scholarly journals Health effects of the September 2009 dust storm in Sydney, Australia: did emergency department visits and hospital admissions increase?

2013 ◽  
Vol 12 (1) ◽  
Author(s):  
Alistair Merrifield ◽  
Suzanne Schindeler ◽  
Bin Jalaludin ◽  
Wayne Smith
Keyword(s):  
Emergency Department ◽  
Health Effects ◽  
Dust Storm ◽  
Hospital Admissions ◽  
Emergency Department Visits ◽  
Sydney Australia

scholarly journals 131Spatio-temporal analysis to assess health effects of landscape fire smoke: an empirical model

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Adeleh Shirangi ◽  
Alex Xiao ◽  
Emmanuel Ongee ◽  
Ivana Ivánová ◽  
Ashraf Dewan ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Cardiovascular Diseases ◽  
Health Effects ◽  
Hospital Admissions ◽  
Temporal Analysis ◽  
Emergency Department Visits ◽  
Increased Risk ◽  
Wide Range ◽  
High Level

Abstract Background Understanding the health effects of smoke from landscape fires (LFs), including wildfires and prescribed burns, is limited due to lack of adequate smoke exposure measures. Methods We used the reported LFs to determine smoke plume shapes from satellite images. Daily remotely sensed fire radiative power, aerosol optical depth, smoke plumes, fire danger rating, venting index and previous day PM 2.5 were then used to estimate smoke-related particulate matter 2.5 (PM2.5). A population based time series design was used to assess associations between smoke-related PM2.5 and selected adverse health outcomes such as hospital admissions, emergency department visits and ambulance callouts. Results We found a significant dose-response relationship between increased smoke-related PM2.5 concentration and 1% to 5% increase for total emergency department attendances and total hospital admissions on the same day and the lag effects of 3 days where the PM2.5 was at medium level (95-98th percentile) and high level ( > =99th percentile) compared to the low level (<95th percentile). There was also 1% to 25% increased risk for individuals who were exposed to high level LF smoke with selected respiratory and cardiovascular diseases in selected health care utilisations. Conclusions Exposure to LF smoke at a high level was spatio-temporally associated with a wide range of adverse respiratory and cardiovascular diseases in selected health care utilisations. Key messages

Risk factors of hospital admissions and recurrent emergency department visits among pediatric asthma patients

2020 ◽  
pp. 1011-1015
Author(s):  
Abdullah Aldamigh ◽  
Afaf Alnefisah ◽  
Abdulrahman Almutairi ◽  
Fatima Alturki ◽  
Suhailah Alhtlany ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Pediatric Asthma ◽  
Emergency Department Visits ◽  
Asthma Patients

scholarly journals Program of Integrated Care for Patients with Chronic Obstructive Pulmonary Disease and Multiple Comorbidities (PIC COPD+): a randomised controlled trial

2018 ◽  
Vol 51 (1) ◽  
pp. 1701567 ◽  
Author(s):  
Louise Rose ◽  
Laura Istanboulian ◽  
Lise Carriere ◽  
Anna Thomas ◽  
Han-Byul Lee ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Case Manager ◽  
Emergency Department Visits ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Secondary Outcomes ◽  
Randomised Controlled ◽  
Component Case

We sought to evaluate the effectiveness of a multi-component, case manager-led exacerbation prevention/management model for reducing emergency department visits. Secondary outcomes included hospitalisation, mortality, health-related quality of life, chronic obstructive pulmonary disease (COPD) severity, COPD self-efficacy, anxiety and depression.Two-centre randomised controlled trial recruiting patients with ≥2 prognostically important COPD-associated comorbidities. We compared our multi-component intervention including individualised care/action plans and telephone consults (12-weekly then 9-monthly) with usual care (both groups). We used zero-inflated Poisson models to examine emergency department visits and hospitalisation; Cox proportional hazard model for mortality.We randomised 470 participants (236 intervention, 234 control). There were no differences in number of emergency department visits or hospital admissions between groups. We detected difference in emergency department visit risk, for those that visited the emergency department, favouring the intervention (RR 0.74, 95% CI 0.63–0.86). Similarly, risk of hospital admission was lower in the intervention group for those requiring hospital admission (RR 0.69, 95% CI 0.54–0.88). Fewer intervention patients died (21 versus 36) (HR 0.56, 95% CI 0.32–0.95). No differences were detected in other secondary outcomes.Our multi-component, case manager-led exacerbation prevention/management model resulted in no difference in emergency department visits, hospital admissions and other secondary outcomes. Estimated risk of death (intervention) was nearly half that of the control.

Management of Poisoning and Drug Overdose

2021 ◽  
Author(s):  
Timothy J Wiegand ◽  
Manish M Patel ◽  
Kent R. Olson
Keyword(s):  
Emergency Department ◽  
Drug Overdose ◽  
Activated Charcoal ◽  
Hospital Admissions ◽  
Clinical Laboratory ◽  
The United States ◽  
Emergency Department Visits ◽  
The Body ◽  
Smoke Inhalation ◽  
Drug Induced

Drug overdose and poisoning are leading causes of emergency department visits and hospital admissions in the United States, accounting for more than 500,000 emergency department visits and 11,000 deaths each year. This chapter discusses the approach to the patient with poisoning or drug overdose, beginning with the initial stabilization period in which the physician proceeds through the ABCDs (airway, breathing, circulation, dextrose, decontamination) of stabilization. The management of some of the more common complications of poisoning and drug overdose are summarized and include coma, hypotension and cardiac dysrhythmias, hypertension, seizures, hyperthermia, hypothermia, and rhabdomyolysis. The physician should also perform a careful diagnostic evaluation that includes a directed history, physical examination, and the appropriate laboratory tests. The next step is to prevent further absorption of the drug or poison by decontaminating the skin or gastrointestinal tract and, possibly, by administering antidotes and performing other measures that enhance elimination of the drug from the body. The diagnosis and treatment of overdoses of a number of specific drugs and poisons that a physician may encounter, as well as food poisoning and smoke inhalation, are discussed. Tables present the ABCDs of initial stabilization of the poisoned patient; mechanisms of drug-induced hypotension; causes of cardiac disturbances; drug-induced seizures; drug-induced hyperthermia; autonomic syndromes induced by drugs or poison; the use of the clinical laboratory in the initial diagnosis of poisoning; methods of gastrointestinal decontamination; methods of and indications for enhanced drug removal; toxicity of common beta blockers; common stimulant drugs; corrosive agents; dosing of digoxin-specific antibodies; poisoning with ethylene glycol or methanol; manifestations of excessive acetylcholine activity; common tricyclic and other antidepressants; seafood poisonings; drugs or classes that require activated charcoal treatment; and special circumstances for use of activated charcoal. This review contains 3 figures, 22 tables, and 198 references.

An Active In-Home Physician Model of Palliative Care and Its Resulting Performance Indicators Related to Home Deaths, Unplanned Emergency Department Visits and Unplanned Hospital Admissions

2020 ◽  
Vol 36 (1) ◽  
pp. 46-49
Author(s):  
Colleen Webber ◽  
Aurelia Ona Valiulis ◽  
Peter Tanuseputro ◽  
Valerie Schulz ◽  
Tavis Apramian ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Hospital Admissions ◽  
Case Series ◽  
Palliative Care Team ◽  
Emergency Department Visits ◽  
Care Team ◽  
Retrospective Case ◽  
Palliative Care Teams ◽  
Unplanned Hospital Admissions

Background: Limited research has characterized team-based models of home palliative care and the outcomes of patients supported by these care teams. Case presentation: A retrospective case series describing care and outcomes of patients managed by the London Home Palliative Care Team between May 1, 2017 and April 1, 2019. Case management: The London Home Palliative Care (LHPC) Team care model is based upon 3 pillars: 1) physician visit availability 2) active patient-centered care with strong physician in-home presence and 3) optimal administrative organization. Case outcomes: In the 18 month study period, 354 patients received care from the London Home Palliative Care Team. Most significantly, 88.4% ( n = 313) died in the community or at a designated palliative care unit after prearranged direct transfer; no comparable provincial data is available. 21.2% ( n = 75) patients visited an emergency department and 24.6% ( n = 87) were admitted to hospital at least once in their final 30 days of life. 280 (79.1%) died in the community. These values are better than comparable provincial estimates of 62.7%, 61.7%, and 24.0%, respectively. Conclusion: The London Home Palliative Care (LHPC) Team model appears to favorably impact community death rate, ER visits and unplanned hospital admissions, as compared to accepted provincial data. Studies to determine if this model is reproducible could support palliative care teams achieving similar results.

scholarly journals High-Cost, High-Need Users of Acute Unscheduled HIV Care: A Cross-Sectional Study

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Conor Grant ◽  
Colm Bergin ◽  
Sarah O’Connell ◽  
John Cotter ◽  
Clíona Ní Cheallaigh
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
High Volume ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Hiv Care ◽  
Psychiatric Disease ◽  
Cross Sectional ◽  
Unscheduled Care ◽  
Cumulative Length

Abstract Background High-cost, high-need users are defined as patients who accumulate large numbers of emergency department visits and hospital admissions that might have been prevented by relatively inexpensive early interventions and primary care. This phenomenon has not been previously described in HIV-infected individuals. Methods We analyzed the health records of HIV-infected individuals using scheduled or unscheduled inpatient or outpatient health care in St James’s Hospital, Dublin, Ireland, from October 2014 to October 2015. Results Twenty-two of 2063 HIV-infected individuals had a cumulative length of stay >30 days in the study period. These individuals accrued 99 emergency department attendances and 1581 inpatient bed days, with a direct cost to the hospital of >€1 million during the study period. Eighteen of 22 had potentially preventable requirements for unscheduled care. Two of 18 had a late diagnosis of HIV. Sixteen of 18 had not been successfully engaged in outpatient HIV care and presented with consequences of advanced HIV. Fourteen of 16 of those who were not successfully engaged in care had ≥1 barrier to care (addiction, psychiatric disease, and/or homelessness). Conclusions A small number of HIV-infected individuals account for a high volume of acute unscheduled care. Intensive engagement in outpatient care may prevent some of this usage and ensuing costs.

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