Articles: emergency-department.
-
Pediatric emergency care · Dec 2024
The Last Straw: Trends in Straw-Related Emergency Department Visits.
With the recent societal push for eco-sustainability, there has been an increase in the prevalence of reusable utensils, particularly multiuse straws. This study is the first to investigate the epidemiology of plastic, glass, and metal straw-related injuries (SRIs) presenting to the emergency department (ED). ⋯ Although most injuries occurred as accidental poking while drinking, nearly half of all injuries were sustained while using straws in an off-label manner. Ensuring the proper use of straws and monitoring children when using a straw may help to decrease the incidence of SRI. Among the options for environmentally friendly straw materials, metal straws pose the greatest risk for injuries requiring ED presentation. Thus, their use should be avoided in the pediatric population.
-
Wien. Klin. Wochenschr. · Dec 2024
ReviewEmergency critical care: closing the gap between onset of critical illness and intensive care unit admission.
Critical illness is an exquisitely time-sensitive condition and follows a disease continuum, which always starts before admission to the intensive care unit (ICU), in the majority of cases even before hospital admission. Reflecting the common practice in many healthcare systems that critical care is mainly provided in the confined areas of an ICU, any delay in ICU admission of critically ill patients is associated with increased morbidity and mortality. However, if appropriate critical care interventions are provided before ICU admission, this association is not observed. ⋯ Emergency critical care is delivered whenever and wherever critical illness occurs such as in the pre-hospital setting, before and during inter-hospital transfers of critically ill patients, in the emergency department, in the operating theatres, and on hospital wards. By closing the management gap between onset of critical illness and ICU admission, emergency critical care improves patient safety and can avoid early deaths, reverse mild-to-moderate critical illness, avoid ICU admission, attenuate the severity of organ dysfunction, shorten ICU length of stay, and reduce short- and long-term mortality of critically ill patients. Future research is needed to identify effective models to implement emergency critical care systems in different healthcare systems.
-
Journal of women's health · Dec 2024
Postpartum Emergency Care Visits Among North Carolina Medicaid Beneficiaries, 2013-2019.
Objective: To describe the rate, timing, and primary diagnosis codes for emergency care visits up to 8 weeks (56 days) after live birth among Medicaid beneficiaries in North Carolina (NC). Materials and Methods: Using a linked dataset of Medicaid hospital claims and certificates of live birth, which included Medicaid beneficiaries who had a live-born infant in NC between January 1, 2013, and November 4, 2019, and met inclusion criteria (n = 321,879), we estimated week-specific visit rates for emergency care visits that did not result in hospital admission (outpatient) and those that did (inpatient). We assessed the 10 leading diagnosis code categories for emergency care visits and described the characteristics of people with 0, 1, or ≥2 outpatient emergency care visits. ⋯ Respiratory concerns and gastrointestinal concerns were the two leading diagnosis code categories for inpatient emergency care visits. Compared with those with zero outpatient emergency care visits, a greater proportion of people with ≥2 visits had less than a high school education, used tobacco during pregnancy, had Medicaid insurance outside of pregnancy, had mental health as a medical comorbidity, and/or had ≥2 medical comorbidities. Conclusions: These findings support scheduling health care visits early in the postpartum period, when emergency care visits are most frequent, and point to unmet needs for substance use support.
-
Preventive medicine · Dec 2024
Multicenter StudyFirearm violence and associated factors among young adults presenting to emergency departments in three cities: Baseline results from Project SPARK.
Recent shifts in U.S. violence dynamics call for updated violence epidemiology among general emergency department (ED) samples of young adults. Using baseline data from a multi-site longitudinal study of firearm violence prediction, we describe violence rates and associated factors. ⋯ Violence, including firearm assault, is common among young adults entering urban EDs, and is associated with several psychosocial factors. High rates of substance use and mental health symptoms underscore this as a high-need population. Leveraging this information could help tailor interventions and optimize resource allocation.
-
Observational Study
Safety of Diltiazem for Acute Management of Atrial Fibrillation (AF) in Patients with Heart Failure and Reduced Ejection Fraction in the Emergency Department.
Diltiazem is an effective rate control agent for atrial fibrillation with rapid ventricular rate (AF RVR). However, its negative inotropic effects may increase the risk for worsening heart failure in patients with a reduced ejection fraction (EF). ⋯ The development of worsening heart failure is multifactorial and may include the use of diltiazem in critically ill patients requiring hospital admission.