Articles: emergency-services.
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Caring for patients with low-acuity conditions in Emergency Departments (ED) is often thought to cost more than treating those patients in other ambulatory settings. Understanding the relative cost of care between settings has critical implications for healthcare policy and system design. ⋯ No studies since 2001 assess the comparative costs of ED versus non-ED care for low-acuity ambulatory conditions. Physician and facility charges for ED care are higher than in other ambulatory settings for low-acuity conditions. Empirical evidence is lacking to support that ED care is more costly than similar care in other ambulatory settings.
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The emergency physician should diagnose and treat the critical illnesses that cause syncope/presyncope in patients presenting to the emergency department (ED). Whole-body ultrasonography can detect the critical etiology of syncope with high diagnostic sensitivity. We aimed to reveal whether whole-body ultrasonography for syncope (WHOBUS-Syncope) protocol recognizes high-risk syncope patients and the effect of WHOBUS-Syncope protocol on the management of patients. ⋯ WHOBUS-Syncope protocol can be included in emergency practice as part of the standard evaluation in patients with syncope or presyncope presenting to the ED.
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To compare outcomes of elderly patients who arrive directly to a lead trauma centre to those who are transferred from a peripheral hospital. ⋯ There was no significant difference in in-hospital mortality between elderly patients transported directly to the trauma centre and those who were transferred from peripheral hospitals.
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Nurses in the emergency department often encounter patients exhibiting signs of aggressive behavior. Nurses need to know the pharmacologic treatment appropriate for the patient scenario to ensure safety for the patient and the emergency department team. ⋯ After each case review is a discussion about the appropriate pharmacologic therapy for that patient. The cases portrayed are fictional but based on experience and previous observations.
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Delay to first antibiotic dose in patients with sepsis has been associated with increased mortality. Second dose antibiotic delay has also been linked to worsened patient outcomes. Optimal methods to decrease second dose delay are currently unclear. The primary objective of this study was to evaluate the association between updating an emergency department (ED) sepsis order set design from one-time doses to scheduled antibiotic frequencies and delay to administration of second piperacillin-tazobactam dose. ⋯ Including scheduled antibiotic frequencies in ED sepsis order sets is a pragmatic mechanism to decrease delays in second antibiotic doses.