ED Management
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The Case for Broader ED-based Screening Strategies for Hepatitis C
Although the CDC recommends frontline providers use a targeted screening strategy for the hepatitis C virus (HCV), some EDs are finding that nontargeted approaches are more effective at uncovering new infections. Further, investigators note there is a new surge in HCV infections among younger people that is associated with the opioid epidemic. Such individuals often are reluctant to disclose their use of injectable drugs or other behaviors that put them at risk for HCV.
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Higher STD Rates Alarm Investigators
Researchers from the CDC report that STD diagnoses are at the highest they have ever been in the United States, signaling what some are calling a public health crisis.
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Medical Centers Employ Rapid Response Teams to Treat Difficult Airways
While emergency providers are trained in the management of difficult airways, there are times when added multidisciplinary expertise can be essential to ensuring a good outcome. To address these instances, some medical centers have established rapid response teams that will come to the bedside of patients with known difficult airways or new complications that make airway access problematic.
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Better Management of Patients With Psychiatric Needs
Recognizing an urgent need to improve the way patients with psychiatric needs are managed in the ED, the Institute for Healthcare Improvement has teamed up with Well Being Trust and nine participating hospitals to test and implement new approaches.
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Burnout Linked to Medical Errors, Malpractice, and Suicide
While no specialty is spared, emergency physicians are particularly vulnerable to burnout, a problem that produces several negative consequences. Experts note the problem must be addressed at both the individual and system levels, but stress that effective interventions likely will deliver a return on investment.
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Which Chest Pain Patients Require Further Testing, Intervention, or Discharge?
Hospitals in Kaiser Permanente’s Southern California region have implemented a new approach to help identify which patients who present with chest pain require further testing or intervention and which can be discharged safely. The core of this approach is use of the HEART score, a tool developed in the Netherlands to help physicians risk-stratify such patients quickly.
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Offering Patients Hospital Care at Home
There is growing interest in an approach that delivers hospital-level care to appropriate patients in their homes. Generally, such programs identify potential candidates for the approach upon their presentation to the ED. Depending on the program, emergency physicians and/or hospitalists determine whether patients should be offered the option of receiving care for their acute condition at home. Investigators have found the approach can deliver equal or superior outcomes to similar hospitalized patients at considerably lower cost, although reimbursement remains a major obstacle.
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Emergency Providers Sound Alarm on Persistent Critical Drug Shortages
There may be fewer drug shortages than in other recent years, but some shortages are more severe, according to experts. Emergency providers report these shortages are affecting patient care. In particular, emergency providers are struggling to deal with a shortage of IV opioid analgesic drugs that has been in effect since the end of 2017. They are working with hospital pharmacists to conserve such drugs for patients most in need and to find alternative therapies.
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CDC: Suicide Rates Up By 30% in Some Areas
In 2016 alone, 45,000 people committed suicide. Data show suicide is one of only three leading causes of death that are increasing.
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Emergency Providers Play a Pivotal Role in Suicide Prevention
Experts point to insufficient mental healthcare resources in the United States as one of the key drivers of the rising suicide rate. However, these experts emphasize that emergency providers have a front-row seat to the problem, and can play an important role in prevention. To address the issue, a growing number of EDs are implementing universal screening to identify patients at risk for suicide. Such steps must be paired with effective protocols to connect at-risk patients with appropriate interventions.