Articles: emergency-services.
-
Randomized Controlled Trial
Could we use the comfort score instead of the numeric rating pain score? A proof of concept pilot study.
Asking patients about pain in the Emergency Department (ED) when deriving a pain score may aggravate perception of pain due to the nocebo-effect. A strategy for diminishing this nocebo-effect is cognitive reframing. Cognitive reframing of the frequently used pain score (PS) in the ED could theoretically be obtained by using the comfort score (CS). The aim of this study was to evaluate whether or not the CS and PS are interchangeable and therefore, whether or not the CS could safely be used in ED patients. ⋯ This proof of concept study suggest interchangeability of the PS and the ICS in patients with pain in the ED. However, while not statistically significant, 33% of the patients had a possible clinical significant difference in score outcome, potentially over- or underestimating the patients pain. Whether or not this can be used as a tool for cognitive reframing to reduce perception of pain and medication consumption has yet to be studied.
-
This study aimed to estimate the direct healthcare cost burden of acute chest pain attendances presenting to ambulance in Victoria, Australia, and to identify key cost drivers especially among low-risk patients. ⋯ Total annual costs for acute chest pain presentations are increasing, and a significant proportion of the cost burden relates to low-risk patients and non-specific pain. These data highlight the need to improve the cost-efficiency of chest pain care pathways.
-
Review
Association between advanced care planning and emergency department visits: A systematic review.
Advance care planning can help provide optimal medical care according to a patient's wishes as a part of patient-centered discussions on end-of-life care. This can prevent undesired transfers to emergency departments. However, the effects of advance care planning on emergency department visits and ambulance calls in various settings or specific conditions remain unclear. ⋯ Advanced care planning may lead to reduced emergency department visits and ambulance calls among nursing home residents and patients with depression or dementia. Further research is warranted to identify the effectiveness of advanced care planning in specific settings and diseases.