Articles: emergency-department.
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Eur. J. Intern. Med. · Sep 2019
Randomized Controlled Trial Multicenter StudyHereditary angioedema, emergency management of attacks by a call center.
Hereditary angiœdema (HAE) is a rare autosomal dominant disease characterized by recurrent, unpredictable, potentially life-threatening swelling. Objective is to assess the management of the acute HAE attacks in the real life setting through a call center in France. ⋯ Use of emergency departments and hospitalizations are reduced by the use of a coordinated national call center in HAE after therapeutic education program that promoted self-administration of specific treatment and use of call to call center.
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Emerg Med Australas · Aug 2019
Multicenter Study Observational StudyAccuracy of clinician gestalt in diagnosing appendicitis in children presenting to the emergency department.
Abdominal pain is a common paediatric presentation to the ED. Accurate diagnosis of acute appendicitis is challenging, with the best-performing clinical scoring systems having sensitivities between 72% and 100%. The aim of this study is to assess the diagnostic accuracy of clinician gestalt according to seniority in diagnosing paediatric acute appendicitis in ED. ⋯ The diagnostic accuracy of ED clinician gestalt in paediatric appendicitis is comparable to current clinical scoring systems irrespective of seniority.
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Presentation rates to Emergency Departments (ED) for people with mental health, drug health and behavioural problems are increasing. This necessitates a reorientation of health services and resources to meet this change in demand. ⋯ Implementing new models of care that require a change in thinking and practice can challenge power relations which subsequently impact on individual willingness to support proposed change. Therefore, even with demonstrated effectiveness, extensive consultation and high level support the cooperation of key local stakeholders is not always assured.
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Multicenter Study
Outcomes and emergency medical services resource utilization among patients with syncope arriving to the emergency department by ambulance.
Syncope accounts for 1% of emergency department (ED) visits, yet few experience a serious adverse event (SAE). Two-thirds of syncope patients are transported to the ED by ambulance, placing considerable burden on emergency medical services (EMS), and many of these transports may be unnecessary. We estimated the proportion of syncope patients who fell into a low-risk category based on an ED diagnosis of vasovagal syncope and the absence of EMS intervention, hospitalization, or SAE. ⋯ About 40% of patients transported to the ED by ambulance are at low risk and may not benefit from paramedic care or transport to a hospital. A robust clinical decision tool would help identify patients safe for treat-and-release, diversion to alternative care, or rapid offload into low-acuity ED areas, potentially reducing EMS workload and cost.
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Multicenter Study
Emergency clinician perceptions of occupational stressors and coping strategies: A multi-site study.
Research exploring multi-disciplinary emergency department (ED) clinicians' perceptions of their working environment is limited, although exposure to occupational stressors is frequent. This study describes ED clinicians' perceptions of their working environment, occupational stressors and their use of coping strategies. ⋯ While stressors were similarly rated among the diverse group of clinicians, the ways in which they reported coping varied. Further research is required to facilitate design of staff support strategies.