Effectiveness of a Regional Poison Center in Reducing Excess Emergency Room Visits for Children's Poisonings

PEDIATRICS ◽  
1983 ◽  
Vol 72 (2) ◽  
pp. 164-169 ◽  
Author(s):  
Claire Chafee-Bahamon ◽  
Frederick H. Lovejoy

A study was done to assess the necessity of hospital care for poisoning episodes in children less than 5 years old and to evaluate the impact of a regional poison center on the use of emergency rooms for pediatric poisonings. Of the pediatric patients seen in emergency rooms for acute poisonings, 63% did not require the services of a hospital; 95% did not contact the regional poison center before going to the hospital. When all poisoning episodes were considered, the regional poison center was found to reduce significantly pediatric visits to emergency rooms. Of parents who did not call the poison center, 44% went to an emergency room whereas less than 1% of parents who called the poison center went to a hospital (P < .001). Moreover, 28% of those who did not call made unnecessary visits to the hospital compared with only 0.5% of parents who called the poison center (P < .001). A regional poison center was found to be an effective means of decreasing unnecessary hospital visits for pediatric poisonings. Regional poison centers, however, need to further their impact by addressing outreach efforts to parents who do not call poison centers, emergency rooms, and pediatricians.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Guerrero Fernández de Alba ◽  
A Gimeno-Miguel ◽  
B Poblador Plou ◽  
K Bliek Bueno ◽  
J Carmona Pirez ◽  
...  

Abstract Background Type 2 diabetes mellitus (T2D) is often accompanied by other chronic diseases, including mental diseases (MD). This work aimed at studying MD prevalence in T2D patients and analyse its impact on T2D health outcomes. Methods Retrospective, observational study of individuals of the EpiChron Cohort aged 18 and over with prevalent T2D at baseline (2011) in Aragón, Spain (n = 63,365). Participants were categorized by the existence or absence of MD, defined as the presence of depression, anxiety, schizophrenia or substance abuse. MD prevalence was calculated, and a logistic regression model was performed to analyse the likelihood of the four studied health outcomes (4-year all-cause mortality, all-cause hospitalization, T2D-hospitalization, and emergency room visits) based on the presence of each type of MD, after adjusting by age, sex and number of comorbidities. Results Mental diseases were observed in 19% of T2D patients, with depression being the most frequent condition, especially in women (20.7% vs. 7.57%). Mortality risk was significantly higher in patients with MD (odds ratio -OR- 1.24; 95% confidence interval -CI- 1.16-1.31), especially in those with substance abuse (OR 2.18; 95% CI 1.84-2.57) and schizophrenia (OR 1.82; 95% CI 1.50-2.21). The presence of MD also increased the risk of T2D-hospitalization (OR 1.51; 95% CI 1.18-1.93), emergency room visits (OR 1.26; 95% CI 1.21-1.32) and all-cause hospitalization (OR 1.16; 95% CI 1.10-1.23). Conclusions The high prevalence of MD among T2D patients, and its association with health outcomes, underscores the importance of providing integrated, person-centred care and early detection of comorbid mental diseases in T2D patients to improve disease management and health outcomes. Key messages Comprehensive care of T2D should include specific strategies for prevention, early detection, and management of comorbidities, especially mental disorders, in order to reduce their impact on health. Substance abuse was the mental disease with the highest risk of T2D-hospitalization, emergency room visits and all-cause hospitalization.


2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 45-46
Author(s):  
K Alazemi ◽  
M Alkhattabi ◽  
J C Gregor

Abstract Background EOE is an increasingly recognized gastrointestinal condition that causes significant morbidity ranging from dietary limitations to food impactions requiring emergency room visits. There are a variety of dietary, pharmacologic and endoscopic treatments available but most are more practically guided by a subspecialist familiar and experienced with the condition. There is a perception among some physicians that follow up is sporadic and may be related at least in part to patient compliance. Aims To assess the true rate of EOE patients follow up rate at Lodon Health Scince Center Methods We used a retrospective cohort of patients diagnosed with EoE between July 2011 and June 2014 who met the traditional diagnostic criteria. As part of a quality improvement initiative, local follow up over the ensuing 5–7 years was tracked. The impact of follow up on subsequent healthcare utilization was analyzed. Results 123 patients with biopsy confirmed EoE were analyzed. Follow up appointments were made for 114/123 (92%) patients. 55/123 (45%) had repeat elective endoscopy booked. Only 10/114 (8.7%) of initial appointments went unattended but 15/55 (27.2%) of the patients offered ongoing follow up failed to attend. There were no complications (ie. perforation or bleeding) attributable to any of the procedures. 5/123 (4%) patients required repeat emergency room endoscopy for food impaction. Two patients required this on multiple occasions. 4/5 patients requiring repeat emergency room endoscopy for food impaction had received some sort of follow up, although 4/5 of these had at least one missed appointment. 2/5 patients having emergency room endoscopy required overnight admission. There were no perforations in the cohort. Conclusions Patients with a confirmed diagnosis of EOE do have a risk of requiring subsequent emergency endoscopy for food impaction although it is not clear that scheduled follow up significantly reduces that risk. Contrary to the perception of some physicians, patients with EoE are very likely to attend their first follow up visit although the attrition rate for subsequent scheduled visits is not insignificant. Funding Agencies None


2014 ◽  
Vol 61 (10) ◽  
pp. 1822-1827 ◽  
Author(s):  
Robert D. Latzman ◽  
Yuri Shishido ◽  
Natasha E. Latzman ◽  
T. David Elkin ◽  
Suvankar Majumdar

Author(s):  
Matthew Hill

Asthma is thought by most to be a benign health issue, but the statistics say otherwise. In Canada there are over 146 000 emergency room visits and 500 deaths each year from asthma. An estimated 80% are preventable. These hospital visits cost the Canadian government over $135 million a year. A solution is needed and that solution is the Emergency Salbutomal Inhaler. I have designed a small, easy­to­carry, two­  dose, dry­powder asthma inhaler, with patent pending. The device can easily be attached to a keychain or  necklace for carrying ease, and will be quickly accessible in the event of an asthma attack. When an  asthmatic has an attack and goes to a hospital, they are given a maximum of 2 doses of the rescue drug  Salbutomal. The device carries two doses. Thus, in a sense I have invented a hospital on a keychain for  asthmatics. During an asthma attack there is no time to fumble with an inhaler; my easy­to­use design  ensures relief will be provided.


2020 ◽  
Vol 10 (1) ◽  
pp. 11-17
Author(s):  
Khaled Suleiman ◽  
Tarek Al-Khaleeb ◽  
Mahmoud Al-Kaladeh ◽  
Loai Abu Sharour

Introduction: Sleep Quality disturbances are common among nurses especially those working in stressful situations such as emergency room. Additionally, sleep quality disturbances were found to interfere with nurses’ quality of life and work performance. No studies have found the effect of fluctuated shifts on sleep quality among nurses. Objectives: To examine the impact of shift fluctuations on sleep quality among nurses working in the emergency room. Methods: A cross-sectional, descriptive design was employed. Five emergency rooms were selected from public and private hospitals located in Amman, Jordan. The selected hospitals were also referral sites with capacity of more than 200 beds. A convenient sample of nurses who had a minimum of six months experience in the emergency room and working on rotating shifts were eligible for participation. Nurses with known chronic respiratory problems and sleep apnea were excluded. A self-administered questionnaire including a demographic and work-related questions, and the Arabic version of the Pittsburgh Sleep Quality Index were provided. Shift fluctuations were clustered based on interchanging between morning, evening and night shifts. Results: A total of 179 emergency nurses working in rotating shifts participated in the study. The majority of the nurses were poor sleepers. The study found no significant differences between different shifts interchange and sleep quality. However, interchange between morning and evening shift reported the highest sleep disturbance. Sleep quality was positively correlated with the length of experience, while negatively correlated with the age and the number of monthly shifts. Nurses who declared higher satisfaction and ability to work under pressure revealed better sleep quality. Conclusion: Emergency room nurses showed poor sleep quality. While there was no specific shift interchange cluster inducing poor sleep quality, some demographical and work-related characteristics indicated their influence on sleep quality.


2015 ◽  
Vol 20 (4) ◽  
pp. 1037-1046 ◽  
Author(s):  
Márcio Dênis Medeiros Mascarenhas ◽  
Alice Cristina Medeiros das Neves ◽  
Rosane Aparecida Monteiro ◽  
Marta Maria Alves da Silva ◽  
Deborah Carvalho Malta

The study objective was to describe the profile and factors related to alcohol consumption among emergency room visits by external causes. It is a cross-sectional study with data from the Survey of Violence and Injuries in Emergency between September and October 2011, in 24 state capitals and the Federal District. Statistical analysis were performed for all cases treated in selected services, comparing the characteristics of the victims, according to the statement of alcohol consumption. 33,289 visits to emergency rooms by external causes in the population above 18 years of age were included. The prevalence of self-reported statement of alcohol consumption among these services was 14.9% for the 24 capitals and the Federal District, and was significantly higher among visits by violent causes than by accidents. For both accidents and violence the associated causes were victims male, black/brown, less educated, members of specific populations, occurrences on public roads. The results support global discussions on the importance of establishing policies and legal measures to restrict the consumption of alcohol and vehicular direction, control advertising of alcoholic beverages, and laws normalizing the functioning of sales points of alcoholic beverages.


2013 ◽  
Vol 37 (2) ◽  
pp. 60-64 ◽  
Author(s):  
Laura Castells-Aulet ◽  
Miguel Hernández-Viadel ◽  
Pedro Asensio-Pascual ◽  
Carlos Cañete-Nicolás ◽  
Carmen Bellido-Rodríguez ◽  
...  

Aims and methodTo evaluate the impact of involuntary out-patient commitment (OPC) in patients with severe mental disorder who use hospital services. This is a retrospective–observational study in a population of 91 patients under OPC. The psychiatric diagnosis, sociodemographic variables, who requested the court order and for what motive were studied. The study also looked at the use of the available health services (emergency room visits, admissions, average length of hospital stay) for the period beginning 2 years before and ending 2 years after the initiation of the OPC.ResultsThe number of emergency room visits, admissions and the length of hospitalisation diminished in the 2 years following the initiation of the OPC. In terms of diagnosis, the OPC has the most impact on individuals with schizophrenia and delusional disorder.Clinical implicationsThe OPC can be useful for certain patients with severe mental disorder, particularly individuals with schizophrenia and delusional disorder.


Health Policy ◽  
2015 ◽  
Vol 119 (10) ◽  
pp. 1358-1365 ◽  
Author(s):  
Iris Raz ◽  
Lena Novack ◽  
Maayan Yitshak-Sade ◽  
Yemima Shahar ◽  
Arnon Wiznitzer ◽  
...  

2017 ◽  
Vol 24 (5) ◽  
pp. 359-364 ◽  
Author(s):  
Sewar S Salmany ◽  
Lujeen Ratrout ◽  
Abdallah Amireh ◽  
Randa Agha ◽  
Noor Nassar ◽  
...  

Purpose The aim of the study was to determine the impact of telephone follow-up calls on satisfaction in oncology patients after hospital discharge. Method A randomized controlled study, in which patients were randomized into two groups: The experimental group with the telephone follow-up (TFU) calls (intervention) and the control group (no intervention). The telephone follow-up call was conducted within 72 h after discharge. During the call, patients were asked about their medications, namely, whether they received them, understood how to take them, and whether they developed any medication-related adverse effect. Both groups were contacted by phone two weeks later to assess their satisfaction with the discharge medication instructions and the provided pharmaceutical services, using the 5-point Likert scale. In addition, hospital records were reviewed for emergency room visits and hospital readmissions within 30 days after discharge. Results There was no difference in the percentage of patients who reported being very satisfied between both the intervention and the control groups (45% intervention vs. 48% control, P = 0.68). The mean time of the intervention phone call was 3 ± 1.7 (SD) min. During the telephone follow-up call, medication-related problems were identified in 20% of the patients. There was no significant difference in emergency room visits and hospital readmissions in the intervention group vs. control (44% vs. 53%, P = 0.123) and (37% vs. 43%, P = 0.317), respectively. Conclusion Telephone follow-up calls conducted by a pharmacist to discharged oncology patients did not improve patients' satisfaction, emergency room visits or hospital readmissions; however, they helped to identify medication-related adverse effects in the oncology patients.


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