Articles: emergency-department.
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Comparative Study
Comparing Intubation Rates in Patients Receiving Parenteral Olanzapine With and Without a Parenteral Benzodiazepine in the Emergency Department.
United States prescribing information recommends against coadministration of injectable olanzapine with injectable benzodiazepines due to a risk of cardiorespiratory depression, whereas European prescribing information recommends the 2 drugs not be administered within 60 minutes of each other. In contrast, a recently published American College of Emergency Physicians clinical policy recommends injectable olanzapine and benzodiazepines be coadministered for treating severe agitation. We sought to compare injectable olanzapine with and without injectable benzodiazepines for evidence of cardiorespiratory depression. ⋯ We found no difference in cardiorespiratory depression between patients receiving only olanzapine versus olanzapine plus a benzodiazepine.
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Emerg Med Australas · Dec 2024
Multicenter StudyIs clinician reported practice in Western Australian emergency departments aligned with direct discharge pathway protocols for minor self-limiting fractures? A multi-centre professional survey.
To determine ED clinician's current management for five common minor self-limiting fractures (MSLF) and evaluate practice against evidence-informed direct discharge pathway (DD) protocols. ⋯ Survey results suggested system wide variation in ED fracture management practice and target areas for service improvement. Avenues for service improvement could include hospital wide agreed management plans for specific fractures and support for less experienced clinicians.
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Delayed intracranial hemorrhage (ICH) after head injury in older patients taking anticoagulants has been reported to be as high as 7.2%. Other studies suggest much lower rates. Its incidence and clinical management are controversial, with some recommending observation and repeat head imaging at 24 h. ⋯ The incidence of delayed ICH is very low in older ED head trauma patients on prescribed pre-injury anticoagulants. Our data have important clinical implications for the management of blunt head trauma among older ED patients on anticoagulants.
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Pediatric emergency care · Dec 2024
Utility of a Smart Device Infrared Camera in Localizing Acute Pediatric Long Bone Fractures: A Pilot Study.
Musculoskeletal injuries are one of the top 10 reasons children present to the emergency department (ED). Infrared thermal imaging (IRT) is a noninvasive and nonradiating imaging modality that can detect subtle temperature differences. IRT may be used to detect the presence of musculoskeletal injury. ⋯ This pilot study shows that the use of smart device infrared camera attachments is feasible and has promising results in fracture localization. This could allow for a decrease in radiographs and be particularly useful in resource-limited areas.
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Pediatric emergency care · Dec 2024
Streamlining Telecommunications Center and Interfacility Patient Throughput to a Pediatric Emergency Department by Utilizing an Electronic Handoff: A Quality Improvement Initiative.
Effective handoffs are critical for patient safety and high-quality care. The pediatric emergency department serves as the initial reception for patients where optimal communication is crucial. The complexities of interfacility handoffs can result in information loss due to lack of standardization. The aim of our project was a 50% reduction in monthly calls routed through the communication center from 157 to 78, for interfacility transfers to the emergency department from outpatient sites within our organization over a 1-year period, through utilization of an electronic handoff activity. ⋯ Our initiative facilitated the safe and efficient transfer of patients and streamlined workflows without sacrificing quality of patient care. Our telecommunications center has been freed up for other tasks with fewer interruptions during patient throughput. Next steps will analyze the encounters of transferred patients to further optimize patient flow at our organization.