Articles: emergency-services.
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Critical care medicine · Feb 2008
Multicenter StudyValidation of the Mortality in Emergency Department Sepsis (MEDS) score in patients with the systemic inflammatory response syndrome (SIRS).
To prospectively and externally validate the Mortality in Emergency Department Sepsis (MEDS) score as a predictor of 28-day mortality in patients who present to the emergency department with a systemic inflammatory response syndrome. ⋯ The MEDS score accurately predicts 28-day mortality in patients who present to the emergency department with systemic inflammatory response syndrome and who are admitted to the hospital.
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Multicenter Study Clinical Trial
Alcohol screening, brief intervention, and referral in the emergency department: an implementation study.
Alcohol is the single greatest contributor to injury in the United States. Numerous studies have reported that a standardized screening, brief intervention, and referral to treatment (SBIRT) intervention can effectively minimize future alcohol consumption, reduce injury recurrence, and decrease the number of repeat ED visits. To date, SBIRT studies have been conducted in settings in which physicians or research assistants carried out SBIRT. Little is known about ED nurses carrying out SBIRT. The purpose of this study was to examine ED nurse training needs and identify both barriers to, and enablers of, SBIRT implementation in the emergency department. ⋯ The SBIRT process can be conducted successfully by emergency nurses. However, substantial operational barriers to widespread routine implementation exist. These barriers need to be addressed before emergency nurses incorporate SBIRT as routine part of ED care.
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The objective of the study was to determine how many patient-related questions emergency medicine physicians have and how they answer them at the point of care. ⋯ Emergency department physicians in this study pursued and found answers for most questions posed at the point of care. Rapid access to electronic resources and drug-prescribing references were critical for answering questions at the point of care.
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Multicenter Study
Introduction of medical emergency teams in Australia and New Zealand: a multi-centre study.
Information about Medical Emergency Teams (METs) in Australia and New Zealand (ANZ) is limited to local studies and a cluster randomised controlled trial (the Medical Emergency Response and Intervention Trial [MERIT]). Thus, we sought to describe the timing of the introduction of METs into ANZ hospitals relative to relevant publications and to assess changes in the incidence and rate of intensive care unit (ICU) admissions due to a ward cardiac arrest (CA) and ICU readmissions. ⋯ Approximately 60% of hospitals in ANZ with an ICU report having an MET service. Most introduced the MET service early and in association with literature related to adverse events. Although available in only a quarter of hospitals, temporal trends suggest an overall decrease in the incidence of ward CAs admitted to the ICU in MET as well as non-MET hospitals.
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Multicenter Study Comparative Study
The emergency department occupancy rate: a simple measure of emergency department crowding?
We examine the validity of the emergency department (ED) occupancy rate as a measure of crowding by comparing it to the Emergency Department Work Index Score (EDWIN), a previously validated scale. ⋯ The ED occupancy rate and the EDWIN classified leaving without being seen and ambulance diversion hours with moderate accuracy. Although the ED occupancy rate is not ideal, its simplicity makes real-time assessment of crowding feasible for more EDs nationwide.