The Vacillated Vagrant

2020 ◽  
pp. 187-192
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Care Hospital ◽  
Shortness Of Breath ◽  
Chest Tightness ◽  
Middle Aged ◽  
Fundamental Attribution Error ◽  
Affective Bias

In this case, a middle-aged male is brought to the emergency department of a tertiary care hospital from the airport. He has had an episode of shortness of breath and chest tightness, associated with nausea, paresthesias, and headache. Initially, he undergoes a cardiac workup and is cleared of any problems with his heart. He is discharged to the community and advised to return if there is any recurrence of symptoms. He does return for a further four visits over a 2-week period, during which he is referred to various other disciplines and services before his correct diagnosis is made. The case illustrates how a variety of biases influence the course of his management, notably diagnosis momentum, fundamental attribution error, and affective bias.

VALIDATION OF QUICK COVID SEVERITY INDEX IN COVID PATIENTS ADMITTED THROUGH EMERGENCY DEPARTMENT OF A PRIVATE TERTIARY CARE HOSPITAL IN WEST BENGAL, INDIA

2021 ◽  
pp. 53-55
Author(s):  
Harsimran Singh Das
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Tertiary Care Hospital ◽  
Clinical Status ◽  
Tertiary Care ◽  
Severity Index ◽  
Adult Patients ◽  
Care Hospital ◽  
Oxygen Requirement ◽  
Clinical Tool

Introduction:qCSI (Quick COVID severity index) is a clinical tool established recently post pandemic to predict respiratory failure within 24 hours of admission in COVID-19 patients; respiratory failure being explain as increased oxygen requirement greater than 6L/min by low ow device, high ow device, noninvasive or invasive ventilation to maintain spO2 of greater than or equal to 94%, or death. Aim:To verify and validate the application of the qCSI in Emergency Department in Indian demographic for evidence-based guidance to aid physician decision making in safely dispositioning adult patients with COVID-19 with oxygen requirement less than or equal to 6L/min via low ow devices including nasal cannula and oxygen mask Materials and methods:This is an observational, retrospective study from Emergency Department in a private tertiary care hospital of admitted adult patients with COVID-19 disease. Clinical parameters in qCSI and disposition of 210 patients admitted through Emergency Department included in this study selected randomly was sought on admission and clinical status with level of care 24 hours following admission was recorded and compared with prediction based on qCSI from a period of 1 May 2020 to 31 October 2020. Result:We found that19(9.0%) patients Initial qCSI Score was Low, 80(38.1%) patients Initial qCSI Score was Low-intermediate, 84(40.0%) patients Initial qCSI Score was High-intermediate and 27(12.9%)patients Initial qCSI Score was High.qCSI Score after 24 hours 16(11.4%) patients were Low, 43(30.7%) patients were Low-intermediate, 63(45.0%) patients was High-intermediate and 18(12.9%) patients was High.Out of 210(100.0%) patients, 70 (33.3%) patients were critically ill. Conclusion:In conclusion these data show that the quick COVID-19 Severity Index provides easily accessed risk stratication relevant to Emergency Department provider.

Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan

2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Syed Ghazanfar Saleem ◽  
Saima Ali ◽  
Nida Ghouri ◽  
Quratulain Maroof ◽  
Muhammad Imran Jamal ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Patient Perception ◽  
Care Hospital ◽  
Structured Interviews ◽  
Privacy Concerns ◽  
Creative Commons ◽  
Privacy And Confidentiality ◽  
And Behavior

Background and Objective: Maintaining privacy and ensuring confidentiality with patients is paramount to developing an effective patient-provider relationship. This is often challenging in over-crowded Emergency Departments (EDs). This survey was designed to explore patients’ perceptions on maintenance of privacy and confidentiality and their subsequent interactions with providers in a busy tertiary care hospital in Karachi. Methods: Trained nursing staff conducted structured interviews with 571 patients who presented to The Indus Hospital (TIH) ED from January to December 2020. All patients were 14 years of age or older, could speak and understand Urdu, and provide informed consent. Patients were asked about their perceptions of privacy and confidentiality in the ED and whether this affected their interactions with providers. Results: Respondents were primarily men (64%) under the age of 45 (62%) presenting for the first time (49%). The majority of patients felt that privacy and confidentiality were maintained, however 10% of patients reported that they had rejected examination due to privacy concerns and 15% of patients reported that they had changed or omitted information provided to a provider due to confidentiality concerns. There was correlation between privacy and confidentiality concerns and patient-provider interactions (p<0.0001). Conclusions: Despite the often over-crowded and busy environment of the ED, patients generally felt that privacy and confidentiality were maintained. Given the correlation between perception and behavior and the importance of an effective patient-provider relationship, particularly in the acute setting when morbidity and mortality is high, initiatives that focus on maintaining privacy and confidentiality should be pursued. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785 How to cite this:Saleem SG, Ali S, Ghouri N, Maroof Q, Jamal MI, Aziz T, et al. Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan. Pak J Med Sci. 2022;38(2):351-355.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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