Articles: emergency-services.
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Multicenter Study Observational Study
Development and validation of a nomogram for assessing comorbidity and frailty in triage: a multicentre observational study.
Assessing patient frailty in the Emergency Department (ED) is crucial; however, triage frailty and comorbidity assessment scores developed in recent years are unsatisfactory. The underlying causes of this phenomenon could reside in the nature of the tools used, which were not designed specifically for the emergency context and, thus, are difficult to adapt to the emergency environment. The objective of this study was to create and internally validate a nomogram for identifying different levels of patient frailty during triage. ⋯ The internal validation of the nomogram reported an area under the receiver operating characteristic of 0.91 (95% CI 0.884-0.937). A nomogram was created for assessing comorbidity and frailty during triage and was demonstrated to be capable of determining comorbidity and frailty in the ED setting. Integrating a tool capable of identifying frail patients at the first triage assessment could improve patient stratification.
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Annals of family medicine · Nov 2024
Beyond Education: What is required to support staff to promote equity-oriented health care in EDs?
Context: Staff in Canadian Emergency Departments (EDs) face increasing workplace demands arising in part from system-wide shortages in primary and community care. Patients experiencing stigmatizing conditions such as chronic pain, substance use, and psychiatric disorders may turn to the ED as the only open "door" to access care in the community. Objective: To examine staff perceptions about their work and role, including how they may be prepared or not to address issues of health and health care inequities in EDs. ⋯ Conclusions: The impacts of shortages in primary care reverberate throughout the system. EDs often prioritize efficiency, a focus which cannot adequately equip staff to promote equity. Attention and commitment to addressing structural inequities within EDs could support patients and staff to move closer to the quintuple aim.
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To assess the rate and characteristics of acute pulmonary embolism (PE) cases diagnosed in the emergency department (ED) following an ED discharge visit within 10 days. ⋯ In this retrospective analysis, about 1 in 20 acute PEs and 2 in 10,000 ED discharges were associated with an ED revisit for acute PE. Some cases may represent potential diagnostic opportunities, whereas others may be progression of disease, risk factors for PE, or unrelated.
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Pediatric emergency care · Nov 2024
Perspectives of Caregivers on Children Boarding With Mental Health Conditions.
Addressing the acute mental healthcare needs of children is a national crisis. Despite the ongoing crisis, there are limited prior studies that capture caregiver perspectives on acute pediatric mental healthcare, notably in a general emergency department (ED) in a rural state. Based on these knowledge gaps, our objective was to assess caregiver opinions and perspectives of acute management for children boarding with mental health conditions. ⋯ Caregivers face considerable challenges in attaining timely and appropriate acute mental health care for their children. Immediate and innovative resource allocation is needed across the healthcare continuum to bolster the acute mental healthcare services currently offered to children and families, especially in the general ED setting.
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Infectious mononucleosis (IM) or mono is typically caused by primary infection with Epstein-Barr virus (EBV) and may have a months-long, complicated course. We utilized population-based data to add to the limited literature on health care utilization following EBV infection. ⋯ There is a substantial short- and mid-term increased risk of serious health care encounters associated with recent EBV infection. Mid- and long-term risks are increased in patients who do not have a concomitant diagnosis of IM.