Articles: emergency-services.
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While use of point-of-care ultrasound (POCUS) has become widespread in emergency medicine, its adoption and usage among emergency clinicians is variable. In this study, we explored the barriers and facilitators to POCUS use among emergency medicine clinicians in a tertiary care emergency department in the United States by clinical role and perceived usability of POCUS. ⋯ Participants reported that POCUS facilitates patient disposition and clinical supervision enhances its use. Early POCUS education in professional school and continued POCUS training in clinical practice could facilitate POCUS use clinically. Structured POCUS courses and continued medical education programs may provide protected time to learn and practice POCUS. Moreover, accessible and standardized machines in the clinical environment could improve POCUS usage.
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To evaluate for increases in the use and costs of respiratory viral testing in pediatric emergency departments (EDs) because of the COVID-19 pandemic. ⋯ Respiratory testing and associated costs increased during the COVID-19 pandemic and were sustained despite decreasing incidence of disease. These findings highlight a need for further efforts to clarify indications for viral testing in the ED and efforts to reduce low-value testing.
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Emerg Med Australas · Feb 2025
SAFE: Safety of procedural sedation and analgesia administration in the fast-track area of the emergency department.
To determine whether undertaking procedural sedation in the low-acuity fast-track area is safe and effective in improving patient flow. ⋯ The sedation of patients outside a high-acuity area is safe and significantly improves patient flow.
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Emerg Med Australas · Feb 2025
Comparative StudyComparison of mechanical restraint use in a metropolitan ED after system change: A before and after analysis.
Prior to 2020, Nepean ED had high rates of restraint of mental health (MH) patients compared to peer hospitals. Restraint can cause emotional and physical trauma to patients and staff and should be used as seldom as possible. The ED undertook a project to reduce the number and duration of restraint episodes, involving telepsychiatry, culture change, staff education, increasing use of sedation and bedside engagement in de-escalation techniques. ⋯ After a year of change implementation, there was a reduction in the use of restraints and an increase in the use of sedation in 2021 when compared to 2019.
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Early recognition of sepsis is essential for timely initiation of adequate care. However, this is challenging as signs and symptoms may be absent or nonspecific. The cascade of events leading to organ failure in sepsis is characterized by immune-metabolic alterations. Volatile organic compounds (VOCs) are metabolic byproducts released in expired air. We hypothesize that measuring the VOC profile using electronic nose technology (eNose) could improve early recognition of sepsis. ⋯ The study is embedded in the Acutelines data-biobank (www.acutelines.nl), registered in Clinicaltrials.gov (NCT04615065).