Articles: emergency-services.
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Multicenter Study Observational Study
Out of hospital cardiac arrest outcomes: Impact of weekdays vs weekends admission on survival to hospital discharge.
Cardiac arrests are a leading cause of mortality with survival of only 12%. In the United States, cardiac arrests were significantly more likely to occur on Saturdays. Hospitals experience a decrease in staffing on weekends. This study aims to assess the relationship between weekend vs weekday admission and outcomes of patients presenting with out of hospital cardiac arrests (OHCA) in the United States. ⋯ In this study, patients with OHCA admitted to the ED on weekends had slightly lower survival compared to those admitted on weekdays. Modifiable factors should be identified in future studies to reduce outcome discrepancies and improve survival in this patient population.
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Multicenter Study Observational Study
Epidemiology of patients presenting with dyspnea to emergency departments in Europe and the Asia-Pacific region.
The primary objective of this study was to describe the epidemiology and management of dyspneic patients presenting to emergency departments (EDs) in an international patient population. Our secondary objective was to compare the EURODEM and AANZDEM patient populations. ⋯ Dyspnea as a symptom in the ED has high ward and ICU admission rates. A variety of causes of dyspnea were observed in this study, with chronic diseases accounting for a major proportion.
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Critical care medicine · Oct 2019
Multicenter StudyCharacteristics of Rapid Response Calls in the United States: An Analysis of the First 402,023 Adult Cases From the Get With the Guidelines Resuscitation-Medical Emergency Team Registry.
To characterize the rapid response team activations, and the patients receiving them, in the American Heart Association-sponsored Get With The Guidelines Resuscitation-Medical Emergency Team cohort between 2005 and 2015. ⋯ Although patients requiring rapid response team activation have high inpatient mortality, most rapid response team activations involve relatively few interventions, which may limit these teams' ability to improve patient outcomes.
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Multicenter Study
Trend analysis of emergency department malpractice claims in the Netherlands: a retrospective cohort analysis.
Over the past two decades, several quality improvement projects have been implemented in emergency departments (EDs) in the Netherlands, one of these being the training and deployment of emergency physicians. In this study we aim to perform a trend analysis of ED quality of care in Dutch hospitals, as measured by the incidence of medical malpractice claims. ⋯ Even though the number of ED visits increased significantly over the past two decades, the number of malpractice claims filed after an ED visit decreased. Various quality improvement initiatives, including the training and employment of emergency physicians, may have contributed to the observed decrease in claims.
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Multicenter Study Observational Study
The Reality of Pain Scoring in the Emergency Department: Findings From a Multiple Case Study Design.
Documentation of pain severity with pain scores is recommended within emergency departments (EDs) to improve consistency of assessment and management of pain. Pain scores are used in treatment guidelines and triage algorithms to determine pain management and in audit and research to evaluate pain management practices. Despite significant debate of their benefits, there has been limited evaluation of their use in practice. We use naturalistic, qualitative methods to understand how pain scores are used in practice and the mechanisms by which pain scoring may influence pain management. ⋯ In practice, pain scoring may not accurately reflect patient experience. Using pain scoring to determine the appropriateness of triage and treatment decisions reduces its validity as a measure of patient experience. Pain scoring should not be central to audit and systems of accountability for pain management.