scholarly journals A prospective evaluation of the availability and utility of the Ambulance Call Record in the emergency department

CJEM ◽  
2016 ◽  
Vol 19 (2) ◽  
pp. 81-87 ◽  
Author(s):  
Natalie Cram ◽  
Shelley McLeod ◽  
Michael Lewell ◽  
Matthew Davis
Keyword(s):  
Emergency Department ◽  
Patient Management ◽  
Treatment Plan ◽  
Tertiary Care ◽  
Relevant Information ◽  
Care Centre ◽  
Prospective Evaluation ◽  
Tertiary Care Centre ◽  
Handover Process ◽  
Collection Form

AbstractObjectiveTo determine how often the Ambulance Call Record (ACR) was available to emergency department (ED) physicians and whether it contained information that changed the ED management of patients.MethodsThis was a prospective cohort study of adult patients transported to one of two tertiary care centre EDs. Physicians completed a data collection form for each patient regarding ACR availability and the perceived value of the ACR. This study began shortly after the implementation of a new electronic ACR (eACR) handover process (Round 1). To control for any confounding factors related to this new eACR handover process, the study was repeated 6 months after its implementation (Round 2).ResultsTotal of 869 forms were collected: 545 in Round 1, and 324 in Round 2. The ACR was available at first physician assessment for 82 (15.7%) patients in Round 1, and 76 (24.4%) patients in Round 2 (Δ8.7%, 95% CI: 3.1%, 14.5%). The ACR was available at some point during patients’ ED stay for 154 (28.9%) patients in Round 1, compared to 111 (34.5%) patients in Round 2 (Δ5.6%, 95% CI: 0.0%, 12.1%). When the ACR was available for a patient (n=265), physicians believed that information in the ACR changed their treatment plan in 76 (28.8%) cases.ConclusionPhysicians who review the ACR believe that the ACR contains relevant information that may influence patient management; however, physicians commonly manage patients without reviewing the ACR.

scholarly journals Triage, Surge Capacity, and Epidemic Emergency Unit: An experience from the 2019 dengue outbreak at a Tertiary Care Centre

2020 ◽  
Vol 58 (224) ◽  
Author(s):  
Ashis Shrestha ◽  
Sumana Bajracharya ◽  
Darlene Rose House
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Health Sciences ◽  
Emergency Unit ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Surge Capacity ◽  
Dengue Outbreak ◽  
Endemic Areas

In September 2019, a dengue outbreak was observed in many non-endemic areas of Nepal. Theemergency department of Patan Academy of Health Sciences also received febrile patients exceedingusual daily numbers. This surge of the patient was managed by epidemic triage and activation ofsurge capacity. A part of the surge plan was to activate an epidemic emergency unit. An observationward adjacent to the emergency was used for the epidemic emergency unit. The febrile patients whowere triaged yellow and green were treated in this unit. The patients who were triaged as Red weretreated in the emergency department.

scholarly journals Factors associated with non-urgent visits to the emergency department in a tertiary care centre, western Saudi Arabia: cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035951
Author(s):  
Saja S Al-Otmy ◽  
Abeer Z Abduljabbar ◽  
Rajaa M Al-Raddadi ◽  
Fayssal Farahat
Keyword(s):  
Emergency Department ◽  
Saudi Arabia ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Factors Associated ◽  
Life Threatening

ObjectivesTo explore magnitude and factors associated with non-urgent visits to the emergency department (ED) in a tertiary care centre, western Saudi Arabia.DesignA cross-sectional study.SettingED of a tertiary care hospital in western Saudi Arabia.Participants400 patients, both men and women.InterventionsAn interview-based questionnaire was administered to a consecutive sample of patients who visited the ED during morning shifts, where primary healthcare centres (PHCs) and outpatient clinics were available.Primary outcome measureED visits classified as non-urgent versus urgent (excluding life-threatening conditions) based on the Canadian Triage and Acuity Scale (CTAS). Levels IV and V were classified as non-urgent.ResultsMajority of the cases were adult (97.3%) and half of them were women (54.8%). Non-urgent visits represented 78.5% among non-life-threatening cases. One-third of the patients (33.8%) had three visits or more to the ED during the past year. Main reasons for visiting the ED were perception that the condition was urgent (42.0%), easy access (25.5%) and limited resources and services at the PHCs (17.8%). Patients 40–50 years old were more likely to have non-urgent visits (OR=3.21, 95% CI 1.15 to 8.98). However, likelihood of non-urgent visits was significantly lower among patients with cancer (OR=0.37, 95% CI 0.19 to 0.72) and cardiovascular disease (OR=0.43, 95% CI 0.23 to 0.83), and those who live near the hospital (OR=0.49, 95% CI 0.28 to 0.88).ConclusionsThe current study reported overuse of the ED. Enhancement of the primary care services, in concordance with community awareness, is an important component to reduce burden due to non-urgent use of the ED.

scholarly journals Cannabinoid hyperemesis syndrome presentation to the emergency department: A two-year multicentre retrospective chart review in a major urban area

CJEM ◽  
2017 ◽  
Vol 20 (4) ◽  
pp. 550-555 ◽  
Author(s):  
Jeremy M. Hernandez ◽  
Jared Paty ◽  
Ira M. Price
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Kappa Statistic ◽  
Cannabis Use ◽  
Urgent Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cannabinoid Hyperemesis Syndrome

AbstractObjectiveCannabinoid hyperemesis syndrome (CHS) is a paradoxical side effect of cannabis use. Patients with CHS often present multiple times to the emergency department (ED) with cyclical nausea, vomiting, and abdominal pain, and are discharged with various misdiagnoses. CHS studies to date are limited to case series. The objective was to examine the epidemiology of CHS cases presenting to two major urban tertiary care centre EDs and one urgent care centre over a 2-year period.MethodsUsing explicit variables, trained abstractors, and standardized abstraction forms, we abstracted data for all adults (ages 18 to 55 years) with a presenting complaint of vomiting and/or a discharge diagnosis of vomiting and/or cyclical vomiting, during a 2-year period. The inter-rater agreement was measured using a kappa statistic.ResultsWe identified 494 cases: mean age 31 (+/-11) years; 36% male; and 19.4% of charts specifically reported cannabis use. Among the regular cannabis users (>three times per week), 43% had repeat ED visits for similar complaints. Moreover, of these patients, 92% had bloodwork done in the ED, 92% received intravenous fluids, 89% received antiemetics, 27% received opiates, 19% underwent imaging, 8% were admitted to hospital, and 8% were referred to the gastroenterology service. The inter-rater reliability for data abstraction was kappa=1.ConclusionsThis study suggests that CHS may be an overlooked diagnosis for nausea and vomiting, a factor that can possibly contribute to unnecessary investigations and treatment in the ED. Additionally, this indicates a lack of screening for CHS on ED history, especially in quantifying cannabis use and eliciting associated symptoms of CHS.

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