Emergency
RSSArticles
-
Psychological Evaluation Unit Provides Specialized Expertise, Calmer Atmosphere for Behavioral Health Patients
Elliot Hospital in Manchester, NH, has unveiled a new $1.5 million psychiatric evaluation unit within the confines of its ED to boost resources and access to care for patients in psychological distress. The center is designed to offer an atmosphere more conducive to emotional healing. Administrators note that the added resources also should help ease crowding and boarding at the level II trauma facility.
-
A Growing Number of ED-based Physical Therapy Programs Taking Root
While a few ED-based physical therapy programs have existed for decades, the practice is gaining new converts as emergency clinicians increasingly turn to physical therapy for expertise with conditions ranging from vertigo and orthopedic issues to wounds, vestibular issues, and gait training. Long-standing programs have shown that leveraging physical therapy in emergency medicine can be a financially viable approach with the proper administrative support and guidance.
-
Coordination Center Uses Real-time Data to Speed Collaborative Decision-making
To handle increasing volumes better, Yale New Haven Hospital has opted to centralize operational decision-making in a new Capacity Coordination Center. Here, a nurse navigator representing the health system’s two busy adult EDs works with representatives from EMS, admitting, bed management, and other key operations to manage incoming and outgoing traffic optimally and to anticipate clinical services that may be needed further upstream.
-
Syncope
Relying on the most current literature, this article discusses the causes of syncope and syncope mimics, provides the best practice evaluation strategies, and will refamiliarize emergency physicians with current state-of-the-art practices regarding syncope risk stratification guidelines.
-
What Is Really BRUEing?
In May 2016, the American Academy of Pediatrics (AAP) published clinical practice guidelines titled Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants, suggesting a new terminology, an evaluation based on the risk of recurrent events or serious underlying causes, and key action statements (management recommendations) for patients meeting the brief resolved unexplained events (BRUE) definition for lower-risk patients. The authors review and discuss the definitions and key management strategies recommended in these new guidelines.
-
Metabolic Acidosis in the ICU
Sodium bicarbonate therapy for severe metabolic acidemia did not affect a primary composite outcome of all-cause mortality at 28 days and at least one organ failure at day 7. However, in an a priori-defined stratum of patients with acute kidney injury, sodium bicarbonate therapy decreased 28-day mortality and the primary outcome.
-
Severe Sepsis and Septic Shock Early Management Bundle
When the Severe Sepsis and Septic Shock Early Management Bundle was used to identify patients with severe sepsis or patients in septic shock, delays in lactate measurements for patients with abnormal lactate levels were associated with delayed initiation of antibiotic therapy and increased mortality.
-
Should We Use Early Physical Therapy for Respiratory Muscles?
Mechanically ventilated patients undergoing inspiratory muscle training demonstrated significant increases in both maximum inspiratory and expiratory muscle pressures; the training was associated with reduced weaning duration of 2.3 days.
-
A Novel Prediction Tool for Hypoxemia During ICU Intubation
The authors of this retrospective analysis of data from two prospective randomized trials of tracheal intubation created a new risk score calculator to identify patients who may develop severe hypoxemia during this procedure.
-
Can Plaintiff Prove Documented ED Evaluation Never Happened?
Inadvertent checking of items is one of the legal risks of electronic medical records. One common scenario: Someone checks a box stating that the patient’s current medications were reviewed. It turns out the patient was taking a medication that was contraindicated to something that was administered in the ED. This can lead to a "he said/she said" situation.