Articles: emergency-services.
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Emerg Med Australas · Jun 2024
Infectious and sepsis presentations to, and hospital admissions from emergency departments in Victoria, Australia.
To investigate the frequency and outcomes of adult infectious and sepsis presentations to, and hospital admissions from, Emergency Departments (EDs) in Victoria, Australia. ⋯ Infections and sepsis are common causes of presentation to, and admission from the ED in Victoria. Such patients experience higher mortality than non-infectious patients, even after adjusting for age. There is a need to identify modifiable factors contributing to these outcomes.
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Chest pain (CP), a common presentation in the emergency department (ED) setting, is associated with significant morbidity and mortality if emergency clinicians miss the diagnosis of acute coronary syndrome (ACS). The HEART (History, Electrocardiogram, Age, Risk Factors, Troponin) score had been validated for risk-stratification patients who are at high risk for ACS and major adverse cardiac events (MACE). However, the use of cocaine as a risk factor of the HEART score was controversial. We hypothesized that patients with cocaine-positive (COP) would not be associated with higher risk of 30-day MACE than cocaine-negative (CON) patients. ⋯ This study, which utilized prospective calculated HEART scores, demonstrated that overall performance of the HEART score was reasonable. Specifically, our analysis showed that the rate of 30-day MACE was not affected by cocaine use as a risk factor. We would recommend clinicians to consider the HEART score for this patient group.
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Emerg Med Australas · Jun 2024
Observational StudyUnderstanding low acuity emergency department presentations in infancy: A cohort study.
Low acuity presentations (LAPs) contribute to large numbers of ED presentations and carry numerous consequences. The present study sought to improve the understanding of regional infant LAPs by analysing temporal patterns of presentation, discharge diagnoses and potential predictive factors. ⋯ A substantial minority of infant ED presentations are LAPs. Targeted interventions may benefit from focusing on families with a background of socioeconomic disadvantage, social isolation, cultural and linguistic diversity and perinatal complications, with a view to strengthening engagement with community-based services among these groups.
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To develop and externally validate models based on neural networks and natural language processing (NLP) to identify suspected serious infections in emergency department (ED) patients afebrile at initial presentation. ⋯ We developed and validated models to identify suspected serious infection in the ED. Extracted information from initial ED physician notes using NLP contributed to increased model performance, permitting identification of suspected serious infection at early stages of ED visits.
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The indications for neuroimaging in emergency department (ED) patients presenting with seizures have not been clearly defined. In this study, we aimed to investigate the findings that may influence the emergency management of patients with seizures undergoing brain computed tomography (CT) and the factors that influence these findings. ⋯ CT scanning of patients presenting to the ED with seizures has a limited impact on emergency patient management. Clinical decision-making guidelines for emergency CT scanning of patients with seizures need to be reviewed and improved to identify zero/near-zero risk patients for whom imaging can be deferred.