UTILIZATION OF EMERGENCY DEPARTMENT, UKM MEDICAL CENTRE: PATTERN OF PATIENT

2016 ◽  
Vol 78 (4-4) ◽  
Author(s):  
Wan Malissa Wan Mohd Aminuddin ◽  
Wan Rosmanira Ismail ◽  
Husyairi Harunarashid ◽  
Raymond Azman Ali ◽  
Ismail Mohd Saiboon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Census Data ◽  
Early Morning ◽  
Cross Sectional Study ◽  
Huge Number ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Ed Overcrowding ◽  
Critical Patients

An emergency department (ED) is a front door for a hospital where a huge number of patients visit the department to seek immediate treatment. This has led to ED overcrowding. A cross sectional study was conducted to determine the pattern of patients attending the ED in a public teaching hospital in Malaysia. 2013 daily census data contained 66,603 patients were used. In this study, 62.1% of ED attendances are non-critical case. They commonly utilized the ED in the early morning, during weekends, and early part of the week. In conclusion, non-critical patients are seen to be the most frequent ED users. They are commonly present at the ED with minor problems. Hence, ED management should implement various solving methods in order to educate such people regarding the real functions of an ED.

scholarly journals COVID-19 Pandemic Impact on Emergency Department Visits and Quality of Service: A Comparative Cross-Sectional Study in a Tertiary Centre

2021 ◽  
pp. 471-483
Author(s):  
Maram Mohammed Jaboua ◽  
Warif Jameel Abdulhaq ◽  
Nada Saeed Almuntashiri ◽  
Sarah Saud Almohammdi ◽  
Asayel Qeblan Aldajani ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Critical Conditions ◽  
Sectional Study ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Ed Visits

Background: The COVID-19 pandemic has contributed to a devastating impact on emergency departments worldwide, resulting in a global crisis with various health consequences. We aimed to evaluate this impact on an emergency department (ED) visit of critical conditions such as Acute Coronary Syndrome (ACS), Cerebrovascular accident (CVA), Sepsis and Febrile neutropenia (FN), and to assess the quality of the ED after new adaptive measures were applied. Methods: This is a comparative cross-sectional study to assess the number of patients who presented to the ED of King Abdullah Medical city with the specified diagnosis. We collected data via the E-medical records. We compared the data over three periods pre-lockdown, lockdown and post lockdown in years 2019-2021. For quality measurement, Adaa (Ministry of Health's program) was used to calculate the percentage of patients who stayed 4 hours or less in the ED. Results: The total number of ED visits in the specified periods of study was 8387. The total numbers of patients for 2019, 2020, and 2020 respectively were 2011 (, ACS 70.4%, CVA 16.3%, sepsis and FN 13.3%.), 2733 (ACS 73.1%, CVA 9.9%, sepsis and FN 17.0%), and 3643 (ACS 64.0%, CVA 19.4%, sepsis and FN 16.7). The average percentage of patients who stayed 4 hours or less in the ED was 60% and 57.5% for 2020 and 2021, respectively. Conclusion: Although we expected reductions in ED visits during COVID-19 periods, we found that visits were rising through the years 2019-2021.

Prisoners seeking healthcare in emergency department

2020 ◽  
pp. 1-15
Author(s):  
Bedriye Muge Sonmez ◽  
Fevzi Yilmaz ◽  
Murat Dogan Iscanli ◽  
Cihat Yel ◽  
Ali Demir ◽  
...  
Keyword(s):  
Emergency Department ◽  
Healthcare Facility ◽  
Cross Sectional Study ◽  
Medical Group ◽  
Cross Sectional ◽  
Medical Disorders ◽  
Number Of Patients ◽  
Tertiary Healthcare ◽  
Training And Research ◽  
Surgical Conditions

Abstract Objectives: To evaluate inmate referrals to emergency department of a tertiary healthcare facility in terms of demographical and clinical characteristics as well as their impact on the department. Method: The retrospective cross-sectional study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, and comprised data of incarcerated patients who were brought to the emergency department from January 01, 2010, to December 31, 2012. . Demographical characteristics, consultations, duration of hospitalisation, recurrent admissions, disposal and mortality rates were noted. The referrals were grouped as surgical conditions, medical disorders, Eye, Ear, Nose, Throat problems, injury and psychiatric disorders. The groups were then subdivided according to diagnosis. SPSS 22 was used for data analysis. Results: Of the 856 patients, 804(93.4%) were men and 52(6.1%) were women. The overall mean age was 37.54±14.81 years (range: 15-83 years). The number of patients was the highest in the medical group 363(42.4%) and the lowest in the Eye, Ear, Nose, Throat group 56(6.5%). Mean age of the surgical group was significantly lower than the medical group (p<0.001) but significantly higher than that of the trauma group (p=0.001). Conclusion: Functional emergency response units, strict emergency triage of inmates, and their rapid care and management in jails can help avoid referring these patients to already overcrowded emergency departments. Key Words: Prisoners, Healthcare, Emergency department.

scholarly journals Factors determining self-harm

1970 ◽  
Vol 32 (3) ◽  
pp. 14-17
Author(s):  
YL Shakya ◽  
R Acharya ◽  
MP Gupta ◽  
MR Banjara ◽  
PR Prasad
Keyword(s):  
Emergency Department ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Institute Of Medicine ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
Delivery Of Care ◽  
Number Of Patients ◽  
Self Harm

Introduction: Self-harm forms a significant proportion of patient attending in emergency departments, typically 10-30 per 100000 people commit suicide annually. The objective of this study was to find out the factors responsible for self harm. Methods: This is a cross sectional study of 100 patients of self harm coming to Emergency Department of Tribhuvan University Teaching Hospital from 1stOctober 2007 to 31stMarch, 2008. Questionnaire about demographic information of patient along with details about cause of self harm, and any other illnesses associated was filled. Information about duration of arrival in emergency department, place of self harm was gathered. Patients were clinically examined and hematological and biochemical tests including liver function test and the type of poison used and its level in blood were examined. Results: Total number of patients with self harm was 100 (female - 71%; male- 29%).Among female, 16-30 years age group to be the largest (76%). Mean duration of arrival in emergency department was 3.08 hour. Metacid ingestion (29%) was found to be the most common cause for self harm. There is no difference of self harm for suicide and threat cause. Only 5% of patient with self harm has psychiatry illness in the past. Conclusions: Self harm forms a significant proportion of patient attending the Emergency department and the most common form of self harm used was metacid ingestion. There is compelling evidence for the need to improve delivery of care for patients who inflict self harm. Key words: Cause; emergency department; self harm. DOI: http://dx.doi.org/10.3126/joim.v32i3.4954 Journal of Institute of Medicine, December, 2010; 32:3 14-17

scholarly journals Analgesia of acute abdominal pain in the Emergency Department

2019 ◽  
Vol 5 (3) ◽  
pp. 86
Author(s):  
Panteleimon Kalaronis ◽  
Antonia Kalogianni ◽  
Martha Kelesi ◽  
Eytichia Evagelidou ◽  
Ioulia-Maria Mpalla ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
International Guidelines ◽  
Closed Type ◽  
Number Of Patients ◽  
The Mean ◽  
First Time

Introduction: Pain accounts for 40% of all patients admitted to the Emergency Department (ED). The most common cause of pain is abdominal pain, which accounts for 8%. In contrast to the international guidelines, pain is under-treated making the phenomenon of oligoanalgesia apparent.Aim: The purpose of this study was to explore the incidence of analgesia in patients admitted to the ED suffering from acute abdominal pain.  Material and Method: This is a descriptive cross-sectional study. The studied sample consisted of 197 patients, who admitted to the ED of a General Hospital of Athens, Greece with reported symptom: acute abdominal pain. For data collection, a special designed form of closed-type questionnaires was used. Data analysis was performed by using the Statistic Package for Social Sciences (SPSS) statistical packet ver.19.Results: Out of the total number of patients admitted to ED with reported abdominal pain, 74.6% received analgesia and the mean time of analgesia administration during ED admission was 46.43 minutes. The mean pain intensity at the first time point measurement was 7.16 and at the second one was 4.04, according to pain recording scale (0-10 scale). Non-opioid anti-inflammatories (52.3%),  non-steroidal analgesics (22.8%) and opioids (9.1%) were mainly administered patients during their ED stayConclusions: Despite the published international guidelines which refer to analgesia time and type, pain and especially abdominal pain, is under-treated. The key to tackling oligoanalgesia is to educate health professionals.

scholarly journals Evaluation of the Patients’ Queue Status at Emergency Department of Nemazee Hospital and How to Decrease It, 2014

2016 ◽  
Vol 9 (2) ◽  
pp. 230 ◽  
Author(s):  
Mehrdad Askarian ◽  
Seyed Ali Hesami ◽  
Erfan Kharazmi ◽  
Nahid Hatam ◽  
Hourvash Akbari Haghighinejad ◽  
...  
Keyword(s):  
Emergency Department ◽  
Waiting Time ◽  
Discharge Rate ◽  
Cross Sectional Study ◽  
Simulation Software ◽  
Theory Analysis ◽  
Cross Sectional ◽  
Ed Overcrowding ◽  
Level 3 ◽  
Bed Capacity

<p><strong>BACKGROUND:</strong> Patients, who seek care in emergency department, are waiting in queue and the health care provision in the department seems to be too overcrowded; the extended waiting time increases dissatisfaction and delays admission of new patients. In most of the hospitals considered to be overcrowded, the discharge rate of patients is managed by the use of “theory of queues”. This study was done to observe waiting time of patients in emergency department by “queue theory analysis” and computer simulator in an Iranian hospital.</p><p><strong>METHODS:</strong> This is a cross-sectional study in which simulation software (Arena, version 14) was used to build the 8 models. They run in a period of one month. The input information for the models was extracted from the hospital database and through sampling. The objective of this study was to evaluate the response variables of “waiting time” and “number waiting” of each level.<strong> </strong></p><p><strong>RESULT: </strong>In level 2A, with increased number of beds with 20 beds, the waiting time decreased to 0.45 minutes and the percentage of deaths declined to 26.2%, but the number of discharge from this level declined, too. In level 3 with increased number of beds 2 times, waiting time decreased to 74 minutes and the percentage of death declined to 3.7% but the number of discharge from this level to ICU declined, too. <strong></strong></p><p><strong>CONCLUSION: </strong>This study showed the magnitude of ED overcrowding in Nemazee hospital. Increasing the bed capacity in the ED could reduce the waiting time in each part of ED.<strong></strong></p>

scholarly journals Knowledge, attitudes, and practices of Cameroonian physicians with regards to acute pain management in the emergency department: a multicenter cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Owono Etoundi ◽  
Junette Arlette Metogo Mbengono ◽  
Ferdinand Ndom Ntock ◽  
Joel Noutakdie Tochie ◽  
Dominique Christelle Anaba Ndom ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Acute Pain Management ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

Development and Performance Assessment of a Digital Serious Game to Assess Multi-Patient Care Skills in a Simulated Pediatric Emergency Department

2020 ◽  
Vol 51 (4) ◽  
pp. 550-570
Author(s):  
Cindy Luu ◽  
Thomas B. Talbot ◽  
Cha Chi Fung ◽  
Eyal Ben-Isaac ◽  
Juan Espinoza ◽  
...  
Keyword(s):  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Patient Care ◽  
Skill Acquisition ◽  
Video Game ◽  
Rank Correlation ◽  
Fixed Time ◽  
Serious Game ◽  
Cross Sectional ◽  
Number Of Patients

Objective. Multi-patient care is important among medical trainees in an emergency department (ED). While resident efficiency is a typically measured metric, multi-patient care involves both efficiency and diagnostic / treatment accuracy. Multi-patient care ability is difficult to assess, though simulation is a potential alternative. Our objective was to generate validity evidence for a serious game in assessing multi-patient care skills among a variety of learners. Methods. This was a cross-sectional validation study using a digital serious game VitalSignsTM simulating multi-patient care within a pediatric ED. Subjects completed 5 virtual “shifts,” triaging, stabilizing, and discharging or admitting patients within a fixed time period; patients arrived at cascading intervals with pre-programmed deterioration if neglected. Predictor variables included generic multi-tasking ability, video game experience, medical knowledge, and clinical efficiency with real patients. Outcome metrics in 3 domains measured diagnostic accuracy (i.e. critical orders, diagnoses), efficiency (i.e. number of patients, time-to-order) and critical thinking (number of differential diagnoses); MANOVA determined differences between novice learners and expected expert physicians. Spearman Rank correlation determined associations between levels of expertise. Results. Ninety-five subjects’ gameplays were analyzed. Diagnostic accuracy and efficiency distinguished skill level between residency trained (residents, fellows and attendings) and pre-residency trained (medical students and undergraduate) subjects, particularly for critical orders, patients seen, and correct diagnoses (p < 0.003). There were moderate to strong correlations between the game’s diagnostic accuracy and efficiency metrics compared to level of training, including patients seen (rho = 0.47, p < 0.001); critical orders (rho = 0.80, p < 0.001); time-to-order (rho = −0.24, p = 0.025); and correct diagnoses (rho = 0.69, p < 0.001). Video game experience also correlated with patients seen (rho = 0.24, p = 0.003). Conclusion. A digital serious game depicting a busy virtual ED can distinguish between expected experts in multi-patient care at the pre- vs. post-residency level. Further study can focus on whether the game appropriately assesses skill acquisition during residency.

scholarly journals Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

2021 ◽  
Author(s):  
Giorgio Cozzi ◽  
Marta Cognigni ◽  
Riccardo Busatto ◽  
Veronica Grigoletto ◽  
Manuela Giangreco ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Relief ◽  
Local Anaesthesia ◽  
Cross Sectional Study ◽  
Emergency Setting ◽  
Older Children ◽  
Cross Sectional ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

scholarly journals Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2475
Author(s):  
Olivier Peyrony ◽  
Danaé Gamelon ◽  
Romain Brune ◽  
Anthony Chauvin ◽  
Daniel Aiham Ghazali ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Cross Sectional Study ◽  
Red Blood Cell Transfusion ◽  
Cross Sectional ◽  
Acute Bleeding ◽  
History Of ◽  
Rbc Transfusion

Background: We aimed to describe red blood cell (RBC) transfusions in the emergency department (ED) with a particular focus on the hemoglobin (Hb) level thresholds that are used in this setting. Methods: This was a cross-sectional study of 12 EDs including all adult patients that received RBC transfusion in January and February 2018. Descriptive statistics were reported. Logistic regression was performed to assess variables that were independently associated with a pre-transfusion Hb level ≥ 8 g/dL. Results: During the study period, 529 patients received RBC transfusion. The median age was 74 (59–85) years. The patients had a history of cancer or hematological disease in 185 (35.2%) cases. Acute bleeding was observed in the ED for 242 (44.7%) patients, among which 145 (59.9%) were gastrointestinal. Anemia was chronic in 191 (40.2%) cases, mostly due to vitamin or iron deficiency or to malignancy with transfusion support. Pre-transfusion Hb level was 6.9 (6.0–7.8) g/dL. The transfusion motive was not notified in the medical chart in 206 (38.9%) cases. In the multivariable logistic regression, variables that were associated with a higher pre-transfusion Hb level (≥8 g/dL) were a history of coronary artery disease (OR: 2.09; 95% CI: 1.29–3.41), the presence of acute bleeding (OR: 2.44; 95% CI: 1.53–3.94), and older age (OR: 1.02/year; 95% CI: 1.01–1.04). Conclusion: RBC transfusion in the ED was an everyday concern and involved patients with heterogeneous medical situations and severity. Pre-transfusion Hb level was rather restrictive. Almost half of transfusions were provided because of acute bleeding which was associated with a higher Hb threshold.

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