Articles: emergency-department.
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The National Early Warning Score (NEWS), Quick Sequential Organ Failure Assessment (qSOFA), and modified qSOFA (MqSOFA) are scoring systems that rely on vital signs. However, NEWS is time-consuming, qSOFA has low sensitivity, and MqSOFA includes a difficult calculation. To address these issues, we developed the Revised qSOFA score (RqSOFA) that consists of percutaneous oxygen saturation, oxygen usage, Simple Shock Index, and the parameters of qSOFA. ⋯ RqSOFA exhibited the same sensitivity and better specificity compared to NEWS. There were no differences in sensitivity and specificity between RqSOFA and MqSOFA. In conclusion, RqSOFA exhibited superior predictability for in-hospital mortality to qSOFA and NEWS, while offering similar predictability to MqSOFA despite relying only on simple measurements.
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Observational Study
The Impact of Point-of-Care Ultrasound on the Diagnosis and Management of Small Bowel Obstruction in the Emergency Department: A Retrospective Observational Single-Center Study.
Background and Objectives: Small bowel obstruction (SBO) requires prompt diagnosis and management. Due to its advantages, POCUS can be beneficial when assessing SBO. However, it is still doubtful whether POCUS performed by an emergency doctor can prolong the time of patients with SBO in the emergency department (ED). ⋯ Five non-POCUS patients died during hospitalization; none died in the POCUS group, but the difference was not statistically significant (p = 0.063). Conclusions: POCUS significantly reduced time to diagnosis and ED LOS. Further exploration is needed to assess long-term outcomes and the cost-effectiveness of integrating POCUS into ED practice.
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To investigate the association between patient-to-physician ratios, a measure of physician workload, and various patient outcomes in the emergency department (ED). ⋯ Higher patient-to-physician ratios are associated with worse outcomes for ED patients. Our findings suggest that maintaining ratios below 10 may be ideal for optimizing care quality, while ratios exceeding 20 pose significant risks to patients.
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The Centers for Disease Control and Prevention sexually transmitted infection (STI) treatment guidelines state that the decision to provide STI/human immunodeficiency virus (HIV) testing and presumptive treatment after sexual assault (SA) should be made on an individual basis to minimize retraumatization of the patient. However, little is known about STI screening, presumptive treatment, and positivity in the emergency department (ED) setting. The objective of this study was to evaluate STI testing rates and positivity, presumptive gonorrhea and chlamydia treatment, pregnancy testing, and emergency contraception offered to SA survivors in the ED in the United States. ⋯ Low STI testing and treatment rates and high STI positivity identified in this study suggest that an important opportunity exists for improving STI screening and presumptive treatment for female patients presenting to the ED after SA.