Articles: emergency-services.
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Multicenter Study
Development of a Clinical Risk Score to Risk Stratify for a Serious Cause of Vertigo in Patients Presenting to the Emergency Department.
Identify high-risk clinical characteristics for a serious cause of vertigo in patients presenting to the emergency department (ED). ⋯ The Sudbury Vertigo Risk Score identifies the risk of a serious diagnosis as a cause of a patient's vertigo and if validated could assist physicians in guiding further investigation, consultation, and treatment decisions, improving resource utilization and reducing missed diagnoses.
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People who use substances increasingly access healthcare primarily through emergency medical services (EMS) and emergency departments (EDs). To meet the needs of these patients, EMS and EDs have become access points for medications for opioid use disorder (OUD), specifically buprenorphine. This systematic review aimed to quantify the efficacy of these programs, examining retention in treatment for OUD, rates of re-presentation to ED or EMS, and rates of precipitated withdrawal, as well as summarise clinician and patient perspectives on buprenorphine initiation in these settings. ⋯ The initiation of buprenorphine in the ED setting is associated with higher odds of short and medium-term treatment engagement. Further research is required into EMS-initiated buprenorphine, as well as patient perspectives of ED- and EMS-initiated buprenorphine.
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Multicenter Study
Pediatric firearm injuries and socioeconomic vulnerability before and during the COVID-19 pandemic.
Pediatric firearm injuries disproportionately affect groups experiencing socioeconomic disadvantage. Firearm injuries increased during the COVID-19 pandemic, but the impact on communities by degree of socioeconomic disadvantage is unknown. We examined the association between socioeconomic vulnerability and change in pediatric firearm injuries before versus during the pandemic. ⋯ The increase in pediatric firearm injuries during the COVID-19 pandemic impacted youth in all but the lowest deprivation quartile. Efforts at curbing gun violence should identify and amplify protective effects in under-resourced communities.
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Emerg Med Australas · Feb 2025
ReviewReview article: Somatization Disorders in emergency department: A critical overview of current challenges and future directions.
Individuals with Somatization Disorders present frequently to the ED with non-cardiac chest pain, non-specific abdominal pain, headaches and a range of other non-specific symptoms. Somatization Disorder presentations are ubiquitous within the healthcare system. ⋯ The current review explores the scope of the problem and, the challenges inherent in diagnosing and treating these disorders in ED environments. Based on available evidence and the essential character of these disorders, future directions are suggested for more effective emergency management and possible referral from ED.
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Observational Study
Door-in-Door-Out Times at Referring Hospitals and Outcomes of Hemorrhagic Stroke.
Interhospital transfer is often required in the care of patients with hemorrhagic stroke. Guidelines recommend a door-in-door-out (DIDO) time of ≤120 minutes at the transferring emergency department (ED); however, it is unknown whether DIDO times are related to clinical outcomes of hemorrhagic stroke. ⋯ These findings suggest that EDs currently expedite the transfer of the sickest patients; however, prospective studies and more granular data are needed to understand the impact of early treatment and timing of transfer for patients with hemorrhagic stroke.