Articles: emergency-department.
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Pediatric emergency care · Nov 2024
Observational StudyDisparities in Adherence to Pediatric Diabetic Ketoacidosis Management Guidelines Across a Spectrum of Emergency Departments in the State of Indiana: An Observational In Situ Simulation-Based Study.
Diabetic ketoacidosis (DKA) is a common presentation to an emergency department (ED), with the majority presenting to community EDs. Adherence to clinical guidelines in these EDs can reduce morbidity and mortality. Few methods to describe practice gaps for DKA management have been reported. ⋯ Using validated in situ simulation; we revealed high variability in adherence to the pediatric DKA management guidelines at a wide range of community EDs. A statewide education initiative focused on decreasing variation and improving adherence to pediatric DKA guidelines is necessary for patient safety.
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Pediatric emergency care · Nov 2024
Multicenter StudyThe Use of Point-of-Care Ultrasound in Pediatric Emergency Departments and Intensive Care Units: A Descriptive Study From Turkey.
The aim was to evaluate the current status of point-of-care ultrasound (POCUS), perceptions, education, training, and barriers to using POCUS in pediatric emergency departments (PEDs) and pediatric intensive care units (PICUs) in Turkey. ⋯ Most participants were aware of the need for POCUS. However, lack of education, equipment, manpower, and infrastructure still emerged as barriers to the use of POCUS. To further promote POCUS use, it would be helpful to improve accessibility by ensuring sufficient numbers of ultrasound devices together with sufficient numbers of appointed physicians and by expanding POCUS education in PEDs and PICUs.
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Multicenter Study Observational Study
Development and validation of a nomogram for assessing comorbidity and frailty in triage: a multicentre observational study.
Assessing patient frailty in the Emergency Department (ED) is crucial; however, triage frailty and comorbidity assessment scores developed in recent years are unsatisfactory. The underlying causes of this phenomenon could reside in the nature of the tools used, which were not designed specifically for the emergency context and, thus, are difficult to adapt to the emergency environment. The objective of this study was to create and internally validate a nomogram for identifying different levels of patient frailty during triage. ⋯ The internal validation of the nomogram reported an area under the receiver operating characteristic of 0.91 (95% CI 0.884-0.937). A nomogram was created for assessing comorbidity and frailty during triage and was demonstrated to be capable of determining comorbidity and frailty in the ED setting. Integrating a tool capable of identifying frail patients at the first triage assessment could improve patient stratification.
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Observational Study
Clinico-epidemiological profile & outcome of patients presenting with cerebral venous thrombosis to emergency department.
To better understand the clinical and radiological characteristics of Cerebral Venous Thrombosis (CVT), we conducted a study focusing on the assessment of neurological outcomes and factors associated with poor prognosis in patients with CVT. ⋯ Our study underscores the importance of recognizing cardinal symptoms and diverse risk factors of CVT, including alcoholism and anemia. Majority of CVT occurrences were observed in males aged 18-29. Critical determinants of heightened morbidity and mortality were identified, including lower GCS scores and the necessity for advanced interventions. Notably, majority of patients presented favorable neurological outcomes at six-week follow-up.