Articles: emergency-medicine.
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Emerg Med Australas · Apr 2023
Prolonged length of stay is associated with reduced hand hygiene compliance in the emergency department: A single centre retrospective study.
To examine whether patient flow factors in the ED such as prolonged length of stay are associated with hand hygiene (HH) compliance. ⋯ The findings show that prolonged ED length of stay may explain, at least partly, lower rates of HH compliance. Improvements in ED HH compliance should also include strategies that enhance patient flow.
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There currently exists no standard productivity measure for emergency physicians. The objectives of this scoping review were to synthesize the literature to identify components of definitions and measurements of emergency physician productivity and to evaluate factors associated with productivity. ⋯ Emergency physician productivity is heterogeneously defined, but includes common elements such as patient volume, complexity, and processing time. Commonly reported productivity metrics include patients per hour and relative value units that incorporate patient volume and complexity, respectively. The findings of this scoping review can guide ED physicians and administrators to measure the impact of QI initiatives, promote efficient patient care, and optimize physician staffing.
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Use of acute care telemedicine is growing, but data on quality, utilization, and cost are limited. We evaluated a Veterans Affairs (VA) tele-emergency care (tele-EC) pilot aimed at reducing reliance on out-of-network (OON) emergency department (ED) care, a growing portion of VA spending. With this service, an emergency physician virtually evaluated selected Veterans calling a nurse triage line. ⋯ Among Veterans initially advised to seek care within 24 h, use of tele-EC compared to standard phone triage led to decreased ED visits, hospitalizations, and OON spending within 7 days.
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While narrow complex tachycardia (NCT) is a common presentation to the emergency department (ED), little is known about its incidence in the ED or about emergency physician expertise in its diagnosis and management. We sought to compare cases of NCT due to primary arrhythmias to those with a rapid heart rate secondary to a medical issue, as well as to determine the accuracy of ED physician diagnosis and appropriateness of treatment. ⋯ NCT was found in 0.8% of all ED visits, with more being primary NCT. ED physicians correctly interpreted 86.6% of ECGs but had difficulty differentiating atrial flutter and SVT. They implemented appropriate care in most cases but sometimes failed to adequately control heart rate or to treat the underlying condition, suggesting opportunities to improve care of NCT in the ED.
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JNMA J Nepal Med Assoc · Apr 2023
Mean Serum Lactate Levels in Patients with Sepsis Presenting to the Department of Emergency Medicine of a Tertiary Care Center: A Descriptive Cross-sectional Study.
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Serum lactate is useful in predicting the prognosis of critically ill patients. Elevated blood lactate levels as well as delayed clearance have been linked to higher mortality in sepsis. Shock index is a simple and effective bedside assessment means of gauging the degree of shock and is an important predictor of identifying high-risk patients. Monitoring lactate levels may aid clinicians in understanding tissue perfusion and detecting unrecognized shock and making prompt therapy adjustments. This study aimed to find out the mean serum lactate levels in patients with sepsis presenting to the Department of Emergency Medicine of a tertiary care centre. ⋯ emergencies; lactate; sepsis.