Articles: emergency-department.
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Multicenter Study
Mortality in Spanish pediatric emergency departments: a 5-year multicenter survey.
Analysis of the causes of death in children in the pediatric emergency department (ED) may aid the development of management and prevention practices. ⋯ The main causes of death in Spanish pediatric EDs are related to previous illnesses, sudden infant death syndrome, and nonintentional lesions. Several actions have to be considered to improve the quality of care of these children in prehospital and emergency settings.
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Multicenter Study Observational Study
Multicenter prevalence of opioid medication use as abortive therapy in the emergency department treatment of migraine headaches.
Despite a range of therapeutic options for treating acute migraine headaches, the use of opioids is still reported to be common practice. This study describes treatment practices in regards to migraines in the ED. It characterizes the prevalence of opioid orders during visits in three different settings, an academic medical center, a non-academic urban ED, and a community ED. ⋯ In the face of evidence against opioids for migraines, over one third of patients received them. There was a higher prevalence in the community setting. There were no significant benefits in overall throughput time, however, opioid visits required more rescue medications, increased length of stay, and resulted in more repeat visits.
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Emerg Med Australas · Dec 2017
Multicenter StudyDo all adult orthopaedic injuries seen in emergency departments need to attend fracture clinic? A Queensland multicentred review.
Musculoskeletal injuries account for a significant proportion of ED presentations annually, with a large percentage being referred to the fracture clinic (FC). A literature review found that many referrals could be safely managed outside the traditional model of care. The present study aims to review all adult presentations to FCs at two Queensland metropolitan hospitals, finding low-risk injuries that can safely and appropriately be managed by their general practitioner (GP) or allied health professionals (AHPs), potentially affording significant savings to the health system. ⋯ Adopting the PCP could potentially reduce fracture clinic referrals by 40%. Having a structured pathway has the potential to empower primary health professionals, which could result in a more streamlined process that aids in significant time and financial savings and maintains good patient satisfaction and outcomes.
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Multicenter Study Observational Study
Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out-of-Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS-KANTO [Survey of Survivors after Out-of-Hospital Cardiac Arrest in Kanto Area] 2012 Study).
Mechanical cardiopulmonary resuscitation (mCPR) for patients with out-of-hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes. ⋯ After accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out-of-hospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients.
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Emerg Med Australas · Oct 2017
Multicenter StudyEmergency airway management in Australian and New Zealand emergency departments: A multicentre descriptive study of 3710 emergency intubations.
The aim of this study was to describe the practice of endotracheal intubation across a range of Australasian EDs. ⋯ Australasian ED doctors, predominantly specialist emergency physicians or trainees, perform the majority of ED intubations using rapid sequence induction as their preferred technique mainly for medical indications. First attempt success rate was not different between different types of EDs, and is comparable published international data. Complications are not infrequent, and are comparable to other published series. Monitoring and reporting of ED intubation practice will enable continued improvements in the safety of this high-risk procedure.