scholarly journals Rapid Viral Testing and Antibiotic Prescription in Febrile Children With Respiratory Symptoms Visiting Emergency Departments in Europe

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Chantal D. Tan ◽  
Nienke N. Hagedoorn ◽  
Juan E. Dewez ◽  
Dorine M. Borensztajn ◽  
Ulrich von Both ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Respiratory Symptoms ◽  
Antibiotic Prescription ◽  
Viral Testing

scholarly journals (P2-81) A Survey of the Health Effects of Bushfire Smoke on Patients Attending Two Sydney Emergency Departments

2011 ◽  
Vol 26 (S1) ◽  
pp. s162-s163
Author(s):  
G.O. Watkins
Keyword(s):  
Emergency Departments ◽  
Respiratory Symptoms ◽  
Medication Use ◽  
Control Group ◽  
Study Group ◽  
Shortness Of Breath ◽  
Chest Tightness ◽  
Respiratory Pathology ◽  
The Subject ◽  
Emergency Department Patients

The objective of this survey was to investigate the incidence of respiratory symptoms reported by emergency department patients during the Christmas 2001–2002 Sydney bushfire disaster. Two hundred and thirty patients attending two Sydney emergency departments for any reason completed questionnaires regarding respiratory symptoms. The symptoms investigated were cough, shortness of breath, chest tightness and wheeze. The same questionnaire was subsequently administered to a similar control group who were not exposed to bushfire smoke. 51% of those surveyed during the bushfires reported one or more of the respiratory symptoms investigated compared to 31% of the control group. This difference was statistically significant (p < 0.01). A significantly higher proportion of respiratory patients in the study group reported an exacerbation of their condition and increased medication use during the bushfires (p < 0.01). The results are consistent with other research on the subject and suggest that exposure to bushfire smoke causes an increased incidence of respiratory pathology.

scholarly journals Variation in antibiotic prescription rates in febrile children presenting to emergency departments across Europe (MOFICHE): A multicentre observational study

PLoS Medicine ◽  
2020 ◽  
Vol 17 (8) ◽  
pp. e1003208 ◽  
Author(s):  
Nienke N. Hagedoorn ◽  
Dorine M. Borensztajn ◽  
Ruud Nijman ◽  
Anda Balode ◽  
Ulrich von Both ◽  
...  
Keyword(s):  
Observational Study ◽  
Emergency Departments ◽  
Antibiotic Prescription ◽  
Prescription Rates

scholarly journals Paediatric Emergencies During the COVID-19 Pandemic

2021 ◽  
Vol 8 ◽  
pp. 2333794X2198952
Author(s):  
María Isabel Lázaro Carreño ◽  
Ana Barrés Fernández ◽  
Diannet Quintero García ◽  
Jesús Ferrer Ferrer ◽  
Ignacio Fernández González ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Departments ◽  
Respiratory Symptoms ◽  
The State ◽  
Ed Visits ◽  
Different Characteristics ◽  
Sports Activities ◽  
At Home

The state of alarm decreed by the Spanish Government, due to the Coronavirus Disease-19 (COVID-19) pandemic, has demanded the lockdown of children and has conditioned a new organization of the Emergency Departments (ED). A pre-triage station and 2 independent circuits were established: suspected COVID-19 and not suspected COVID-19. The ED visits decreased 84,5% from pre-alarm with no increase in the level of urgencies. During the alarm state, 40.97% of the children were classified as suspected COVID-19. Fever and respiratory symptoms, used as discriminators, generated 2 groups of patients with different characteristics. Although the interruption of sports activities and isolation of children at home contributed to the decrease in emergencies, it was also probably conditioned by adults’ fear of contagion, who avoided going to the hospital in situations that would never have really required ED and resolved themselves in primary care or spontaneously.

scholarly journals Evaluation on Triaging Pathway Strategy Guidelines for Cases with Elipidae Bite during COVID-19 Pandemic at Emergency Department

2021 ◽  
Vol 5 ◽  
pp. 15
Author(s):  
Zainul Ikhwan Ahmad Khusairi
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Respiratory Symptoms ◽  
Rapid Screening ◽  
Shortness Of Breath ◽  
Emergency Rooms ◽  
Triage System ◽  
Respiratory Impairment ◽  
Priority Levels ◽  
Supplementary Issue

Introduction: Emergency departments (ED) typically practice a triage system to classify patients into priority levels. A triage system is commonly used in crowded emergency rooms to determine which patient should be seen and treated immediately.Objective: The objective of this study was to evaluate the effectiveness of triaging pathway guidelines for critical cases seen in the Emergency Department during the COVID-19 outbreak.Case Presentation: Emergency Department, Taiping Hospital is practicing a triaging system which consists of two divisions; cases with respiratory symptoms (SARI) and cases without symptoms of respiratory impairment (non-SARI). A patient with snake bite was presented at the Emergency Department, Taiping Hospital with symptoms of numbness at the site of the bite and a complaint of difficulty to open the eyes, while tachycardia was noted. However, no shortness of breath or difficulty in breathing was reported. COVID-19 rapid screening was done and the patient was treated under Red Zone (non-SARI). Luckily, the patient survived and was stable with no reaction observed after treated with Neuro Polyvalent Antivenom 50ml in 500ml normal saline over one hour.Conclusion: The available patient triaging pathway strategy guideline was effectively practiced by paramedics when managing critical cases at the Emergency Department during COVID-19 outbreak. Other emergency departments are advised to practice effective and appropriate triaging pathway strategy guidelines to save patients’ lives.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S15

scholarly journals Antibiotic Prescription Rates After eVisits Versus Office Visits in Primary Care: Observational Study (Preprint)

2020 ◽  
Author(s):  
Artin Entezarjou ◽  
Susanna Calling ◽  
Tapomita Bhattacharyya ◽  
Veronica Milos Nymberg ◽  
Lina Vigren ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Sore Throat ◽  
Respiratory Symptoms ◽  
Antibiotic Prescription ◽  
Private Health Care ◽  
Office Visits ◽  
Direct To Consumer ◽  
Virtual Visits ◽  
Prescription Rates

BACKGROUND Direct-to-consumer telemedicine is an increasingly used modality to access primary care. Previous research on assessment using synchronous virtual visits showed mixed results regarding antibiotic prescription rates, and research on assessment using asynchronous chat-based eVisits is lacking. OBJECTIVE The goal of the research was to investigate if eVisit management of sore throat, other respiratory symptoms, or dysuria leads to higher rates of antibiotic prescription compared with usual management using physical office visits. METHODS Data from 3847 eVisits and 759 office visits for sore throat, dysuria, or respiratory symptoms were acquired from a large private health care provider in Sweden. Data were analyzed to compare antibiotic prescription rates within 3 days, antibiotic type, and diagnoses made. For a subset of sore throat visits (n=160 eVisits, n=125 office visits), Centor criteria data were manually extracted and validated. RESULTS Antibiotic prescription rates were lower following eVisits compared with office visits for sore throat (169/798, 21.2%, vs 124/312, 39.7%; <i>P</i>&lt;.001) and respiratory symptoms (27/1724, 1.6%, vs 50/251, 19.9%; <i>P</i>&lt;.001), while no significant differences were noted comparing eVisits to office visits for dysuria (1016/1325, 76.7%, vs 143/196, 73.0%; <i>P</i>=.25). Guideline-recommended antibiotics were prescribed similarly following sore throat eVisits and office visits (163/169, 96.4%, vs 117/124, 94.4%; <i>P</i>=.39). eVisits for respiratory symptoms and dysuria were more often prescribed guideline-recommended antibiotics (26/27, 96.3%, vs 37/50, 74.0%; <i>P</i>=.02 and 1009/1016, 99.3%, vs 135/143, 94.4%; <i>P</i>&lt;.001, respectively). Odds ratios of antibiotic prescription following office visits compared with eVisits after adjusting for age and differences in set diagnoses were 2.94 (95% CI 1.99-4.33), 11.57 (95% CI 5.50-24.32), 1.01 (95% CI 0.66-1.53), for sore throat, respiratory symptoms, and dysuria, respectively. CONCLUSIONS The use of asynchronous eVisits for the management of sore throat, dysuria, and respiratory symptoms is not associated with an inherent overprescription of antibiotics compared with office visits. CLINICALTRIAL ClinicalTrials.gov NCT03474887; https://clinicaltrials.gov/ct2/show/NCT03474887

scholarly journals 1509. Impact of Respiratory Viral Infection on Outcomes of Congenital Heart Repair Surgery

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S758-S758
Author(s):  
Namun Srivastava ◽  
Emy Kuriakose ◽  
Heather Sowinski ◽  
Daliya Khuon
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Respiratory Symptoms ◽  
Congenital Heart ◽  
Pediatric Population ◽  
Respiratory Illness ◽  
The United States ◽  
Heart Repair ◽  
Viral Testing ◽  
The Impact

Abstract Background Respiratory viral infections are common in the pediatric population and can range from mild to life-threatening. Given the risk factors that accompany these infections, some pediatric cardiothoracic surgeons in the United States avoid performing surgery for patients with congenital heart disease when there is a possibility of concurrent viral respiratory illness. Studies in this patient population have been limited either by small study populations, or a study focus that is too narrow. The impact of respiratory infections on patient outcomes based on previous literature is also unclear. Methods This retrospective chart review study aimed to compare outcomes after congenital heart repair surgery in patients with positive respiratory viral testing to those with negative testing over a five-year period, to determine if there are significant differences related to post-operative hospital course or morbidity. Patient Inclusion Flowchart Results This study included 120 patients, of whom 43 tested positive for respiratory viruses and 77 tested negative. Patients were additionally divided based on the presence or absence of symptoms of respiratory infection, with 79 patients demonstrating respiratory symptoms and 41 who did not. Results demonstrate that negative respiratory viral testing is associated with a significant increase in post-operative ICU LOS (p = 0.01), hospital LOS (p &lt; 0.01), and duration of post-operative respiratory support (p &lt; 0.01), compared to positive testing. Additionally, an absence of respiratory symptoms at the time of testing was associated with a significant increase in post-operative ICU LOS (p = 0.01) and hospital LOS (p &lt; 0.01), compared to patients who were symptomatic. Outcomes by Positive vs. Negative FilmArray Outcomes by Symptomatic vs. Asymptomatic Conclusion These results suggest that negative respiratory viral testing or lack of respiratory infectious symptoms should not be a reassuring factor in patients scheduled for repair of congenital heart disease, and positive testing does not appear to result in worse outcomes after surgery. Based on this data, we would recommend that respiratory viral testing should not be a routine component of preoperative planning for patients scheduled to undergo congenital heart repair surgery, which would reduce the burdens of unnecessary testing and delays in definitive heart repair. Disclosures All Authors: No reported disclosures

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