Articles: emergency-services.
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BMC emergency medicine · Oct 2018
Multicenter StudyPrior CT imaging history for patients who undergo whole-body CT for acute traumatic injury and are discharged home from the emergency department.
Recurrent CT imaging is believed to significantly increase lifetime malignancy risk. We previously reported that high acuity, admitted trauma patients who received a whole-body CT in the emergency department (ED) had a history of prior CT imaging in 14% of cases. The primary objective of this study was to determine the CT imaging history for trauma patients who received a whole-body CT but were ultimately deemed safe for discharge directly home from the ED. ⋯ We found a positive history for prior CT for 25% of trauma patients who received whole-body CT scan but were discharged from the ED to home.
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Multicenter Study
Impact of Electronic Physician Order-Set on Antibiotic Ordering Time in Septic Patients in the Emergency Department.
Sepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outcomes and reduce mortality. ⋯ Utilization of the order-set was associated with a potentially clinically significant, but not statistically significant, reduced time to antibiotic ordering in patients with sepsis. Electronic order-sets are a promising tool to assist hospitals with meeting the Centers for Medicare and Medicaid Services core measure.
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Multicenter Study Observational Study
Are testers also admitters? Comparing emergency physician resource utilization and admitting practices.
To describe the relationship between emergency department resource utilization and admission rate at the level of the individual physician. ⋯ In a two-facility study, emergency physician resource utilization and admission rate were positively correlated: those who used more ED resources also tended to admit more patients. These results add to a growing understanding of emergency physician variability.
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Eur J Trauma Emerg Surg · Oct 2018
Multicenter Study Observational StudyDiagnostics and early treatment in prehospital and emergency-room phase in suspicious pelvic ring fractures.
Testing for mechanical stability in pelvic ring fractures is advocated for the initial assessment and management of pelvic ring fractures. A survey among trauma surgeons showed that 91% agree with this recommendation. The aim of the present study was to describe the actual workup of patients with a high risk for unstable pelvic fractures in daily routine. ⋯ Testing of mechanical stability of the pelvic ring was carried out less often and with lower consequences for the actual management than expected. It seems worthwhile to rather put on a pelvic binder at earliest occasion based on trauma mechanism or clinical findings to reduce the risk of serious pelvic bleeding.
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Pediatric emergency care · Oct 2018
Multicenter StudySingle-Use Detergent Sacs: A Retrospective Multicenter Canadian Review of Emergency Department Cases.
Single-use detergent sacs (SUDS) are widely used in North America and Europe with emerging literature on their toxicity. This is the first Canadian multicenter study aimed to quantify and compare SUDS exposures to traditional detergent exposures. ⋯ This multicenter study is the first to establish the incidence of SUDS and traditional detergent exposure in 3 Canadian cities. Overall, the frequency of exposure to detergents-both traditional and SUDS-is very low. Given the increase in SUDS exposure seen from 2011 to 2013, alongside larger sales of SUDS, continued efforts are required to monitor exposures, and reduce potential exposures to SUDS and traditional detergents in the future.