scholarly journals Trends in emergency department use by older people during the COVID-19 pandemic

2021 ◽  
Author(s):  
Fergal Howley ◽  
Amanda Lavan ◽  
Eimear Connolly ◽  
Geraldine McMahon ◽  
Mustafa Mehmood ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older People ◽  
Teaching Hospital ◽  
Significant Decline ◽  
Time Dependent ◽  
University Teaching ◽  
Timely Manner ◽  
Emergency Department Use ◽  
Unscheduled Care ◽  
Orthopaedic Injuries

Abstract Purpose Reports suggest that many older people deferred seeking healthcare during the COVID-19 pandemic due to fear of contracting COVID-19. The aim of this study was to examine trends of emergency department (ED) use by older people during the first wave of the COVID-19 pandemic compared to previous years. Methods The study site is a 1000-bed university teaching hospital with annual ED new-patient attendance of > 50,000. All ED presentations of patients aged ≥ 70 years from March to August 2020, 2019 and 2018 inclusive (n = 13,989) were reviewed and compared for presenting complaint, Manchester Triage Score, and admission/discharge decision. Results There was a 16% reduction in presentations across the 6 months in 2020 compared to the average of 2018/2019. On average, 4 fewer people aged ≥ 70 years presented to the ED per day in 2020. Much of this was concentrated in March (33% fewer presentations) and April (31% fewer presentations), when the country was in ‘lockdown’, i.e. non-essential journeys were banned. There was a 20% reduction in patients presenting with stroke and cardiac complaints. In the 3 months following easing of restrictions, there was a 25% increase in falls and orthopaedic injuries when compared to 2018/2019. Conclusion This study demonstrates a significant decline in the number of older people presenting to the ED for unscheduled care, including for potentially time-dependent illnesses such as stroke or cardiac complaints. Given the possibility of further lockdowns, it is imperative that we consider enabling strategies to ensure older people access unscheduled care in a timely manner when necessary.

Ecological factors associated with Emergency Department use by older people in Italy

2020 ◽  
Author(s):  
Francesco Barbabella ◽  
Francesco Balducci ◽  
Carlos Chiatti ◽  
Antonio Cherubini ◽  
Fabio Salvi
Keyword(s):  
Emergency Department ◽  
Older People ◽  
Ecological Factors ◽  
Emergency Department Use ◽  
Factors Associated

A chest pain clinic to improve the follow-up of patients released from an urban university teaching hospital emergency department

1987 ◽  
Vol 16 (10) ◽  
pp. 1145-1150 ◽  
Author(s):  
Gregory W Rouan ◽  
Jerris R Hedges ◽  
Robert Toltzis ◽  
Beth Goldstein-Wayne ◽  
Donald Brand ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Teaching Hospital ◽  
University Teaching ◽  
Pain Clinic ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Urban University

scholarly journals Pralidoxime in organophosphorus poisoning

2010 ◽  
Vol 50 (180) ◽  
Author(s):  
N R Simkhada ◽  
KK Kafle ◽  
PN Prasad
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Initial Dose ◽  
Maintenance Dose ◽  
Normal Limit ◽  
University Teaching ◽  
Serum Cholinesterase ◽  
Prospective Analysis ◽  
Organophosphorus Poisoning ◽  
Acute Organophosphorus Poisoning

INTRODUCTION: Pralidoxime are enzyme reactivator that are known to reactivate the phosphorylated acetylcholinesterase by binding to the organophosphorus molecule. The use of oximes in acute organophosphorus poisoning has been a controversial subjects for over two decades. This study was conducted with the objective to find out the estimation of serum cholinesterase and use of pralidoxime in organophosphorus poisoning. METHODS: A prospective analysis of all organophosphorus poisoning cases presented at the Emergency Department, Tribhuvan University Teaching Hospital for seven months was done. RESULTS: Out of 26 cases about 60% of poisoning cases were monitored for pseudocholinesterase level. About 50% of them had pseudocholinesterase level within normal limit and 20% had less than 10% of normal value. Only 33% cases with pseudocholinesterase level less than 10% were treated with pralidoxime. CONCLUSIONS: The initial dose of Pralidoxime used was 1 gm followed by maintenance dose of 500mg 6 hourly, the doses prescribed were less than WHO recommended doses.  Keywords: cholinesterase, emergency, organophosphorus,poisoning, Pralidoxime.  

Emergency Department Management of Pediatric Asthma at a University Teaching Hospital

2007 ◽  
Vol 41 (10) ◽  
pp. 1625-1631 ◽  
Author(s):  
Cynthia D Ly ◽  
Cathi E Dennehy
Keyword(s):  
Emergency Department ◽  
Pulse Oximetry ◽  
San Francisco ◽  
Teaching Hospital ◽  
Peak Flow ◽  
Medical Center ◽  
Action Plan ◽  
Pediatric Asthma ◽  
University Teaching ◽  
Major Health Problem

Background: Asthma is a major health problem and the most frequent cause of chronic illness and emergency department (ED) visits in children. Limited data examining the ED management of pediatric asthma within university teaching hospitals across the US exist. Objective: To compare the ED management of children (aged 1–17 y) with asthma at a university teaching hospital using National Asthma Education and Prevention Program (NAEPP) guidelines. Methods: All cases of pediatric asthma that presented to the University ot California, San Francisco, Medical Center ED between October 1, 2003, and October 31, 2004, were included. Patients who required hospital admission were excluded. Data pertaining to patient demographics, primary diagnosis, pharmacologic management, diagnostic tests performed, and follow-up plans were abstracted and compared with NAEPP guidelines issued in 1997 and updated topics released in 2002. Results: A total of 141 cases were Identified. Mean patient age was 5.8 years. Most (61.7%) patients were male and of African American ethnicity (31.9%). Asthma severity was typically mild (66.7%) or moderate (29.1%). In persons at least 6 years of age (n = 58), peak expiratory flow rate (PEFR) was performed in 25.9% of cases. Pulse oximetry, however, was always performed. Based on NAEPP guidelines, β-agonists and corticosteroids should have been used, but were not, in 2.8% and 31.9% ot cases, respectively. At discharge, no corticosteroid prescription was given in 40.4% of the cases, no written action plan was prepared in 80.1% of the cases, no formal device training was administered in 67.3% of cases, and no peak flow meter was provided for persons at least 6 years of age in 50.0% of cases. Conclusions: NAEPP guidelines were met in all patients regarding pulse oximetry and in most patients with respect to the use of β-agonists. Improvements could be made, however, in the use of corticosteroids in the ED: in performing PEFR measurements for persons al least 6 years of age upon arrival; and in providing formal device training, a written action plan, prescriptions for steroids, and peak flow meters at discharge.

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