Articles: emergency-services.
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Ann Acad Med Singap · Dec 2023
An augmented reality mobile application for weight estimation in paediatric patients: A prospective single-blinded cross-sectional study.
Determining the exact weight of children is a challenging task during emergency situations. Current guidelines recommend the use of length-based weight-estimating tapes. However, healthcare providers must either always carry the tapes or take time to locate them. Moreover, they may not know how to use them. To address these issues, we developed an augmented reality smartphone application for length-based weight estimation called the Paediatric Augmented Reality Scale (PARS). We evaluated its performance and compared it to that of the Broselow tape (BT) and Paediatric Advanced Weight Prediction in the Emergency Room extra-long and extra-large (PAWPER-XL) tape methods. ⋯ PARS exhibited a modestly better performance than BT and PAWPER-XL in estimating body weight. PARS-estimated body weights correlated fairly accurately with the actual body weights. PARS holds potential utility in paediatric emergencies.
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Long waiting times in the ED have been shown to cause negative outcomes for patients. This study aims to assess the effect in reducing length of stay of (1) preventing low-acuity attenders from attending the ED and (2) diverting low-acuity attenders at triage to a colocated general practice (GP) service. ⋯ Reducing the proportion of low-acuity attenders at the ED could have an impact on the time in the ED for higher acuity patients due to their use of shared resources, but is insufficient alone to meet current targets. The simulation model could be adapted for further analyses to understand which other changes would be needed to meet current government targets.
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Multicenter Study
MEESSI-AHF score to estimate short-term prognosis of acute heart failure patients in the Emergency Department: a prospective and multicenter study.
The assessment of acute heart failure (AHF) prognosis is primordial in emergency setting. Although AHF management is exhaustively codified using mortality predictors, there is currently no recommended scoring system for assessing prognosis. The European Society of Cardiology (ESC) recommends a comprehensive assessment of global AHF prognosis, considering in-hospital mortality, early rehospitalization rates and the length of hospital stay. ⋯ Among patients admitted to ED for an episode of AHF, the MEESSI-AHF score estimates with good performance the number of days alive and out of the hospital.
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Emerg Med Australas · Dec 2023
ReviewReview article: Scoping review of the characteristics and outcomes of adults presenting to the emergency department during heatwaves.
As a result of climate change heatwaves are expected to increase in frequency and intensity and will have detrimental impacts on human health globally. EDs are often the critical point of care for acute heat illnesses and other conditions associated with heat exposure. Existing literature has focused on heatwave-related hospitalisation and mortality. ⋯ Outcomes including hospitalisation and mortality rates after ED admissions showed positive associations with heatwaves. The heatwaves resulting from climate change will place increasing demands on EDs providing care for increasingly susceptible populations. Significant public heatwave planning across multiple sectors is required to reduce the risk of overwhelming EDs with these patients.
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Frequent emergency department (ED) users with mental health issues are particularly vulnerable patients, who often receive insufficient or inadequate outpatient care. This systematic review identified and evaluated studies on ED-based interventions to reduce acute care use by this population, while improving outpatient service use and patient outcomes. Searches were conducted in five databases for studies published between January 1, 2000, and April 30, 2022. ⋯ Ten studies assessed outcomes related to use of other services than ED, mainly hospitalizations, while five assessed patients' clinical conditions and three, social conditions (e.g., housing status). This review revealed that case management and care plan interventions, based in ED, decrease ED use among frequent users, while case management also showed promising results for outpatient service use and clinical and social outcomes. Thus, the results support continued deployment of intensive ED-based interventions for frequent ED users with mental health issues although firm conclusions regarding the effectiveness of these interventions, particularly outcomes related to services other than ED, require further investigation.