Articles: emergency-department.
-
Elderly patients often have atypical clinical presentations. Lactate measurement on arrival at the Emergency Department (ED) could be useful to identify elderly patients with a bad prognosis. ⋯ Serum lactate measured at ED arrival has a significant and exponential relationship with inhospital mortality and ICU admission in elderly patients.
-
To describe mortality predictive factors in patients 80years or older with infection who were visited at the emergency department and were admitted to hospital. ⋯ qSOFA and SOFA scores, the sepsis and septic shock criteria, as well as frailty are predictive factors of poor prognosis in very elderly patients who come to the emergency room due to infection. Knowing frailty would allow us to adapt the treatment and therapeutic effort to the patient's characteristics.
-
Hospital admission is a significant event in the healthcare trajectory of older adults (age 60 +). Numerous harms such as delirium, falls, and adverse medication events can arise that outweigh the benefits of admission. Little is known about how older adults feel about being hospitalized or what they think admission will achieve for them. These issues are particularly important to understand in socioeconomically disadvantaged patients, who have poor access to outpatient care and higher hospitalization rates. ⋯ Older adults' expectations of hospitalization exceed stabilization of acute illness. Hospital admission of older adults presents an opportunity for shared decision-making and communication about likely outcomes of hospitalization. Incorporating patient-centered outcomes into admission decisions may help align care with older adults' priorities in the ED.
-
Pediatric emergency care · Dec 2024
Understanding Strategies to Reduce the Impact of Non-urgent Visits to the Pediatric Emergency Department: A Scoping Review.
The pediatric emergency department (PED) is increasingly being used for non-urgent reasons. This impacts PED input and throughput, and contributes to overcrowding. To identify solutions, it is essential to identify and describe the approaches that have been trialed. ⋯ Consistent definitions of non-urgent visits and standardized outcome measures may allow for more precise comparisons between studies. We identify 3 commonly employed strategies that may help reduce the impact of non-urgent visits on the PED.
-
skin lacerations are one of the main causes of children's referral to the emergency department (ED). We introduced in our general ED a pediatric sedo-analgesia protocol (SAP) for suturing skin wounds using LAT gel, a local anesthetic solution of lidocaine, adrenaline and tetracaine, with or without low-dose oral midazolam according to patient's age, to improve the experience of laceration repair. ⋯ The introduction of a LAT gel and low-dose oral midazolam SAP allows an improvement of both the sedo-analgesia provided and the ED operators' suturing experience of skin lacerations in children. Our SAP appeared to be safe and effective, with low cost and high tolerability.