Articles: emergency-services.
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This study aims to assess compliance with medical protocols and outcomes, as well as determine the consistency in clinical practice across different Pediatric Emergency Departments (PED) in public sector hospitals of a low-middle income country. ⋯ The overall mortality rate was 2% in these five emergency departments and the medical protocol was followed in every third patient out of fourth in those three diseases. The survival rate till ED disposition was doubled in those patients for whom medical protocols were followed as compared to those for non-compliant. The majority of PED demonstrated good compliance with standardized practices. However, this study identified areas that require attention and further training, especially early recognition and management of septic shock where compliances seem alarmingly low. Our data analysis indicates that adherence to guidelines has resulted in uniformity in clinical practice and the provision of early evidence-based quality care. Nevertheless, there is still room for improvement in ensuring consistent adherence to medical protocols in pediatric emergency settings and thus improving patient outcomes.
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Randomized Controlled Trial Pragmatic Clinical Trial
Prognostic clinical decision support for pneumonia in the emergency department: A randomized trial.
Hospitalization rates for childhood pneumonia vary widely. Risk-based clinical decision support (CDS) interventions may reduce unwarranted variation. ⋯ EHR-based prognostic CDS did not improve ED disposition decisions for children with pneumonia. Although the intervention's content was favorably received, low subject accrual and workflow integration problems likely limited effectiveness. Clinical Trials Registration: NCT06033079.
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Ulus Travma Acil Cerrahi Derg · Sep 2024
Management of antimicrobial therapy in emergency department admissions and hospitalizations for firearm injuries: A single-center experience.
Firearm injuries (FI) remain a significant cause of morbidity and mortality globally. Antibiotic use, supported by guideline recommendations for preventing post-injury infections in FI cases, encounters uncertainties regarding the selection of anti-microbial agents and associated outcomes. This study aimed to investigate the relationship between Injury Severity Scores (ISS) for FI cases presented to the emergency department. ⋯ In conclusion, for cases of firearm injuries, we believe empirical antimicrobial therapy should be initiated with narrow-spectrum agents such as beta-lactam + beta-lactamase inhibitor or third-generation cephalosporin + nitroimidazole in the mild group, considering the lack of Pseudomonal activity.
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Meta Analysis
Intranasal midazolam for procedural distress in children in the emergency department: a systematic review and meta-analysis.
Intranasal (IN) midazolam is the most common anxiolytic for children in the emergency department (ED), but evidence of benefit is conflicting. We synthesized the evidence on IN midazolam for procedural distress in children undergoing ED painful procedures. ⋯ There is limited methodologically rigorous evidence that IN midazolam is better than placebo for IV insertion and laceration repair. At the doses studied, preliminary evidence suggests that IN dexmedetomidine may be superior to IN midazolam for both IV insertion and laceration repair.