scholarly journals Bringing sepsis care back to the emergency department: New prognostic tools and extended role of emergency physicians

2021 ◽  
Vol 28 (4) ◽  
pp. 197-198
Author(s):  
Kevin KC Hung ◽  
Rex PK Lam ◽  
CT Lui
Keyword(s):  
Emergency Department ◽  
Emergency Physicians ◽  
Sepsis Care

scholarly journals Emergency Department Physical Therapist Service: A Pilot Study Examining Physician Perceptions

2010 ◽  
Author(s):  
Michele Lebec ◽  
Steven Cernohous ◽  
Lisa Tenbarge ◽  
Colleen Gest ◽  
Kristen Severson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
Emergency Care ◽  
Qualitative Methodology ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Emergency Physicians ◽  
Physician Perceptions ◽  
Potential Benefits

Though physical therapist consultation has been described as a means of enhancing care in the Emergency Department (ED), such services are rare and often poorly understood. This pilot study utilizes qualitative methodology for the purpose of describing how one group of emergency physicians experienced with physical therapist consultation in the ED perceive these services and the challenges associated with their provision. Transcripts of interviews with 11 emergency physicians were analyzed for recurrent themes. Findings indicated that these physicians found ED physical therapist services to be of value for themselves, their patients, and the department as a whole and described specific manners in which such consultations enhanced emergency care. Implementation and maintenance of the program, however, presented various challenges. Furthermore, physicians perceived that possession of certain characteristics better prepared physical therapists for success in this practice environment. These findings may help clarify the role of the ED physical therapist and aid in communicating the potential benefits and complications associated with the delivery of such services.

scholarly journals Proadrenomedullin in Sepsis and Septic Shock: A Role in the Emergency Department

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 920
Author(s):  
Andrea Piccioni ◽  
Angela Saviano ◽  
Sara Cicchinelli ◽  
Federico Valletta ◽  
Michele Cosimo Santoro ◽  
...  
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Early Diagnosis ◽  
Literature Review ◽  
Current Knowledge ◽  
Organ Damage ◽  
Emergency Physicians ◽  
Improve Patient Survival ◽  
Sepsis And Septic Shock

Sepsis and septic shock represent a leading cause of mortality in the Emergency Department (ED) and in the Intensive Care Unit (ICU). For these life-threating conditions, different diagnostic and prognostic biomarkers have been studied. Proadrenomedullin (MR-proADM) is a biomarker that can predict organ damage and the risk of imminent death in patients with septic shock, as shown by a large amount of data in the literature. The aim of our narrative review is to evaluate the role of MR-proADM in the context of Emergency Medicine and to summarize the current knowledge of MR-proADM as a serum indicator that is useful in the Emergency Department (ED) to determine an early diagnosis and to predict the long-term mortality of patients with sepsis and septic shock. We performed an electronic literature review to investigate the role of MR-proADM in sepsis and septic shock in the context of ED. We searched papers on PubMed®, Cochrane®, UptoDate®, and Web of Science® that had been published in the last 10 years. Data extracted from this literature review are not conclusive, but they show that MR-proADM may be helpful as a prognostic biomarker to stratify the mortality risk in cases of sepsis and septic shock with different degrees of organ damage, guiding emergency physicians in the diagnosis and the succeeding therapeutic workup. Sepsis and septic shock are conditions of high complexity and have a high risk of mortality. In the ED, early diagnosis is crucial in order to provide an early treatment and to improve patient survival. Diagnosis and prognosis are often the result of a combination of several tests. In our opinion, testing for MR-proADM directly in the ED could contribute to improving the prognostic assessment of patients, facilitating the subsequent clinical management and intensive treatment by the emergency physicians, but more studies are needed to confirm these results.

Management of Pleural Effusions in the Emergency Department.

2020 ◽  
Vol 15 ◽  
Author(s):  
MT Congedo ◽  
GM Ferretti ◽  
D Nachira ◽  
MA Pennisi
Keyword(s):  
Emergency Department ◽  
Systematic Approach ◽  
Acute Chest Pain ◽  
Pleural Effusions ◽  
Therapeutic Approaches ◽  
Massive Pleural Effusion ◽  
Emergency Department Setting ◽  
Clinical Conditions ◽  
Definitive Management

Background: In symptomatic patients, admitted in emergency department for acute chest pain and dyspnea, who require an urgent treatment, a rapid diagnosis and prompt management of massive pleural effusion or hemothorax can be lifesaving. The aim of this review was to summarize the current diagnostic and therapeutic approaches for the management of the main types of pleural effusions that physicians can have in an emergency department setting. Methods: Current literature about the topic was reviewed and critically reported, adding the experience of the authors in the management of pleural effusions in emergency settings. Results: The paper analyzed the main types of pleural effusions that physicians can have to treat. It illustrated the diagnostic steps by the principal radiological instruments, with a particular emphasis to the role of ultrasonography, in facilitating diagnosis and guiding invasive procedures. Then, the principal procedures, like thoracentesis and insertion of small and large bore chest drains, are indicated and illustrated according to the characteristics and the amount of the effusion and patient clinical conditions. Conclusion: The emergency physician must have a systematic approach that allows rapid recognition, clinical cause identification and definitive management of potential urgent pleural effusions.

scholarly journals Management of sepsis and septic shock in the emergency department

2021 ◽  
Author(s):  
Francesco Gavelli ◽  
Luigi Mario Castello ◽  
Gian Carlo Avanzi
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Patient Management ◽  
Emergency Physicians ◽  
Surviving Sepsis Campaign ◽  
Sepsis Management ◽  
Early Management ◽  
New Information ◽  
Sepsis And Septic Shock ◽  
Early Phases

AbstractEarly management of sepsis and septic shock is crucial for patients’ prognosis. As the Emergency Department (ED) is the place where the first medical contact for septic patients is likely to occur, emergency physicians play an essential role in the early phases of patient management, which consists of accurate initial diagnosis, resuscitation, and early antibiotic treatment. Since the issuing of the Surviving Sepsis Campaign guidelines in 2016, several studies have been published on different aspects of sepsis management, adding a substantial amount of new information on the pathophysiology and treatment of sepsis and septic shock. In light of this emerging evidence, the present narrative review provides a comprehensive account of the recent advances in septic patient management in the ED.

scholarly journals Patient Suggestions to Improve Emergency Physician Empathy and Communication

2021 ◽  
Vol 8 ◽  
pp. 237437352199698
Author(s):  
Sophia Aguirre ◽  
Kristen M Jogerst ◽  
Zachary Ginsberg ◽  
Sandeep Voleti ◽  
Puneet Bhullar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Emergency Physician ◽  
Active Listening ◽  
Patient Relationship ◽  
Emergency Physicians ◽  
Future Improvement ◽  
Survey Responses ◽  
Physician Empathy

Emergency physician empathy and communication is increasingly important and influences patient satisfaction. This study investigated if there is a need for improvement in provider empathy and communication in our emergency department and what areas could be targeted for future improvement. Patients cared for by emergency physicians with the lowest satisfaction scores were surveyed within 1 week of discharge. Patients rated their emergency provider’s empathy and communication and provided feedback on the patient–provider interaction. Compared to survey responses nationally, our providers fell between the 10th and 25th percentiles for all questions, except question 5 (making a plan of action with [the patient]) which was between the 5th and 10th percentile. Areas most frequently cited for improvement were “wanting to know why” (N = 30), “time is short” (N = 15), and “listen to the patient” (N = 13). Survey percentiles and open-ended suggestions demonstrate a need for providers to give thorough explanations, spend more time with the patient, and demonstrate active listening. These themes can be used to strengthen the provider–patient relationship.

scholarly journals A Rational Evaluation of the Syncope Patient: Optimizing the Emergency Department Visit

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 514
Author(s):  
Tarek Hatoum ◽  
Robert S. Sheldon
Keyword(s):  
Emergency Department ◽  
Diagnostic Yield ◽  
Clinical Decision ◽  
Emergency Department Visits ◽  
Decision Tools ◽  
Short And Long Term ◽  
Electrocardiogram Ecg ◽  
Structured Approach

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.

scholarly journals The International Federation for Emergency Medicine report on emergency department crowding and access block: a brief summary

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
A. P. Javidan ◽  
◽  
K. Hansen ◽  
I. Higginson ◽  
P. Jones ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Task Force ◽  
Video Conferencing ◽  
International Federation ◽  
Emergency Physicians ◽  
Emergency Department Crowding ◽  
Comprehensive Guidance ◽  
The World ◽  
Ed Crowding

Abstract Objective To develop comprehensive guidance that captures international impacts, causes, and solutions related to emergency department crowding and access block Methods Emergency physicians representing 15 countries from all IFEM regions composed the Task Force. Monthly meetings were held via video-conferencing software to achieve consensus for report content. The report was submitted and approved by the IFEM Board on June 1, 2020. Results A total of 14 topic dossiers, each relating to an aspect of ED crowding, were researched and completed collaboratively by members of the Task Force. Conclusions The IFEM report is a comprehensive document intended to be used in whole or by section to inform and address aspects of ED crowding and access block. Overall, ED crowding is a multifactorial issue requiring systems-wide solutions applied at local, regional, and national levels. Access block is the predominant contributor of ED crowding in most parts of the world.

Sign in / Sign up

Export Citation Format

Share Document