Articles: emergency-services.
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Pediatric emergency care · Nov 2008
Multicenter StudyPredicting need for hospitalization in acute pediatric asthma.
To develop and validate predictive models to determine the need for hospitalization in children treated for acute asthma in the emergency department (ED). ⋯ Successful discharge from the ED for children with acute asthma can be predicted accurately using a simple clinical model, potentially improving disposition decisions. However, predicting correct placement of patients requiring extended care is problematic.
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Multicenter Study
Validation of the triage risk stratification tool to identify older persons at risk for hospital admission and returning to the emergency department.
To assess the predictive validity of the Triage Risk Stratification Tool (TRST) to identify return to the emergency department (ED) or hospitalization in a multicenter patient sample. ⋯ The TRST demonstrated only moderate predictive ability, and ideally, a better prediction rule should be sought. Future studies to develop better prediction rules should compare their performance with that of existing prediction rules, including the TRST and Identifying Seniors at Risk tool, and assess the effect of any new prediction rule on patient outcomes.
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Multicenter Study
Prevalence of Staphylococcus aureus nasal colonization in emergency department personnel.
Nasal colonization with Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) can precede infection in patients and contacts. Although general population S aureus/MRSA rates are well described, the prevalence of S aureus and MRSA nasal colonization in emergency department health care workers is not defined. We seek to determine the prevalence of S aureus and MRSA nasal colonization among ED health care workers without evidence of an active site of staphylococcal infection and identify variables associated with colonization. ⋯ In this urban ED health care worker population, the prevalence of S aureus is similar but MRSA nasal colonization is higher than previously reported estimates in the general population of the United States. Physicians and nonpatient contact ED health care workers did not have MRSA colonization.
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Multicenter Study
Standards of practice in UK emergency departments before, during and after conscious sedation.
The agents used for conscious sedation are well known to have potentially serious complications. It is recommended that patients receiving them should be objectively monitored until it is deemed safe. An audit of our departmental practices led us to conduct a national questionnaire to determine how we compared with other units in the UK. ⋯ Certain practices were applied in most departments but none were universal, with most being subject to wide variation. The local results reflected this, suggesting that a variation may exist both within and between individual units.
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The 2006 Centers for Disease Control and Prevention recommendations place increased emphasis on emergency departments (EDs) as one of the most important medical care settings for implementing routine HIV testing. No longitudinal estimates exist regarding national rates of HIV testing in EDs. We analyzed a nationally representative ED database to assess HIV testing rates and characterize patients who received HIV testing, prior to the release of the 2006 guidelines. ⋯ Prior to the release of the 2006 Centers for Disease Control and Prevention guidelines for routine HIV testing in all healthcare settings, baseline national HIV testing rates in EDs were extremely low and appeared to be driven by clinical presentation.