Articles: emergency-services.
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Pediatric emergency care · Apr 2012
Multicenter Study Comparative StudyIs pediatric emergency department utilization by pregnant adolescents on the rise?
This study evaluates trends of pregnant adolescents' utilization of pediatric emergency departments (PEDs), describes patient demographics, and reviews common pregnancy-related conditions seen in the PED. ⋯ Pregnant adolescents make up a small (<1%) but growing proportion of overall visits to PEDs. Future direction should include an evaluation of the educational opportunities provided during pediatric residency and pediatric emergency medicine fellowship training and, if inadequacies exist, work to develop an innovative curriculum for this particular patient population.
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Aust J Rural Health · Apr 2012
Randomized Controlled Trial Multicenter StudyDo clinical pathways enhance access to evidence-based acute myocardial infarction treatment in rural emergency departments?
The objective of this study is to measure the impact of a five-step implementation process for an acute myocardial infarction (AMI) clinical pathway (CPW) on thrombolytic administration in rural emergency departments. ⋯ The lack of impact of the implementation process for a chest pain CPW on thrombolytic delivery or time to electrocardiogram in these rural hospitals can be explained by a ceiling effect in outcome measures but was also compromised by the small sample. Results suggest that quality of AMI treatment in rural emergency departments (EDs) is high and does not contribute to the worse mortality rate reported for AMIs in rural areas.
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Multicenter Study
The Emergency Department Action in Smoking Cessation (EDASC) trial: impact on delivery of smoking cessation counseling.
The focus on acute care, time pressure, and lack of resources hamper the delivery of smoking cessation interventions in the emergency department (ED). The aim of this study was to 1) determine the effect of an emergency nurse-initiated intervention on delivery of smoking cessation counseling based on the 5As framework (ask-advise-assess-assist-arrange) and 2) assess ED nurses' and physicians' perceptions of smoking cessation counseling. ⋯ Emergency department nurses and physicians can effectively deliver smoking cessation counseling to smokers in a time-efficient manner. This trial also provides empirical support for expert recommendations that call for nursing staff to play a larger role in delivering public health interventions in the ED.
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Eur J Gastroenterol Hepatol · Apr 2012
Multicenter StudyPredictive validity of the Glasgow Blatchford Bleeding Score in an unselected emergency department population in continental Europe.
Glasgow Blatchford Bleeding Score stratifies patients presenting with acute upper gastrointestinal haemorrhage at the emergency department according to the likelihood of the need for treatment. The objective of this study was to validate the Glasgow Blatchford Bleeding Score for use in an emergency department in the Netherlands. Furthermore, we assessed its clinical usefulness for safe discharge of low-risk acute upper gastrointestinal haemorrhage patients and compared its test validity to that of other scoring systems. ⋯ Patients presenting at an emergency department in continental Europe with acute upper gastrointestinal haemorrhage and a Glasgow Blatchford Bleeding Score of 2 or less can be safely discharged. The Glasgow Blatchford Bleeding Score performed better than the other commonly used scoring systems.
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Multicenter Study
Feasibility of percutaneous vagus nerve stimulation for the treatment of acute asthma exacerbations.
This study assessed the feasibility of an investigational vagus nerve stimulation (VNS) device for treating acute asthma exacerbations in patients not responding to at least 1 hour of initial standard care therapy. ⋯ Percutaneous VNS did not result in serious AEs and was associated with improvements in FEV(1) and perceived dyspnea. Percutaneous VNS appears to be feasible for use in the treatment of moderate to severe acute asthma in patients unresponsive to initial standard care treatment.