scholarly journals 73.1 “I’M SUICIDAL BECAUSE OF ISSUES AT HOME”: WHAT PSYCHIATRISTS CAN DO FOR CHILDREN AND FAMILIES IN THE EMERGENCY DEPARTMENT

2021 ◽  
Vol 60 (10) ◽  
pp. S108
Author(s):  
Rakin Hoq
Keyword(s):  
Emergency Department ◽  
Children And Families ◽  
At Home

scholarly journals Short‐term outcomes in children following emergency department visits for minor injuries sustained at home

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Matthew J Molloy ◽  
Wendy Shields ◽  
Molly W Stevens ◽  
Andrea C Gielen
Keyword(s):  
Emergency Department ◽  
Pediatric Population ◽  
Pediatric Emergency ◽  
Emergency Department Visits ◽  
Short Term ◽  
Minor Injury ◽  
Minor Injuries ◽  
A Minor ◽  
The Impact ◽  
At Home

Abstract Background Minor injuries are very common in the pediatric population and often occur in the home environment. Despite its prevalence, little is known about outcomes in children following minor injury at home. Understanding the impact of these injuries on children and their families is important for treatment, prevention, and policy. The objectives of our study were (1) To describe the distribution of short-term outcomes following pediatric minor injuries sustained at home and (2) To explore the relationship of injury type and patient and household demographics with these outcomes. Methods Children (n = 102) aged 0–7 years with a minor injury sustained at home were recruited in an urban pediatric emergency department as part of the Child Housing Assessment for a Safer Environment (CHASE) observational study. Each patient had a home visit following the emergency department visit, where five parent-reported outcomes were assessed. Relationships were explored with logistic regression. Results The most common type of injury was soft tissue (57.8 %). 13.2 % of children experienced ≥ 7 days of pain, 21.6 % experienced ≥ 7 days of abnormal activity, 8.9 % missed ≥ 5 days of school, 17.8 % of families experienced ≥ 7 days of disruption, and 9.1 % of parents missed ≥ 5 days of work. Families reported a total of 120 missed school days and 120 missed work days. Children who sustained a burn had higher odds of experiencing pain (OR 6.97), abnormal activity (OR 8.01), and missing school (OR 8.71). The parents of children who sustained a burn had higher odds of missing work (OR 14.97). Conclusions Families of children suffering a minor injury at home reported prolonged pain and changes in activity as well as significant school and work loss. In this cohort, burns were more likely than other minor injuries to have these negative short-term outcomes reported and represent an important target for interventions. The impact of these injuries on missed school and disruption of parental work warrants further consideration.

Catheters at home: managing urinary catheters in the home environment

2021 ◽  
Vol 26 (8) ◽  
pp. 370-376
Author(s):  
Drew Payne
Keyword(s):  
Emergency Department ◽  
Health Service ◽  
Literature Review ◽  
Home Environment ◽  
Negative Impact ◽  
Community Settings ◽  
Urinary Catheters ◽  
Factors Affecting ◽  
The Common ◽  
At Home

In England, there are some 90000 people with catheters in the community, and community nurses often have to manage catheter-related problems. This article looks at these common catheter problems found in the community, for example, blockage, infections and positioning problems. These problems were identified by a literature review and from the author's experience, from many years working in the community. It has been found that education, knowledge, empowerment and communication are vital factors affecting patients' ability to manager their catheters themselves. The article begins with a discussion about how patients can be involved in and manage many aspects of care for their own catheters. It goes on to talk about the common catheter-associated problems and how these can be avoided or addressed. It is hoped that better management of catheter-associated complications in the community settings can prevent unnecessary visits to the emergency department, which will save time and costs for the health service, as well as avoid the negative impact of these on patient lives.

Analysis of written resources for parents of children discharged from a paediatric emergency department

2019 ◽  
Vol 23 (4) ◽  
pp. 652-662
Author(s):  
Kodchanipa Phonpruk ◽  
Karen Flowers ◽  
Geraldine Naughton ◽  
Paul Fulbrook
Keyword(s):  
Emergency Department ◽  
Quality Assessment ◽  
Community Resources ◽  
Health Providers ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Wide Range ◽  
Care At Home ◽  
High Level ◽  
At Home

The aim of this study was to profile the information and readability of parent-focused resources to support care at home following a child’s discharge from a paediatric emergency department (ED). Analysis included recording the scope, source, readability scores and benchmarking the contents against previous recommendations for discharge information. Information from 46 resources (on 41 conditions) from three separate sources was analysed. Overall, a wide range of resources was available. Inconsistency was evident in the framework and design of resources available. Approximately two-thirds of resources provided information about referral to community resources, and most had links to community health providers. Assessment of readability levels showed a predominant pitch towards a relatively high level of schooling. Existing written resources available for parents to use in caring for their child following discharge from an ED could improve with more streamlined designs as well as consistent references to community resources and additional health providers. Parents with low reading capacity may not be able to make the most of existing resources to care for their child at home following ED discharge. This framework was developed for reviewing the resources that could be useful for quality assessment of other parent-focused discharge information.

scholarly journals P1546UK ANNUAL THERAPY COST OF DIALYSIS WITH THE QUANTA SC+ PERSONAL HAEMODIALYSIS SYSTEM

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Thomas Ferguson ◽  
Paul Komenda ◽  
Gerard Harper ◽  
John Milad
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care System ◽  
Self Care ◽  
Emergency Department Visits ◽  
Weekend Effect ◽  
Care At Home ◽  
The Uk ◽  
Care System ◽  
At Home

Abstract Background and Aims The number of patients receiving dialysis is increasing in the United Kingdom, costing the National Health Service (NHS) over 500 million GBP annually. New personal haemodialysis systems are being developed, such as the Quanta SC+, that are smaller and simpler to use by patients while providing the clearances of conventional systems. Increasing uptake of lower intensity assistance and full self-care dialysis may provide economic benefits to the public health payer. In addition, promotion of every other day dialysis (3.5x weekly) may improve costs to the health system by helping to close the “post-weekend effect” with increased emergency department use and hospitalisations following the long interdialytic gap. As such, we aimed to describe the annual therapy costs of using SC+ in the UK for 3x weekly and 3.5x weekly dialysis regimens, both for self-care haemodialysis provided in-centre and at home in comparison to dialysis provided with conventional machines from the perspective of the health care system. Method Cost minimisation approach. Costs for human resources, equipment, and consumables were sourced from the dialysis machine developer (Quanta Dialysis Technologies). Other costs, such as facility expenses, dialysis-related drugs, avoided emergency department and hospitalisation events, and utilities were taken from a review of the literature. Costs are provided in 2018 GBP. Results Therapy provided as self-care in-centre or full self-care at home were found to have similar costs (£33,721 in-centre versus £33,836 at home for the 3x weekly regimen). Costs increased to £37,238 for self-care in-centre and £35,557 at home for the 3.5x weekly regimen. A comparator cost of £39,416 was established for dialysis provided with conventional machines in-hospital 3x weekly. For each dialysis patient, the health care system is anticipated to save £3,666 in costs associated with excess hospital stays and £2,176 in costs associated with excess emergency department visits. Conclusion In the UK, SC+ offers cost savings when used both for self-care in-centre and full self-care at home in comparison to dialysis provided in the clinic using conventional machines.

scholarly journals A Descriptive Analysis of Location of Older Adult Falls That Resulted in Emergency Department Visits in the United States, 2015

2020 ◽  
pp. 155982762094218
Author(s):  
Briana L. Moreland ◽  
Ramakrishna Kakara ◽  
Yara K. Haddad ◽  
Iju Shakya ◽  
Gwen Bergen
Keyword(s):  
United States ◽  
Older Adults ◽  
Emergency Department ◽  
The United States ◽  
Emergency Department Visits ◽  
Targeted Prevention ◽  
Injury Surveillance System ◽  
Injurious Falls ◽  
Ed Visits ◽  
At Home

Introduction. Falls among older adults (age ≥65) are a common and costly health issue. Knowing where falls occur and whether this location differs by sex and age can inform prevention strategies. Objective. To determine where injurious falls that result in emergency department (ED) visits commonly occur among older adults in the United States, and whether these locations differ by sex and age. Methods. Using 2015 National Electronic Injury Surveillance System-All Injury Program data we reviewed narratives for ED patients aged ≥65 who had an unintentional fall as the primary cause of injury. Results. More fall-related ED visits (71.6%) resulted from falls that occurred indoors. A higher percentage of men’s falls occurred outside (38.3%) compared to women’s (28.4%). More fall-related ED visits were due to falls at home (79.2%) compared to falls not at home (20.8%). The most common locations for a fall at home were the bedroom, bathroom, and stairs. Conclusion. The majority of falls resulting in ED visits among older adults occurred indoors and varied by sex and age. Knowing common locations of injurious falls can help older adults and caregivers prioritize home modifications. Understanding sex and age differences related to fall location can be used to develop targeted prevention messages.

Willful Death and Painful Decisions: A Failed Assisted Suicide

1992 ◽  
Vol 1 (2) ◽  
pp. 147-158 ◽  
Author(s):  
Kenneth V. Iserson ◽  
Dorothy Rasinski Gregory ◽  
Kate Christensen ◽  
Marc R. Ofstein
Keyword(s):  
Emergency Department ◽  
Social Life ◽  
Assisted Suicide ◽  
Emergency Department Physician ◽  
Rapid Progression ◽  
Neurologic Disease ◽  
Intellectual Capacity ◽  
Personal Needs ◽  
At Home

The patient was a woman in her 30s who, until the rapid progression of an ultimately fatal neurologic disease, had been a very successful professional, enjoying athletics and an active social life. In the 6 months of swift deterioration, she had gone from being extremely vibrant and energetic to being totally unable to care for her personal needs. There had been no loss of intellectual capacity. Her sister later recounted to Dr. J., the emergency department physician, that she had found the patient unconscious and unresponsive at home and had immediately called the patient's neurologist in a neighboring city. He directed her to call the paramedics.

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