Articles: emergency-department.
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Eur. J. Intern. Med. · May 2017
Multicenter Study Observational StudyThe effect of a short-stay unit on hospital admission and length of stay in acute heart failure: REDUCE-AHF study.
To determine whether the presence of a short-stay unit(SSU) in a hospital influences the percentage of admissions, length of hospital stay(LOS) and outcomes in emergency department(ED) patients with acute heart failure(AHF). ⋯ The data suggest that SSU may improve the safety of emergency care of patients with AHF, but at the cost of a higher rate of hospital admissions, and it may also reduce the LOS for admitted patients without affecting post discharge safety.
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Multicenter Study Observational Study
Predicting morphine related side effects in the emergency department: An international cohort study.
Morphine is the reference treatment for severe acute pain in an emergency department. The purpose of this study was to describe and analyse opioid-related ADRs (adverse drug reactions) in a large cohort of emergency department patients, and to identify predictive factors for those ADRs. ⋯ Serious morphine related ADRs are rare and unpredictable. Prophylactic antiemetic therapy could be proposed to patients with history of travel sickness and history of nausea or vomiting in a postoperative setting or after morphine administration.
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Multicenter Study
Epinephrine Use in Older Patients with Anaphylaxis: Clinical Outcomes and Cardiovascular Complications.
There is little data describing the differences in epinephrine (epi) administration and cardiac complications among older and younger patients with anaphylaxis. ⋯ Older patients with anaphylaxis were less likely to receive epi injection. Intramuscular epi appears safe in this population; however, the use of intravenous epi should be avoided in older patients due to the potential of developing serious cardiac complications.
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Multicenter Study Observational Study
Prospective and Explicit Clinical Validation of the Ottawa Heart Failure Risk Scale, With and Without Use of Quantitative NT-proBNP.
We previously developed the Ottawa Heart Failure Risk Scale (OHFRS) to assist with disposition decisions for acute heart failure patients in the emergency department (ED). We sought to prospectively evaluate the accuracy, acceptability, and potential impact of OHFRS. ⋯ Prospective clinical validation found the OHFRS tool to be highly sensitive for SAEs in acute heart failure patients, albeit with an increase in admission rates. When available, NT-proBNP values further improve sensitivity. With adequate physician training, OHFRS should help improve and standardize admission practices, diminishing both unnecessary admissions for low-risk patients and unsafe discharge decisions for high-risk patients.
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Multicenter Study Observational Study
An Observational Study of Dyspnoea in Emergency Departments: The Asia, Australia, and New Zealand Dyspnoea in Emergency Departments Study (AANZDEM).
The objective was to describe the epidemiology of dyspnea presenting to emergency departments (EDs) in the Asia-Pacific region, to understand how it is investigated and treated and its outcome. ⋯ Dyspnea is a common symptom in ED patients contributing substantially to ED, hospital, and ICU workload. It is also associated with significant mortality. There are a wide variety of causes however chronic disease accounts for a large proportion.