Articles: emergency-services.
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Patients with suspected infections account for 15% to 35% of hospital emergency department (ED) caseloads in Spain and Latin America. The main objective of this systematic review was to compare evidence supporting the safety and efficacy of early (3 hours after triage) vs deferred ($ 3-6 hours) antibiotic therapy prescribed in EDs for adults with serious infections or sepsis. Efficacy and improved clinical course were defined by reduced progression to septic shock and short- and long-term mortality. ⋯ Early initiation of antibiotic therapy, preferably within 3 hours of triage, can be recommended in cases of serious infection (sepsis or serious sepsis that do not meet the criteria for septic shock). In fact, based on a tendency for higher short- and long-term mortality associated with delay and a higher probability of developing septic shock with each hour of delay, therapy should start as soon as possible if infection is confirmed or suspected in the absence of an alternative diagnosis.
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Southern medical journal · Feb 2025
Effect of COVID-19 on Emergency Department Visits for Suicidal Ideation and Suicide Attempts among South Carolina Youth.
Evidence suggests that the coronavirus disease 2019 pandemic negatively affected children's mental health (MH). The emergency department (ED) is often the first point of contact with a physician for youth who are experiencing suicidal thoughts and behaviors. Population-level reports of ED utilization in South Carolina for suicidal ideation (SI) and suicide attempts (SAs) during the pandemic are lacking. This study compares trends in ED visits for SI and SAs among youth in South Carolina ages 5 to 24 years, before (ie, March-December 2019) and during (ie, March-December 2020) the coronavirus disease 2019 pandemic. ⋯ The percentage of MH- and SI/SA-related visits increased during the pandemic. These data underscore the need for adequate MH services in EDs and increased access to outpatient MH resources to reduce the strain on EDs during public health emergencies.
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Scand J Trauma Resus · Jan 2025
ReviewKey performance indicators in emergency department simulation: a scoping review.
One way to measure emergency department (ED) performance is using key performance indicators (KPIs). Thus, identifying reliable KPIs can be critical in appraising ED performance. This study aims to introduce and classify the KPIs related to ED in simulations through the Balanced Scorecard (BSC) framework. ⋯ The study findings have collected a comprehensive set of KPIs to measure ED performance in simulations. These results can assist policymakers, managers, and researchers in measuring ED performance and help improve ED performance through a holistic view.
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EXPRESS: Implementation of telepsychiatry in an urban pediatric satellite emergency department (ED).
While pediatric mental health emergencies are increasing in frequency and severity, psychiatric resources remain concentrated in tertiary care facilities. Telepsychiatry has successfully mitigated these challenges in rural emergency departments (EDs), suggesting potential benefits for urban EDs that lack psychiatric resources. We implemented telepsychiatry in an urban ED to reduce ED length of stay and the need for transferring pediatric patients with mental and behavioral health complaints. ⋯ The median length of stay decreased significantly from 473 minutes (95% CI=431-733) to 275 min (95% CI=316-462) after implementation. Repeat visits for mental health complaints within 30 days decreased from 23% to 10%. Implementing a telepsychiatry evaluation program in an urban pediatric satellite ED reduced transfers and decreased patient length of stay.
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Eur J Trauma Emerg Surg · Jan 2025
Outcomes of electrical injuries in the emergency department: epidemiology, severity predictors, and chronic sequelae.
Electrical injuries (EIs) represent a significant clinical challenge due to their complex pathophysiology and variable presentation, ranging from minor burns to severe internal organ damage. Despite their prevalence in both; domestic and occupational settings, there remains a rareness of systematic guidelines and comprehensive literature to aid clinicians in effectively managing these injuries. Understanding these factors is crucial for developing protocols that can mitigate the risk of delayed complications, such as cardiac arrhythmias, in patients who initially appear stable. ⋯ EIs are frequent, with diverse clinical presentations requiring multidisciplinary care. Awareness of potential delayed complications is essential, and prevention is crucial.