead toward precision medicine, and improve clinical decision-making to promote gender equality in health.
-
The COVID-19 pandemic forced emergency departments (EDs) to change operations to minimize nosocomial infection risk. Many EDs cohort patients using provincial screening tools at triage. Despite cohorting, staff exposures occurred in the 'cold zone' due to lack of personal protective equipment (PPE) use with patients deemed low risk, resulting in staff quarantines. The cohorting strategy was perceived to lengthen time to physician initial assessment and ED length of stay times in our ED without protecting staff well enough due to varying PPE use. The objective of this study was to assess the impact of hot/cold zones for patient cohorting during a viral pandemic on ED length of stay. ⋯ Cohorted waiting areas may provide a safety benefit without operational compromise, but cohorting staff and care spaces is likely to compromise efficiency and create delays.
-
This study describes the characteristics of hand trauma treated in community-based emergency centers (CBECs) in Israel. It was hypothesized that the rate of hand trauma, as well as patient and injury characteristics, would differ from a recent study of patients treated in hospital emergency departments (EDs) in Jerusalem. ⋯ A higher rate of hand trauma was found in the CBECs in comparison to the hospital ED report (35% vs. 20% of all trauma patients, respectively). Patients treated at the CBECs, in comparison to the ED, were less often male, less often young adults, and differed in terms of type of injury. In the CBECs there were more contusions, as well as fewer lacerations and open wound injuries. In contrast, dog bites in children were found to be much more prevalent than previously reported. Hospital referral indications, the use of immobilization and pain management were found to vary according to age, gender and treatment center. Due to the high rate of hand trauma in CBECs, specific protocols are needed for these patients. The use of opioids should be specifically addressed, considering recent changes in treatment protocols. Thus, the prevalence and characteristics of hand trauma may be biased in studies based on hospital records.
-
Identification of patients with asthma at increased risk for hospitalization and emergency department (ED) visits presents opportunity for intervention. ⋯ Texas Children's Health Plan asthma risk score stratifies risk of asthma hospitalization and ED visits for Medicaid-insured children. The risk score performs better for children aged 3 to less than 18 years than for those aged 1 to less than 3 years.