Articles: emergency-services.
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Head injury is a common reason children present to EDs. Guideline development to improve care for paediatric head injuries should target the information needs of ED clinicians and factors influencing its uptake. ⋯ Information needs of ED clinicians, factors influencing use of head CT in children with head injuries and the role of guidelines were identified. These findings informed the scope and implementation strategies for an Australasian guideline for mild-to-moderate head injuries in children.
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Although evidence suggests that racial and ethnic minority (REM) patients receive inadequate pain management in the acute care setting, it remains unclear whether these disparities also occur during the prehospital period. The aim of this study is to assess the impact of race and ethnicity on prehospital analgesic use by emergency medical services (EMS) in trauma patients. ⋯ Patients from racial and ethnic minority groups were less likely to receive prehospital pain medication after traumatic injury than White patients. Forms of conscious and unconscious bias contributing to this inequity need to be identified and addressed.
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In-hospital cardiac arrest (IHCA) in the emergency department (ED) is not uncommon but often fatal. Using the machine learning (ML) approach, we sought to predict ED-based IHCA (EDCA) in patients presenting to the ED based on triage data. We retrieved 733,398 ED records from a tertiary teaching hospital over a 7 year period (Jan. 1, 2009-Dec. 31, 2015). ⋯ Although the differences between each of ML models and LR (AUC: 0.905, 95% CI 0.882-0.926) were not significant, all constructed ML models performed significantly better than using the NEWS2 scoring system (AUC 0.678, 95% CI 0.635-0.722). Our ML models showed excellent discriminatory performance to identify EDCA based only on the triage information. This ML approach has the potential to reduce unexpected resuscitation events if successfully implemented in the ED information system.
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Pediatric emergency care · Mar 2023
Examining Parental Acceptance of Confidential Contraception Initiation in a Pediatric Emergency Department.
The pediatric emergency department (PED) is a valuable site for contraceptive services among adolescents at risk for pregnancy. Studies have shown that adolescents are interested in such services; however, little is known about parental opinions on contraceptive care in the PED. We aimed to (1) assess parental acceptance of confidential provisions of contraception in the PED and (2) identify facilitators/barriers to parental acceptance of contraception in this setting. ⋯ Although most parents were accepting of the PED provider offering confidential contraception to their adolescent, more parents preferred to be involved with decisions regarding contraception, in a collaborative approach. Further research is necessary to better elucidate parental/adolescent preferences.