Emergency Department Visits in a Cohort of Persons with Substance Use: Incorporating the Role of Social Networks

Syncope accounts for up to 2% of emergency department visits and results in the hospitalization of 12–86% of patients. There is often a low diagnostic yield, with up to 50% of hospitalized patients being discharged with no clear diagnosis. We will outline a structured approach to the syncope patient in the emergency department, highlighting the evidence supporting the role of clinical judgement and the initial electrocardiogram (ECG) in making the preliminary diagnosis and in safely identifying the patients at low risk of short- and long-term adverse events or admitting the patient if likely to benefit from urgent intervention. Clinical decision tools and additional testing may aid in further stratifying patients and may guide disposition. While hospital admission does not seem to offer additional mortality benefit, the efficient utilization of outpatient testing may provide similar diagnostic yield, preventing unnecessary hospitalizations.

Download Full-text

An agent-based model of social networks for evaluating asthma control interventions on reducing the emergency department visits

Journal of Simulation ◽

10.1057/jos.2015.19 ◽

2017 ◽

Vol 11 (2) ◽

pp. 87-102

Author(s):

N Celik ◽

OM Araz ◽

M Bastani ◽

J P Saenz

Keyword(s):

Emergency Department ◽

Social Networks ◽

Asthma Control ◽

Emergency Department Visits ◽

Agent Based Model ◽

Agent Based

Download Full-text

The Effects of Abuse and Substance Use on Emergency Department Visits and Hospital Admissions Among Child and Adolescent Patients

10.1542/peds.141.1_meetingabstract.310 ◽

2018 ◽

Author(s):

Lalanthica V. Yogendran ◽

Manassa Hany ◽

Benjamin Chaucer ◽

Saira Pasha ◽

Simar Kaur ◽

...

Keyword(s):

Emergency Department ◽

Substance Use ◽

Hospital Admissions ◽

Child And Adolescent ◽

Emergency Department Visits ◽

Adolescent Patients

Download Full-text

ROLE OF PARTICULATE MATTER ON EMERGENCY DEPARTMENT VISITS FOR ASTHMA EXACERBATION

CHEST Journal ◽

10.1016/j.chest.2020.05.377 ◽

2020 ◽

Vol 157 (6) ◽

pp. A311

Author(s):

L. Pini ◽

J. Giordani ◽

C. Concoreggi ◽

P. Piovanelli ◽

A. Pini ◽

...

Keyword(s):

Emergency Department ◽

Particulate Matter ◽

Asthma Exacerbation ◽

Emergency Department Visits

Download Full-text

Benzodiazepine use, misuse, and abuse: A review

Mental Health Clinician ◽

10.9740/mhc.2016.05.120 ◽

2016 ◽

Vol 6 (3) ◽

pp. 120-126 ◽

Cited By ~ 28

Author(s):

Allison Schmitz

Keyword(s):

Emergency Department ◽

Central Nervous System ◽

Substance Use ◽

Nervous System ◽

Elevated Risk ◽

Emergency Department Visits ◽

Prescription Drug Abuse ◽

Benzodiazepine Use ◽

History Of ◽

Poor Outcomes

Abstract Benzodiazepine (BZD) abuse has reached epidemic levels and results in poor outcomes, particularly when combined with concomitant central nervous system depressants. BZDs are abused most commonly in combination with opioids and alcohol. Emergency department visits and related deaths have soared in recent years. In the absence of other medications or illicit substances, BZDs are rarely the sole cause of death. Prescription drug abuse has received more attention in recent years, yet much remains unknown about BZD abuse. BZDs have low abuse potential in most of the general population. A subset is at elevated risk of abuse, especially those with a history of a substance use disorder. Education, prevention, and identification are vital in reducing BZD abuse.

Download Full-text

P008: Addressing chronic pain and problematic substance use of opioids in the emergency department: can a comprehensive framework for care work?

CJEM ◽

10.1017/cem.2016.185 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S81-S81

Author(s):

M.A. Allen

Keyword(s):

Emergency Department ◽

Chronic Pain ◽

Substance Use ◽

Best Practice ◽

Electronic Record ◽

Emergency Department Visits ◽

Direct Result ◽

Complex Needs ◽

Problematic Substance Use ◽

Problematic Substance

Introduction: Chronic pain and substance misuse are complex chronic illness that are subject to prejudice, misinterpretation and cultural biases. They require a broad, multi-disciplined approach if they are to be effectively managed. Barrier’s to effective care in the emergency department include our reliance on pain scales alone to effectively triage and manage chronic pain, differing philosophy’s and attitudes regarding the appropriate use of high risk pain pharmacology including opioids and confusing classifications systems used to describe pain and problematic substance use which can often lead to further stigmatization and over medicating. Methods: The charts of thirteen patients with complex pain and problematic substance use who had more than 360 visits to a regional emergency department in one year were reviewed retrospectively and data collected regarding frequency of visits and disposition after the implementation of a comprehensive pain and addiction strategy from April 2011 to August 2015. Results: In the first year of implementation there was a 70% drop in the frequency of emergency department visits. Five patients (38%) required a comprehensive pain plan. Six agreed (46%) to a direct referral to our mental health, addiction and chronic pain services. Two patients (15%) were lost to follow-up. Review of the electronic record to track patient visits to provincial emergency departments did not show an increase in visits to other facilities within the province. Review of visits in 2015 show a 97% drop in the frequency of visits. Family Physicians in the community did not report an increase in the frequency of patient visits as a direct result of the implementation of this strategy nor was there an increase in complaints to administration regarding ineffective pain management. Conclusion: Although survey numbers are low it suggests that a framework for the management of complex pain and substance use disorders can be successfully implemented in the emergency department improving timely access to appropriate management and resources for patients based on best practice to address their complex needs.

Download Full-text