Septic knee arthritis in the emergency department of a tertiary hospital

Abstract Background Occupational hazards like sharp injury and splash exposure (SISE) are frequently encountered in health-care settings. The adoption of standard precautions by healthcare workers (HCWs) has led to significant reduction in the incidence of such injuries, still SISE continues to pose a serious threat to certain groups of HCWs. Materials and Methods This was a retrospective study which examined the available records of all patients from January 2015 to August 2019 who self-reported to our emergency department with history of sharp injury and/or splash exposure. Details of the patients, mechanism of injury, the circumstances leading to the injury, status of the source (hepatitis B surface antigen, human immunodeficiency virus, and hepatitis C virus antibody status), and the postexposure prophylaxis given were recorded and analyzed. Data were represented in frequency and percentages. Results During the defined period, a total of 834 HCWs reported with SISE, out of which 44.6% were doctors. Majority of the patients have SISE while performing medical procedures on patients (49.5%), while 19.2% were exposed during segregation of waste. The frequency of needle stick injury during cannulation, sampling, and recapping of needle were higher in emergency department than in wards. More than 80% of HCWs received hepatitis B vaccine and immunoglobulin postexposure. Conclusion There is need for periodical briefings on practices of sharp handling as well as re-emphasizing the use of personal protective equipment while performing procedures.

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Prospective observational study of the practice of endotracheal intubation in the emergency department of a tertiary hospital in Sydney, Australia

Emergency Medicine Australasia ◽

10.1111/1742-6723.12005 ◽

2012 ◽

Vol 24 (6) ◽

pp. 617-624 ◽

Cited By ~ 31

Author(s):

Toby Fogg ◽

Nick Annesley ◽

Kerry Hitos ◽

John Vassiliadis

Keyword(s):

Emergency Department ◽

Observational Study ◽

Endotracheal Intubation ◽

Prospective Observational Study ◽

Tertiary Hospital ◽

Sydney Australia

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A 12-year retrospective analysis of differences between elderly and oldest old patients referred to the emergency department of a large tertiary hospital

Maturitas ◽

10.1016/j.maturitas.2018.11.011 ◽

2019 ◽

Vol 120 ◽

pp. 7-11 ◽

Cited By ~ 6

Author(s):

Marcello Covino ◽

Carmine Petruzziello ◽

Graziano Onder ◽

Alessio Migneco ◽

Benedetta Simeoni ◽

...

Keyword(s):

Emergency Department ◽

Retrospective Analysis ◽

Oldest Old ◽

Tertiary Hospital ◽

Old Patients

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A Sample of The Relationship Between The Non-Integrated Healthcare System And National Epidemic of Emergency Department Overcrowding In Turkey

10.21203/rs.3.rs-818815/v1 ◽

2021 ◽

Author(s):

Cihad Dundar ◽

Seydanur Dal Yaylaoglu

Keyword(s):

Emergency Department ◽

Female Gender ◽

Tertiary Hospital ◽

Emergency Department Visits ◽

Work Hours ◽

Diagnostic Code ◽

Diagnostic Codes ◽

Logistic Analysis ◽

Ed Visits ◽

Negative Impacts

Abstract Background: The use of EDs has significantly increased, and a majority of this increase is attributed to non-urgent visits, which has negative impacts. We aim to explore the frequency of non-urgent emergency department (ED) visits and to identify risk factors for non-urgent ED visits. Methods: This retrospective, the record-based study was conducted at a tertiary hospital in Samsun province of Turkey. The records of all adult patients who visited to the ED between January 1 and December 31, 2017, were included in this study. All emergency department visits were evaluated according to age, gender, time of visit, means of arrival, ICD diagnostic codes, and the number of repeated non-urgent ED visits. The number of ED visits was 87,528 for the year 2017. Results: The non-urgent emergency visit rate was 9.9%. According to binary logistic analysis, non-urgent visits were associated with young age (OR = 2.75), female gender (OR = 1.11) and non-ambulance transportation (OR = 9.86). The prevalence of non-emergent visits was very similar between weekends and weekdays but was significantly higher in work hours on weekdays than non-work hours (p<0.001). The most frequent diagnostic code was “Pain, unspecified” (R52) and the rate of repeated visits was 14.8% of non-urgent ED visits. Conclusions: Harmonization of various databases at the primary level in terms of design and connectivity and integration with hospital information systems will contribute to the identification of problems and the generation of solutions. The next step is establishing an integrated health care system that can benefit emergency care organizations in Turkey.

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Clinical profile of patients presenting to emergency with upper gastrointestinal bleeding in a tertiary hospital of Nepal

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v8i2.28839 ◽

2021 ◽

Vol 8 (2) ◽

pp. 105-111

Author(s):

Sunil Adhikari ◽

Suraj Rijal ◽

Darlene Rose House

Keyword(s):

Emergency Department ◽

Gastrointestinal Bleeding ◽

Variceal Bleeding ◽

Clinical Presentation ◽

Upper Gastrointestinal Bleeding ◽

Tertiary Hospital ◽

Clinical Profile ◽

Ulcer Bleeding ◽

Cross Sectional ◽

Upper Gastrointestinal

Introduction: Upper gastrointestinal bleeding is an acute emergency condition. It is an important cause for the hospital admission. This study descriptively analyses the clinical profile of upper gastrointestinal bleeding presenting to a tertiary hospital in Nepal. Method: This is a cross-sectional study of patients presenting with upper gastrointestinal bleeding from 01 Oct 2018 to 30 Sep 2019 at Patan Hospital Emergency Department, Patan Academy of Health Sciences, Nepal. Patient’s demographics, clinical presentation, duration of illness before presenting to Emergency, vitals, and laboratory parameters were descriptively analyzed. Ethical approval was obtained. Result: There were 121 patients, male 82(67.8%) and female 38(31.4%) aging 14 to 90 years. Fifty-three patients (43.8 %) presented with hematemesis, 38(31.4%) with melena, and 27(22.3%) with both hematemesis and melena. Variceal bleeding was the main cause of upper gastrointestinal bleeding found in 73(60.33%) followed by ulcer bleeding in 48(39.66%). Conclusion: Variceal bleeding was the main cause of upper gastrointestinal bleeding and hematemesis was the most common clinical presentation in patients presenting to the Emergency Department.

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Risk Stratification with Extreme Learning Machine: A Retrospective Study on Emergency Department Patients

Mathematical Problems in Engineering ◽

10.1155/2014/248938 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Nan Liu ◽

Jiuwen Cao ◽

Zhi Xiong Koh ◽

Pin Pin Pek ◽

Marcus Eng Hock Ong

Keyword(s):

Emergency Department ◽

Risk Stratification ◽

Extreme Learning Machine ◽

Tertiary Hospital ◽

Support Vector ◽

Characteristic Analysis ◽

Scoring Method ◽

Stratification Method ◽

Emergency Department Patients ◽

Learning Machine

This paper presents a novel risk stratification method using extreme learning machine (ELM). ELM was integrated into a scoring system to identify the risk of cardiac arrest in emergency department (ED) patients. The experiments were conducted on a cohort of 1025 critically ill patients presented to the ED of a tertiary hospital. ELM and voting based ELM (V-ELM) were evaluated. To enhance the prediction performance, we proposed a selective V-ELM (SV-ELM) algorithm. The results showed that ELM based scoring methods outperformed support vector machine (SVM) based scoring method in the receiver operation characteristic analysis.

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Anaphylactic Reactions in the Emergency Department of a Portuguese Tertiary Hospital: Clinical Characterization and Disease Notification

Acta Médica Portuguesa ◽

10.20344/amp.10820 ◽

2019 ◽

Vol 32 (2) ◽

pp. 91

Author(s):

Ana Teresa Fróis ◽

Teresa Cardoso

Keyword(s):

Emergency Department ◽

Adverse Reactions ◽

Tertiary Care ◽

Tertiary Hospital ◽

Clinical Approach ◽

National Guidelines ◽

Disease Notification ◽

Health Products ◽

Mandatory Notification ◽

Clinical Records

Introduction: Anaphylaxis is significantly underdiagnosed, and the medical community’s knowledge about it is precarious. The aim of this study is to characterize the patient population and the Emergency Department approach of anaphylaxis.Material and Methods: Retrospective study of adult patients attending the Emergency Department of a tertiary care Portuguese hospital, over a year, with anaphylaxis. Data were obtained from each patient’s clinical records and anonymized. A questionnaire evaluating knowledge about the notification of anaphylaxis was applied to Emergency Department physicians.Results: The study included 69 patients. Cutaneous (97%) and respiratory features (80%) were most prevalent; 22% of patients presented with shock or related symptoms. There were no reported biphasic reactions or deaths. The likely allergen was identified in 73%, most commonly food; 12% of reactions were related to a previously known allergen. Epinephrine was administered to 15%. Referral to an Immunoallergologist was done in 36% of patients, and 10% received or already possessed an epinephrine autoinjector. Among six parameters recommended for auditing clinical practice, 70% of cases fulfilled less than half. Only 13% of physicians knew it was mandatory to register all cases in the Portuguese Catalogue of Allergies and Other Adverse Reactions, and only 4% knew how to do it; regarding notification to the National Authority of Medicines and Health Products results were slightly better.Discussion: Many patients with anaphylaxis present to the Emergency Department every year, and their clinical approach is not in agreement with national guidelines. Conclusion: An educational program to increase medical awareness of the national guidelines and mandatory notification of all anaphylactic reactions should be implemented.

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