Articles: emergency-department.
-
Antipsychotic and sedative combinations are commonly used for treating agitation in the emergency department despite limited evidence regarding their comparative safety and efficacy. ⋯ Both the B52 and 52 combinations infrequently required repeat agitation medication; however, the B52 combination resulted in more oxygen desaturation, hypotension, physical restraint use, and longer length of stay.
-
Escalation of care is the timely recognition and communication of deterioration in a previously stable patient. Delays in escalating care may lead to unnecessary patient morbidity and mortality. There is currently a paucity of synthesis of work focused on the initiation of escalation of care in the emergency department (ED), where unique challenges may be present. We sought to complete a scoping review to investigate: (1) factors (barriers and/or facilitators) affecting clinicians in escalating care in the ED; and (2) tools that support clinicians in ED escalation of care processes. ⋯ This scoping review identified 13 studies that contained information on processes, factors influencing and/or tools used to facilitate escalation of care in the ED. They may serve as valuable starting points for ED clinicians and administrators who are building or reforming local escalation of care processes.
-
Observational Study
Retrospective single-centre descriptive study of the characteristics, management and outcomes of adult patients with suspected sepsis in the emergency department.
Guidelines for adults presenting to the emergency department (ED) with suspected sepsis recommend protocols and bundles that promote rapid and potentially intensive treatment, but give little consideration of how patient characteristics, such as age, functional status and comorbidities, might influence management. This study aimed to describe the characteristics, management and outcomes of adults attending the ED with suspected sepsis, and specifically describe the prevalence of comorbidities, functional impairment and escalations of care. ⋯ Adults with suspected sepsis have substantial functional limitations, comorbidities and treatment directives that should be considered in guidelines, especially recommendations for escalation of care.