Articles: emergency-services.
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Observational Study
The effect of emergency department history on health literacy level and role of digital literacy: An observational study.
In this research, it was aimed to evaluate the effect of emergency department history on health literacy level and the role of digital literacy. A total of 454 participants were subjected to survey including health literacy scale, the digital literacy scale, and the demographic information form. Participants were divided into 2 groups as emergency medicine service (EMS) history (n = 269) and no EMS history (n = 185) groups. ⋯ Digital literacy had significant and positive effect on health literacy for all participants (OR = 0.126; P < .01), no EMS history (OR = 0.059; P < .01) and EMS history group (OR = 0.191; P < .01). People's health literacy skills are positively impacted if they have ever received medical attention from EMS units, regardless of the reason. Furthermore, among those who have used emergency medical services in the past, the impact of digital literacy on health literacy is statistically substantially larger.
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The COVID-19 pandemic led to a decline in emergency department (ED) visits and a subsequent return to baseline pre-pandemic levels. It is unclear if this trend extended to paramedic services and if patient cohorts accessing paramedics changed. We examined trends and associations between paramedic utilization (9-1-1 calls and ED transports) and the COVID-19 timeframe. ⋯ Post-pandemic, 9-1-1-initiated paramedic calls experienced a substantial increase, surpassing pre-pandemic growth rates. ED transports returned to pre-pandemic levels but with a steeper and continuous pattern of growth. The resurgence in paramedic 9-1-1 calls and ED transports post-COVID-19 emphasizes an urgent necessity to expedite development of new care models that address how paramedics respond to 9-1-1 calls and transport to overcrowded EDs.
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Ethnic inequalities in acute health acute care are not well researched. We examined how attendee ethnicity influenced outcomes of emergency care in unselected patients presenting with a gastrointestinal (GI) disorder. ⋯ Significant differences in usage patterns and disparities in acute care outcomes for patients of different ethnicities with GI disorders were observed in this study. These differences persisted after adjustment both for confounders and for measures of deprivation and illness acuity and indicate that minority ethnic individuals are less likely to be investigated or admitted to hospital than White patients.
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Multicenter Study
Prospective evaluation of single-dose aminoglycosides for treatment of complicated cystitis in the emergency department.
Antimicrobial resistance among Enterobacterales continues to be a growing problem, particularly in those with urinary infections. Previous studies have demonstrated safety and efficacy with the use of single-dose aminoglycosides in uncomplicated cystitis. However, data in complicated infections are limited. Single-dose aminoglycosides may provide a convenient alternative for those with or at risk for resistant pathogens causing complicated urinary infections, especially when oral options are unavailable due to resistance, allergy, intolerance, or interactions with other medications. This study evaluated the safety and effectiveness of single-dose aminoglycosides in treatment of complicated cystitis in the emergency department (ED). ⋯ Single-dose aminoglycosides appear to be a reasonably effective and safe treatment for complicated cystitis, which avoided hospital admission in this cohort.
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Critical care clinics · Jul 2024
ReviewCritical Care Delivery in the Emergency Department: Bringing the Intensive Care Unit to the Patient.
Boarding of critically ill patients in the Emergency Department (ED) has increased over the past 20 years, leading hospital systems to explore ED-focused models of critical care delivery. ED-critical care delivery models vary between health systems due to differences in hospital resources and the needs of the critically ill patients boarding in the ED. Three published systems include an ED critical care intensivist consultation model, a hybrid model, and an ED-intensive care unit model. Paraphrasing the Greek philosopher, Plato, "necessity is the mother of invention." This proverb rings true as EDs are facing an increasing challenge of caring for boarding patients, especially those who are critically ill.