Articles: emergency-services.
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Multicenter Study
Preliminary investigation of the Panic Screening Score for emergency department patients with unexplained chest pain.
The objective was to demonstrate the derivation and the preliminary validation of a brief screening score to improve recognition of panic-like anxiety in emergency department (ED) patients with unexplained chest pain. ⋯ The PSS may be useful to identify patients with unexplained chest pain who could benefit from referral to mental health professionals or their primary care providers for evaluation of panic attack and panic disorder. Prospective studies to improve and validate the PSS, followed by impact analysis, are mandatory before clinical implementation.
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Door-to-physician time in the emergency department (ED) correlates with patient satisfaction and clinical quality and outcomes. Delays in seeing a provider result in a 3% nationwide rate of patients leaving without being seen (LWBS) after presenting for ED care. Two community hospitals had door-to-physician times of 51 and 47 minutes. ⋯ The change occurred in less than a month and was sustained for 6 months after the study. In addition, the LWBS rates at each facility fell by one third. Basic process improvement strategies borrowed from service industries were used in 2 EDs to improve the door-to-physician process.
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Nurses working in emergency departments (EDs) are in the most danger of workplace violence (WPV) because of the critical nature of the wards. ⋯ It is believed that finding the pattern and nature of WPV is the first step to develop suitable strategies to deal with the issue. Establishing WPV management teams and enacting appropriate laws can improve workplace safety for nurses and patients' care quality.
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Pediatric blood & cancer · Mar 2011
Multicenter StudySickle-cell disease in California: a population-based description of emergency department utilization.
Acute and chronic clinical manifestations of sickle-cell disease (SCD) lead to significant healthcare utilization, especially of the emergency department (ED). Limited population-level data are available in SCD with the ability to connect patients to visits, leaving us with minimal description of utilization patterns. ⋯ ED utilization by the California SCD population is described on a population level. Utilization patterns by adults point towards increased utilization in the population no longer eligible for Title V pediatric coverage for their disease. Further investigation using population-level socioeconomic and geographic correlates is warranted to evaluate the factors leading to ED utilization in SCD.
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J. Am. Coll. Cardiol. · Feb 2011
Multicenter StudyClinical characteristics, management, and outcomes of patients diagnosed with acute pulmonary embolism in the emergency department: initial report of EMPEROR (Multicenter Emergency Medicine Pulmonary Embolism in the Real World Registry).
In a large U.S. sample, this study measured the presentation features, testing, treatment strategies, and outcomes of patients diagnosed with pulmonary embolism (PE) in the emergency department (ED). ⋯ Patients diagnosed with acute PE in U.S. EDs have high functional status, and their mortality rate is low. These registry data suggest that appropriate initial medical management of ED patients with severe PE with anticoagulation is poorly standardized and indicate a need for research to determine the appropriate threshold for empiric treatment when PE is suspected before diagnostic confirmation.