Articles: emergency-services.
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To determine frequency that ED visits are needed, and the most common chief complaints and medications prescribed to Veterans with spinal cord injuries and disorders (SCI/D). ⋯ This national study of Veterans with SCI/D characterized ED healthcare utilization. Overall, more than half of Veterans with SCI/D required an ED visit during the five-year study period and over one third of Veterans in each fiscal year required an ED visit. Interventions to target prevention of ED visits and subsequent hospitalizations could focus on these areas.
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Pediatric emergency care · Oct 2024
Developing a Mental Health Screening Questionnaire in an Asian Children's Hospital Emergency Setting.
Mental health concerns among adolescents are increasingly prevalent, yet underrecognized. Adolescents with psychological distress often present to the emergency department (ED) with somatic symptoms. Due to inadequate time for rapport building and lack of familiarity of ED clinicians with psychosocial evaluation, these concerns often get missed. We describe the development and implementation of the Youth Well Being (YWB) questionnaire, a self-administered psychosocial screening tool that aims to overcome the communication barriers to psychosocial evaluation. ⋯ The YWB questionnaire is the first initiative in Singapore to enable efficient psychosocial screening of at-risk adolescents in the ED. This communication tool can potentially be used in other health care settings to enable early recognition and intervention for adolescents distressed by psychosocial problems.
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Emerg Med Australas · Oct 2024
Growing burden of gamma-hydroxybutyrate intoxication on emergency department resource utilisation.
Recreational gamma-hydroxybutyrate (GHB) use is rising in Australia. We aimed to describe ED presentation patterns related to GHB over time and the impact this has on ED resource use. ⋯ GHB presentations to ED are rising and the impact on acute bed space and clinical resources is significant.
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Observational Study
Trends in non-focal neurological chief complaints and CT angiography utilization among adults in the emergency department.
Prudent imaging use is essential for cost reduction and efficient patient triage. Recent efforts have focused on head and neck CTA in patients with emergent concerns for non-focal neurological complaints, but have failed to demonstrate whether increases in utilization have resulted in better care. The objective of this study was to examine trends in head and neck CTA ordering and determine whether a correlation exists between imaging utilization and positivity rates. This is a single-center retrospective observational study at a quaternary referral center. ⋯ The percentage of patients who received a scan over the study period increased from 7.89% (422/5351) in 2017 to 13.24% (662/5001) in 2021, representing a 67.4% increase from baseline (OR, 1.14; 95% CI 1.11-1.18; P < .001). The positivity rate, or the percentage of scans ordered that revealed attributable acute pathology, dropped from 16.8% (71/422) in 2017 to 10.4% (69/662) in 2021 (OR, 0.86; 95% CI 0.79-0.94; P = .001), a 38% reduction in positive examinations. Throughout the study period, there was a 67.4% increase in head and neck CTA ordering with a concomitant 38.1% decrease in positivity rate.
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To examine if an ED interprofessional team ("ED1Team") could safely decrease hospital admissions among older persons. ⋯ ED1Team consultation was associated with a decreased hospital admission rate in older ED patients. It was associated with a slightly longer ED length-of-stay and subsequent early hospitalizations. Given that even a small increase in freed hospital beds would release some of the pressure on an overextended healthcare system, these results suggest that upscaling of the intervention might procure systems-wide benefits.