Articles: emergency-services.
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Multicenter Study
Delivering tailored asthma family education in a pediatric emergency department setting: a pilot study.
Many children are brought to the pediatric emergency department (ED) with acute asthma symptoms. Emergency asthma care is costly, and many ED visits may be preventable. Families often do not have written asthma action plans and lack asthma self-management skills. This study tests a tailored self-management intervention delivered in the ED for families of children with asthma. The primary hypotheses were that the intervention group would have greater confidence to manage asthma 14 days postintervention and more well-asthma visits and fewer urgent care/ED visits at 9 and 12 months. ⋯ The tailored ED self-management intervention demonstrates significant effects on caregiver self-confidence and well-visit follow-up. Additional evaluation is needed to determine what impact this intervention has long-term.
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The diversion of ambulances away from their intended emergency departments (EDs) in the United States has become commonplace and may compromise patient care. Although ambulance diversion resulting from ED overcrowding has been well described in the literature, little is known about how to reduce the incidence of ambulance diversion on a regional level. We describe the development, implementation, and impact of a region-wide program to reduce ambulance diversion. ⋯ Our results demonstrate a sizeable reduction of ambulance diversion in a large urban region after the successful implementation of a comprehensive ambulance diversion reduction program. The description of this effort may serve as a model for other regions across the country that do not have an organized approach in place for ambulance diversion, although boarding of admitted patients will still be a major hurdle to effective reduction of ambulance diversion.
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Ann R Coll Surg Engl · Mar 2006
Multicenter StudyHow well equipped are ENT wards for airway emergencies?
With increased cross cover of specialities at night and more direct triaging of casualty patients to ENT wards, there is an increased need to ensure that there is adequate provision of emergency airway management. There are currently no national guidelines on what equipment should be available on ENT wards, and the authors have devised a portable airway box with all equipment deemed necessary to manage an acute airway. We believe that all junior doctors covering ENT should have airway training and access to an airway box. The aim of this study was to determine the provision of on-ward airway equipment and training on ENT wards in England. ⋯ Results suggest poor provision of emergency airway equipment and training on wards. We recommend the use of an airway box, and list of minimal equipment required.
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Randomized Controlled Trial Multicenter Study
Randomized controlled trial of emergency department interventions to improve primary care follow-up for patients with acute asthma.
Emergency department (ED) visits for asthma are frequent and may indicate increased morbidity and poor primary care access. Our objective was to compare the effect of two interventions on primary care follow-up after ED treatment for asthma exacerbations. ⋯ An intervention including free medication, transportation vouchers, and appointment assistance significantly increased the likelihood that discharged asthma patients obtained primary care follow-up but did not impact long-term outcomes.
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Hawaii medical journal · Feb 2006
Multicenter StudyDemographics and characteristics of wheezing/asthmatic children with repeat emergency department visits in O'ahu, Hawai'i.
A profile of Hawai'i's pediatric asthmatic patients who repeatedly visit the ED is lacking. This multi-centered prospective study found that repeat ED utilization occurs more frequently in a particular subset of patients. Characteristics of the asthmatic cohort can help health care providers, caregivers, children, and their families understand and better manage asthma as a chronic condition and improve quality of life.