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Asthma patients have worse outcomes and more hospitalizations if they wait too long before coming to the ED, according to a recent study, which found that one-third of 296 asthma patients seen in two New York City EDs waited more than five days before they decided to go to the ED.
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The ED at Shands Critical Care Center at the University of Florida in Gainesville, FL, sees about 9,000 patients every year who present with chest pain, and until recently, a high percentage of the low- to moderate-risk patients were being admitted to the hospital for further observation.
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Faster throughput can clear waiting rooms and boost patient satisfaction, but there are also instances where time-to-treatment can make a critical difference in outcomes.
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One new study suggests that crowding in the ED does not necessarily prevent patients who are having ST-segment-elevation myocardial infarction (STEMI) heart attacks from receiving needed treatment quickly.
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Like many EDs across the country, the ED at St. Charles Medical Center in Bend, OR, sees its share of patients with urgent or primary care needs, and many of these patients frequent the ED 10 or more times a year.
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The medical literature is rife with information on the trends of various infectious diseases. Much of this begins with the diagnosis made and helps us connect the diagnosis to a preferred regimen of antimicrobials or antivirals. The real detective work starts before this. Our tools are constant vigilance for subtle clues in the history and physical examination, some nonspecific laboratory tests (for example white blood cell [WBC] count or lactate), and a high level of suspicion for infection.
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Regardless of hospital trauma level designation, every emergency department (ED) manages patients with traumatic injury and needs to address the pain and discomfort that accompanies it.
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My hospital has a contract to provide medical care to the county jail. At any one time, there are more than 10,000 inmates in the county jail facilities supervised by the sheriff's office. We often see patients who are in custody and have sustained trauma, sometimes from less than lethal weapons. In my humble opinion, these devices reduce the risk of injury to the law enforcement officer when attempting to arrest or control a violent individual, and they greatly reduce the risk of serious injury or even death to the violent individuals themselves. However, even these less than lethal force weapons can cause significant damage when used at close range or on individuals with underlying medical conditions that render them vulnerable to the effects of these weapons.
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My emergency department (ED) has had an electronic medical record for the past two years. Part of that record includes a medication list that is created from past encounters and updated by the triage nurse. Because it is electronic and prints out nicely in the triage summary, it has the appearance of truth. My experience with the list is likely similar to some of yours: Patients are often taking medications not on the list and are not currently taking those that are.