Articles: emergency-services.
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Journal of critical care · Dec 2017
Multicenter Study Observational StudyClinical predictors of early death from sepsis.
Patients with severe sepsis who experience rapid, early deterioration and death are of particular concern. Our objective was to identify predictors of early death in Emergency Department (ED) patients with severe sepsis. ⋯ Initial serum lactate and mSOFA score were independent predictors of mortality within 24h of ED admission in patients with severe sepsis.
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Multicenter Study
Predicting 30-Day Mortality for Patients With Acute Heart Failure in the Emergency Department: A Cohort Study.
Physicians in the emergency department (ED) need additional tools to stratify patients with acute heart failure (AHF) according to risk. ⋯ Instituto de Salud Carlos III, Spanish Ministry of Health; Fundació La Marató de TV3; and Catalonia Govern.
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Multicenter Study
Rate-control with beta-blockers versus calcium-channel blockers in the emergency setting: predictors of medication class choice and associated hospitalization.
Rate control is an important component of the management of patients with atrial fibrillation (AF). Previous studies of emergency department (ED) rate control have been limited by relatively small sample sizes. We examined the use of beta-blockers (BBs) versus nondihydropyridine calcium channel blockers (CCBs) in ED patients from 24 sites and the associated hospital admission rates. ⋯ In this study of 24 EDs, CCBs were used more frequently for rate control than BBs, and complications were rare and easily managed using both agents. Variation between hospitals in BB versus CCB use was predominantly due to hospital characteristics such as teaching status and AF volumes, rather than different case mix. Among patients who did not receive attempts at rhythm control, use of a BB for rate control was associated with a lower rate of hospitalization.
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Multicenter Study
Pain management of acute appendicitis in Canadian pediatric emergency departments.
Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). ⋯ Suboptimal and delayed analgesia remains a significant issue for children with suspected appendicitis in Canadian PEDs. This suggests a role for multidimensional knowledge translation interventions and care protocols to improve timely access to analgesia.
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In South Korea, injury is a public health problem due to its high incidence and high mortality. To improve emergency medical systems, the government announced plans to increase the emergency medical resources for each region. This study investigated the association between regional emergency medical resources and mortality during hospitalization in severely injured inpatients. ⋯ Our findings suggest that regional emergency medical resources are associated with a lower risk of mortality during hospitalization in severely injured patients. Thus, health care policymakers need to determine the proper distribution of emergency medical resources for each region and the function of emergency departments to provide a superior quality of emergency medical services to patients.