scholarly journals Factors influencing emergency department observation time following anaphylaxis: a systematic review

CJEM ◽  
2021 ◽  
Author(s):  
David Simard ◽  
Vanessa Bouchard ◽  
Annie Plourde ◽  
Sébastien Lefebvre ◽  
Antoine Herman-Lemelin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Observation Time ◽  
Factors Influencing

scholarly journals Systematic review of factors influencing decisions to limit treatment in the emergency department

2021 ◽  
pp. emermed-2019-209398
Author(s):  
Nathan Walzl ◽  
Ian A Sammy ◽  
Paul M Taylor ◽  
Jason E Smith ◽  
David J Lowe
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Narrative Analysis ◽  
Functional Limitation ◽  
Significant Heterogeneity ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Patient Groups ◽  
Cost Factors

BackgroundEmergency physicians are frequently faced with making decisions regarding how aggressive to be in caring for critically ill patients. We aimed to identify factors that influence decisions to limit treatment in the Emergency Department (ED) through a systematic search of the available literature.DesignProspectively registered systematic review of studies employing any methodology to investigate factors influencing decisions to limit treatment in the ED. Medline and EMBASE were searched from their inception until January 2019. Methodological quality was assessed using the Mixed Methods Appraisal Tool, but no studies were excluded based on quality. Findings were summarised by narrative analysis.Results10 studies published between 1998 and 2016 were identified for inclusion in this review, including seven cross-sectional studies investigating factors associated with treatment-limiting decisions, two surveys of physicians making treatment-limiting decisions and one qualitative study of physicians making treatment-limiting decisions. There was significant heterogeneity in patient groups, outcome measures, methodology and quality. Only three studies received a methodology-specific rating of ‘high quality’. Important limitations of the literature include the use of small single-centre retrospective cohorts often lacking a comparison group, and survey studies with low response rates employing closed-response questionnaires. Factors influencing treatment-limiting decisions were categorised into ‘patient and disease factors’ (age, chronic disease, functional limitation, patient and family wishes, comorbidity, quality of life, acute presenting disorder type, severity and reversibility), ‘hospital factors’ (colleague opinion, resource availability) and ‘non-patient healthcare factors’ (moral, ethical, social and cost factors).ConclusionsSeveral factors influence decisions to limit treatment in the ED. Many factors are objective and quantifiable, but some are subjective and open to individual interpretation. This review highlights the complexity of the subject and the need for more robust research in this field.

Elderly patientsʼ experiences of care in the emergency department: a systematic review

2010 ◽  
Vol 8 (Supplement) ◽  
pp. 1-25
Author(s):  
Lim Siew Hoon ◽  
Sandra Mackey ◽  
He Hong-Gu
Keyword(s):  
Systematic Review ◽  
Emergency Department

scholarly journals Injuries and frequent use of emergency department services: a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040272
Author(s):  
Catherine Laferté ◽  
Andréa Dépelteau ◽  
Catherine Hudon
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Cohort Studies ◽  
Eligibility Criteria ◽  
Geriatric Population ◽  
Physical Injuries ◽  
Frequent Use ◽  
Different Types ◽  
Ed Visits ◽  
Return Visits

ObjectiveTo review all studies having examined the association between patients with physical injuries and frequent emergency department (ED) attendance or return visits.DesignSystematic review.Data sourceMedline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO databases were searched up to and including July 2019.Eligibility criteriaEnglish and French language publications reporting on frequent use of ED services (frequent attendance and return visits), evaluating injured patients and using regression analysis.Data extraction and synthesisTwo independent reviewers screened the search results, and assessed methodological quality using the Joanna Briggs Institute tool for prevalence studies. Results were collated and summarised using a narrative synthesis. A sensitivity analysis was performed to evaluate the repercussions of removing a study that did not meet the quality criteria.ResultsOf the 2184 studies yielded by this search, 1957 remained after the removal of duplicates. Seventy-eight studies underwent full-text screening leaving nine that met the eligibility criteria and were included in this study: five retrospective cohort studies; two prospective cohort studies; one cross-sectional study; and one case-control study. Different types of injuries were represented, including fractures, trauma and physical injuries related to falls, domestic violence or accidents. Sample sizes ranged from 200 to 1 259 809. Six studies included a geriatric population while three addressed a younger population. Of the four studies evaluating the relationship between injuries and frequent ED use, three reported an association. Additionally, of the five studies in which the dependent variable was return ED visits, three articles identified a positive association with injuries.ConclusionsPhysical injuries appear to be associated with frequent use of ED services (frequent ED attendance as well as return ED visits). Further research into factors including relevant youth-related covariates such as substance abuse and different types of traumas should be undertaken to bridge the gap in understanding this association.

scholarly journals Patients with first versus multiple episodes of self-harm: how do their profiles differ?

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Philippe Golay ◽  
Louise Ostertag ◽  
Alessandra Costanza ◽  
Bénédicte Van der Vaeren ◽  
Yves Dorogi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Personality Disorder ◽  
Suicide Attempt ◽  
Professional Activity ◽  
Suicidal Risk ◽  
Factors Influencing ◽  
Several Variables ◽  
French Speaking ◽  
Self Harm ◽  
Multiple Episodes

Abstract Background Self-harm (SH) is among the strongest predictors of further episodes of SH, suicide attempt, and death by suicide. People who repeteadly harm themselves are at even higher risk for suicide. Factors influencing the repetition are important to identify when assessing suicidal risk and thereafter to offer specific interventions. Therefore, this study aimed to compare first versus multiple episodes characteristics in a large sample of patients in french-speaking Switzerland. Method We used the database from the French-speaking Swiss program for monitoring SH. Data of the psychiatric assessment of all adults admitted for SH were collected in the emergency department of four Swiss city hospitals between December 2016 and October 2019. Results 1730 episodes of SH were included. Several variables were significantly associated with multiple episodes, including diagnosis (over representation of personality disorders and under representation of anxiety disorders), professional activity (Invalidity insurance more frequent) and prior psychiatry care. Conclusions Patients suffering from a personality disorder and those with invalidity insurance are at risk for multiple episodes of SH and should be targeted with specific interventions.

scholarly journals Factors influencing environmental perception: A Systematic Review

2021 ◽  
Vol 1950 (1) ◽  
pp. 012040
Author(s):  
R.V Shynu ◽  
K.G Santhosh Kumar ◽  
R.D Sambath
Keyword(s):  
Systematic Review ◽  
Environmental Perception ◽  
Factors Influencing
Sign in / Sign up

Export Citation Format

Share Document