Articles: emergency-services.
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Randomized Controlled Trial
Randomized controlled trial demonstrates novel tools to assess patient outcomes of Indigenous cultural safety training.
Health care routinely fails Indigenous peoples and anti-Indigenous racism is common in clinical encounters. Clinical training programs aimed to enhance Indigenous cultural safety (ICS) rely on learner reported impact assessment even though clinician self-assessment is poorly correlated with observational or patient outcome reporting. We aimed to compare the clinical impacts of intensive and brief ICS training to control, and to assess the feasibility of ICS training evaluation tools, including unannounced Indigenous standardized patient (UISP) visits. ⋯ Patient-oriented evaluation design and tools including UISPs were demonstrated as feasible and effective. Results show potential impact of cultural safety training on patient recommendation of clinician and improved patient experience. A larger trial to further ascertain impact on clinical practice is needed.
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Case Reports
A Case Report of Radial Artery Pseudoaneurysm After Repeated Radial Puncture for Arterial Blood Gas.
Arterial blood gas, with subsequent radial arterial puncture as a simple access point, comprises a ubiquitous medical procedure in the diagnostic workup of patients admitted to the emergency department with dyspnea. Despite being a relatively safe and technically straightforward procedure, due to its considerable use, it is of vital importance to be able to promptly recognize its potential complications. We present the case of a 96-year-old female patient admitted to the emergency department with dyspnea and cough who underwent left radial arterial puncture for arterial blood gas. ⋯ The patient was hospitalized and underwent surgical resection of radial pseudoaneurysm, with subsequent arterial repair. Although severe complications from arterial blood gas have a low incidence rate, prompt diagnosis and management are required. Therefore, point-of-care ultrasound, as an additional diagnostic tool, may play a role in minimizing the risk of procedural complications.
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JNMA J Nepal Med Assoc · Jan 2024
Over-the-counter Medication Use among Patients Presenting with Fever in the Emergency Department in a Tertiary Care Hospital.
Over-the-counter medication use is commonly practised all over the world. However, in a developing country like Nepal, antibiotics form an essential component of OTC drugs. Fever is one of the most common clinical complaints which makes a patient go to the local pharmacy for over-the-counter medication. This study aimed to find out the prevalence of over-the-counter medication use among patients presenting with fever in the Emergency Department in a tertiary care hospital. ⋯ emergency departments; fever; prevalence.
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Pediatric emergency care · Jan 2024
Meta AnalysisMedication Errors in Pediatric Emergency Departments: A Systematic Review and Recommendations for Enhancing Medication Safety.
This systematic review aims to investigate the prevalence, preventability, and severity of medication errors in pediatric emergency departments (P-EDs). It also aims to identify common types of medication errors, implicated medications, risk factors, and evaluate the effectiveness of interventions in preventing these errors. ⋯ Overall, this systematic review provides valuable insights into the complexity of medication errors in the P-ED, emphasizes the need for targeted interventions, and offers recommendations to enhance medication safety and reduce preventable errors in this critical health care setting.
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Law enforcement (LE) professionals are often dispatched to out-of-hospital cardiac arrests (OHCA) to provide early cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) application with mixed evidence of a survival benefit. Our objective was to comprehensively evaluate LE care in OHCA. ⋯ LE arrival before EMS and ensuring both CPR and AED application is associated with significantly improved functional survival in OHCA patients not already receiving bystander CPR.