Articles: emergency-services.
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Observational Study
Effect of access block on emergency department crowding calculated by NEDOCS score.
Emergency department (ED) crowding poses a significant challenge in healthcare systems globally, leading to delays in patient care and threatening public health and staff well-being. Access block, characterized by delays in admitting patients awaiting hospitalization, is a primary contributor to ED overcrowding. To address this issue, the National Emergency Department Overcrowding Study (NEDOCS) score provides an objective framework for assessing ED crowding severity. This study aims to evaluate the impact of access block on ED crowding using the NEDOCS score and to explore strategies for mitigating overcrowding through scenarios over a 39-day period. ⋯ Although ED crowding is a multifactorial problem, our study has shown that access block contribute significantly to this problem. The study emphasizes that eliminating access block through timely admissions could substantially alleviate crowding, highlighting the importance of addressing this issue to enhance ED efficiency and overall healthcare delivery.
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This study aims to assess the outcome of challenging documented moderate, severe, or unknown beta-lactam allergies with full dose administration of a beta-lactam antibiotic in emergency department (ED) patients admitted for acute bacterial infection. ⋯ This study suggests that full-dose challenge of moderate, severe, or unknown beta-lactam allergies can be safely accomplished in the ED. This approach avoids unnecessary penicillin allergy skin testing and reduces utilization of suboptimal alternative antibiotic regimens.
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Observational Study
Neutrophil-to-lymphocyte ratio as a predictor for outcomes in patients with short-term emergency department revisits.
Analysis of short-term emergency department (ED) revisits is a common emergency care quality assurance practice. Previous studies have explored various risk factors of ED revisits; however, laboratory data were usually omitted. This study aimed to evaluate the prognostic significance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), and systemic immune-inflammation index (SII) in predicting outcomes of patients revisiting the ED. ⋯ The intensity of the inflammatory response expressed by NLR was an independent predictor for poor outcomes of ED revisits and should be considered when ED revisits occur. Future prediction models for ED revisit outcomes can include revisit-NLR as a potential predictor to reflect the progressive conditions in ED patients.
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Observational Study
Concordance Between Electronic Health Record-Recorded Race and Ethnicity and Patient Report in Emergency Department Patients.
We assessed the concordance of patient-reported race and ethnicity for emergency department (ED) patients compared with what was recorded in the electronic health record. ⋯ Documentation discordance regarding race and ethnicity exists between electronic health records and self-reported data for our ED patients, particularly for ethnically Hispanic and Latino/a patients. Future efforts should focus on ensuring that demographic information in the electronic health record is accurately collected.
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Emerg Med Australas · Aug 2024
A cohort profile of children and adolescents who had a suicide-related contact with police or paramedics in Queensland (Australia).
Suicide is a leading cause of death in children and adolescents worldwide and a major public health concern. While suicidal behaviours place a significant demand on mental health and emergency services, data regarding suicide-related contacts with police and paramedics are an underutilised resource. The aim of the present study was to identify the demographic profile of young individuals (aged 5-17) and had a suicide-related contact with police or paramedics in Queensland (Australia). ⋯ Findings provide a comprehensive profile of children and adolescents in suicidal crisis and highlight the substantial number of interactions that occur with police and paramedics. Due to the way the linked dataset was constructed, it must be assumed that the number of young persons in suicidal crisis is higher. Findings highlight the value of considering pre-hospital alternatives to presenting to emergency departments (EDs) for this cohort, to reduce impost on EDs and improve outcomes. Further examination of re-presentations by young persons is warranted to inform prevention and intervention strategies.