Articles: emergency-services.
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Although the Pneumonia Severity Index (PSI) has been extensively validated, little is known of the impact of its routine use as an aid to site-of-treatment decisions for patients with pneumonia who present to emergency departments (EDs). ⋯ The routine use of the PSI was associated with a larger proportion of patients in PSI risk classes I and II who had pneumonia and who were treated in the outpatient environment without compromising their safety.
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Multicenter Study
Do elective surgical and medical admissions impact emergency department length of stay measurements?
Emergency department access block is a growing problem in emergency departments across Canada. Access block is defined as hospital occupancy >85% causing emergency department overcrowding. Hospital overcrowding leads to prolonged emergency department wait times, and delays in the transfer of admitted patients from the emergency department to inpatient beds. The relationship between elective admissions to hospital and emergency department wait times has not been adequately assessed. We undertook a simple linear regression analysis of the impact of elective admissions to hospital on emergency department length of stay. ⋯ For the year 2004, in the Calgary Health Region, elective acute care admissions to hospital had no relationship to emergency department length of stay for patients admitted via the emergency department. Further study is required to determine causative factors that prolong Emergency Department length of stay. Emergency departments across Canada continue to struggle with the demands of providing high quality care with diminishing resources.
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Multicenter Study
Procedural sedation in the community emergency department: initial results of the ProSCED registry.
Procedural sedation and analgesia (PSA) has been well profiled in experimental studies in university emergency departments. Extrapolation of these practices into the community hospital setting is not well established. This report describes community hospital practices and outcomes in a multicenter PSA registry. ⋯ Community emergency physicians deliver safe and effective PSA over a wide variety of ages and procedures while using a broad selection of agents.
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Multicenter Study
Use of non-invasive ventilation in UK emergency departments.
To describe the current use of non-invasive ventilation in UK emergency departments. ⋯ NIV is commonly used in UK emergency departments. Practices vary significantly. One solution would be the development of guidelines on when and how to use NIV in emergency medicine practice.
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Previous research has shown the safety of procedural sedation in the emergency department in university settings involving multiple emergency physicians. ⋯ Procedural sedation in the emergency department performed by a single emergency physician is safe and effective.