scholarly journals Diagnostic imaging trends in the emergency department: an extensive single-center experience

2019 ◽  
Vol 8 (7) ◽  
pp. 205846011986040 ◽  
Author(s):  
Gunnar Juliusson ◽  
Birna Thorvaldsdottir ◽  
Jon Magnus Kristjansson ◽  
Petur Hannesson
Keyword(s):  
Emergency Department ◽  
Diagnostic Imaging ◽  
Single Center ◽  
Single Center Experience

Abstract P175: Dizziness-Related Symptoms are Associated With Delayed Diagnostic Imaging in Patients With Intracerebral Hemorrhage

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Savannah R Doelfel ◽  
Scott Moody ◽  
Carlin C Chuck ◽  
Roshini Kalagara ◽  
Helen Zhou ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Cohort Study ◽  
Linear Regression ◽  
Diagnostic Imaging ◽  
Intracerebral Hemorrhage ◽  
Single Center ◽  
Separate Model ◽  
Adjusted Model ◽  
Univariate Analyses

Background: Acute dizziness can present diagnostic challenges for emergency department (ED) clinicians because of the potential for an underlying cerebrovascular cause. Although various strategies may aid in diagnosing cases caused by stroke, it is unclear whether dizziness due to intracerebral hemorrhage (ICH) is associated with delays in diagnostic imaging. Methods: We performed a single center cohort study on consecutive ICH patients admitted over 2 years. We retrospectively abstracted initial reported symptoms and aggregated patients with dizziness, vertigo, lightheadedness, or nausea under the category of dizziness-related symptoms. After excluding patients with ED intubation due to potential procedural delays, we calculated time from initial ED arrival to first computed tomography (CT) scan. Using linear regression, we determined associations between dizziness-related symptoms and ED-to-CT time after adjusting for demographics and time from symptom onset, with additional analyses considering the presence of typical stroke symptoms and cerebellar ICH. Results: Of 427 patients, 110 (26%) presented with dizziness-related symptoms and 36 (8%) had cerebellar ICH. In univariate analyses, patients with dizziness-related symptoms had longer ED-to-CT times than other patients (median [IQR] 51 [21-144] vs. 32 [14-92] min, p=0.007), as did those with cerebellar ICH (71 [27-182] min). In our primary adjusted model, dizziness-related symptoms were associated with longer ED-to-CT times (+26 min [95% CI 6-46]). This imaging delay was further compounded in a subgroup analysis of patients without typical stroke symptoms (+45 min [95% CI 7-84], and in a separate model considering patients with cerebellar ICH (+48 min [95% CI 17-80]). Conclusions: Dizziness-related symptoms are associated with delayed diagnostic imaging in patients with ICH, which suggests the need for increased early awareness and urgency in these cases.

scholarly journals Occult Klebsiella pneumoniae bacteremia at emergency department: A single center experience

2015 ◽  
Vol 48 (6) ◽  
pp. 684-691 ◽  
Author(s):  
Eileen Kevyn Chang ◽  
Kai-Liang Kao ◽  
Mao-Song Tsai ◽  
Chia-Jui Yang ◽  
Yu-Tsung Huang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Klebsiella Pneumoniae ◽  
Single Center ◽  
Single Center Experience

scholarly journals ENT Referral From Emergency Department During COVID-19: A Single-Center Experience

2021 ◽  
pp. 014556132098456
Author(s):  
Massimo Campagnoli ◽  
Michele Cerasuolo ◽  
Martina Renna ◽  
Valeria Dell’Era ◽  
Paolo Aluffi Valletti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health System ◽  
Bone Fracture ◽  
Foreign Bodies ◽  
Pediatric Patients ◽  
Diagnostic Delay ◽  
The Other ◽  
System Response ◽  
Single Center ◽  
Single Center Experience

Purpose: COVID-19 pandemic transformed the health system response worldwide. The aim of this study is to report changes about numbers and reason for ENT consultations in emergency department (ED) during COVID-19 pandemic comparing with those occurred the previous year (2019). Methods: Data about patients admitted to adult and pediatric ED were collected from March 1 to May 31, 2019 and 2020. Patients referred for urgency from general practitioners were excluded from the study. Results: Global ED admission (except for dyspnea or COVID-19–related symptoms) dramatically decreased during pandemic (−50.9% among adults and −71.4% among pediatrics). At the same time, ENT consultancy significantly reduced too, by 71.5% ( P < .01) among adults and 45.1% ( P < .01) for pediatrics. Among adults, it was reported a statistically significant decrease in consultation for ear problems (−88.5%, P = .0146). Reduction in ENT referral for bone fracture (−40%, P = .059), vertigo (−77.8%, P = .637), and tonsillitis (−87.5%, P = .688) was consistent, but not significant. Among pediatric patients, it was observed an increase by 25% about foreign bodies (12 vs 15, P < .01). A reduction in numbers of consults for ear problem (−90.8%; P = .045), epistaxis (−80%; P = .196), and nasal fracture (−70%; P = .36) was also observed. Conclusion: Fear of infection and the forced lock down caused a significant decrease in the number of ED accesses and in ENT consultancy. These data may suggest that some ED referral usually could be deferred, but on the other hand, pandemic will cause a great diagnostic delay.

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