Articles: emergency-services.
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Observational Study
Adult patients with severe respiratory syncytial virus infections in the emergency department.
Respiratory syncytial virus (RSV) is a seasonal virus known to cause significant morbidity in pediatric patients; however, morbidity in adult patients has not been well investigated. We aimed to characterize adult patients with RSV infection in the emergency department (ED) and their clinical course. During the winter term 2022/23, all adult ED patients were screened for RSV, severe acute respiratory syndrome coronavirus type 2, and influenza infection using point-of-care polymerase chain reaction tests. ⋯ Our data show that RSV is a medically relevant pathogen among adult ED patients, often requiring inpatient treatment. In particular, elderly patients with some medical preconditions seem to be more prone to a severe course of infection requiring inpatient treatment. Lower respiratory tract involvement, proven by pulmonary infiltrates, seems to be crucial for a more severe disease course.
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Ultrasound-guided (USG) erector-spinae plane block (ESPB) may be better than intravenous opioids in treating acute hepatopancreaticobiliary (HPB) pain in the ED. ⋯ ESPB is a promising alternative to morphine in those with HPB pain.
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The number of asylum seekers awaiting decisions on their claims in the UK has more than tripled since 2014. How we meet international obligations to provide appropriate healthcare to asylum seekers and refugees (ASRs) is therefore an increasingly important issue. The views of frontline healthcare workers are vital to ensure the development of sustainable and effective health policy when it comes to caring for this group. ⋯ This study provides an insight into the views of EDCPs in providing care to ASRs in the ED. Study findings can potentially contribute to the development of ED-specific guidelines as well as inform wider health policy and provide a focus and direction for further research.
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There is compelling evidence that AXRs have limited clinical value in the acute setting. Despite this, they are frequently used in many EDs. This quality improvement project (QIP) aimed to reduce unnecessary AXR use in a single-centre ED. ⋯ In this single-centre QIP, coordinated multidisciplinary interventions were effective in reducing unnecessary AXR usage without resulting in excess CTs. The methods and interventions described are easily reproducible at minimal expense and may be of interest to other departments undertaking quality improvement work in this area.