Articles: emergency-services.
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Emerg Med Australas · Feb 2025
Impact of the XVII Pacific Games on the National Referral Hospital Emergency Department, Solomon Islands.
The XVII Pacific Games was held in Honiara, Solomon Islands in 2023 and was attended by competitors from 24 Pacific nations. The National Referral Hospital (NRH) is the sole tertiary hospital and largest emergency department (ED) in the Solomon Islands, located in the capital city, Honiara, and was the designated referral hospital for the Pacific Games. ⋯ Planned mass gathering events can provide opportunities for EDs to increase workforce capacity and strengthen systems, but proper preparedness is required to minimise additional strain on already busy departments.
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Multicenter Study
Emergency centre thoracotomy for penetrating trauma: Insights from 2 South African district-level emergency centres.
Trauma is a major contributor to global disease burden, disproportionally affecting low- and middle-income countries, especially in the African Region. Emergency centre thoracotomy (ECT) is a potentially life-saving procedure for a sub-group of trauma patients in extremis. Most literature regarding ECT originated in high-income countries. This study aimed to describe patient, procedure and outcome characteristics of ECTs performed at two facilities in a resource-limited setting in South Africa. ⋯ The performance of ECT in this resource-limited district-level setting, followed by stabilisation and transfer of patients to tertiary hospitals seems to result in comparable or better survival rates than reported in international literature. Further research is needed to better describe the performance and outcomes of EC thoracotomies in a resource-limited setting. This study setting, with high incidence of trauma and ECT performed, provides an excellent opportunity for further research. Prospective studies may demonstrate correlations between specific patient and procedural characteristics and outcomes and may guide the development of local guidelines.
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Multicenter Study Observational Study
Development and Implementation of a Multicenter Registry for Resuscitation-Focused Transesophageal Echocardiography.
To evaluate the clinical effect, safety, and clinical outcomes of focused transesophageal echocardiography (TEE) in the evaluation of critically ill patients in the emergency department (ED) and ICUs. ⋯ A prospective, multicenter, and multidisciplinary TEE registry was successfully implemented, and demonstrated that focused TEE is safe and clinically impactful across multiple critical care applications. Further studies from this research network will accelerate the development of outcome-oriented research and knowledge translation on the use of TEE in emergency and critical care settings.
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Chlamydia trachomatis is the most prevalent, reportable sexually transmitted infection (STI) in the United States. In 2021, the Centers for Disease Control and Prevention (CDC) updated treatment recommendations from a single azithromycin 1000 mg dose to doxycycline 100 mg twice daily for seven days for the treatment of chlamydia infections. In response to changes in treatment recommendations and addressing patient barriers to treatment, pharmacists at an urban, academic medical center collaborated with the state health department to create doxycycline kits dispensed upon emergency department (ED) discharge. ⋯ Doxycycline discharge kits significantly increased guideline-directed treatment and decreased time-to-treatment for chlamydia in the ED population at an urban academic medical center.
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Pediatric emergency care · Feb 2025
Oral Ketamine and Midazolam for Procedural Sedation in the Pediatric Emergency Department: A Retrospective Study.
Needle-free procedural sedation (PS) is an attractive option for children presenting to the emergency department (ED) who require a painful procedure, as it avoids inflicting additional pain either with intravenous line placement or intramuscular injection. While use of oral (PO) ketamine has been reported in the literature, limited information is available to guide ED-based use in children. ⋯ PO ketamine with or without midazolam resulted in procedure completion of a variety of procedures in the pediatric ED with minimal AE, no SAE, and without need for additional sedative medications in 86.2% (50). This regimen is an option for needle-free moderate PS in this setting. Further study is needed to clarify the benefit of the addition of midazolam to PO ketamine, rates of AE and SAE, sedation duration, and recovery times.