scholarly journals Utility of serum tryptase in Emergency Department patients with possible anaphylaxis

2021 ◽  
Vol 107 (10) ◽  
pp. 470-475
Author(s):  
Karólína Hansen ◽  
◽  
Hjalti Már Björnsson ◽  
María I Gunnbjörnsdóttir ◽  
◽  
...  
Keyword(s):  
Emergency Department ◽  
Gastrointestinal Symptoms ◽  
Serum Tryptase ◽  
Tryptase Level ◽  
Atypical Symptoms ◽  
Patient Demographics ◽  
Presenting Symptoms ◽  
Institutional Review ◽  
Emergency Department Patients

BACKGROUND Diagnosing anaphylaxis is often straightforward but can be challenging if the presentation is atypical. In patients with atypical symptoms suspected to be due to an acute allergic reaction, s-tryptase can give additional diagnostic information. Measuring s-tryptase is also helpful in diagnosing mastocytosis. Obtaining s-tryptase levels has been done in the emergency department (ED) at Landspitali since 2011. The aim of this study was to evaluate the benefit of obtaining s-tryptase levels in the ED. METHODS With institutional review board approval, all cases where s-tryptase level was obtained in ED patients from 2011 – 2018 were retrospectively reviewed. A database was collected including information on patient demographics, presenting symptoms, treatment, diagnosis, s-tryptase level and follow up. RESULTS A total of 214 patients had a s-tryptase level measured. Serum tryptase was elevated (>12 µg/L) in 36 cases. Females were 131 and average age 40.6 years. Of the patients, 86.4% had skin or mucosal symptoms, 48.1% cardiovascular symptoms, 49.5% respiratory symptoms and 36.0% had gastrointestinal symptoms. An allergist reviewed 126 returning patients and 65 were considered to have had an episode of anaphylaxis. Of those 65 were 4 patients which did not meet the diagnostic criteria for anaphylaxis but had raised s-tryptase levels. Sensitivity of s-tryptase measurement was 40.9% and specificity 97.1%. CONCLUSIONS Obtaining a s-tryptase level from ED patients with possible anaphylaxis seems to be useful in atypical cases. The measurement is specific but not sensitive. No cases of mastocytosis were identified in the patient cohort.

scholarly journals Follow Up for Emergency Department Patients After Intravenous Contrast and Risk of Nephropathy

2014 ◽  
Vol 15 (3) ◽  
pp. 276-281 ◽  
Author(s):  
Getaw Worku Hassen ◽  
Albert Hwang ◽  
Lydia Liyun Liu ◽  
Felicia Mualim ◽  
Toshiro Sembo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Intravenous Contrast ◽  
Emergency Department Patients

240: Primary and Specialty Care Follow-Up for Uninsured Emergency Department Patients

2009 ◽  
Vol 54 (3) ◽  
pp. S75
Author(s):  
A.A. Ginde ◽  
B.E. Talley ◽  
S.A. Trent ◽  
A.S. Raja ◽  
A.F. Sullivan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Specialty Care ◽  
Emergency Department Patients

scholarly journals Prescriptions for self-injectable epinephrine and follow-up referral in emergency department patients presenting with anaphylaxis

2008 ◽  
Vol 101 (6) ◽  
pp. 631-636 ◽  
Author(s):  
Ronna L. Campbell ◽  
Anuradha Luke ◽  
Amy L. Weaver ◽  
Jennifer L. St Sauver ◽  
Eric J. Bergstralh ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Department Patients

scholarly journals P061: Barriers to distributing discharge materials in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S86-S86
Author(s):  
A. Maneshi ◽  
H. Gangatharan ◽  
M. Cormier ◽  
S. Gosselin
Keyword(s):  
Emergency Department ◽  
Online Survey ◽  
Annual Conference ◽  
Discharge Instructions ◽  
Patient Comprehension ◽  
Emergency Department Patients ◽  
Time Required ◽  
To Receive ◽  
Common Barriers

Introduction: An efficient discharging process provides an opportunity for the patient to receive information about their diagnosis, prognosis, treatments, follow-up plan and reasons to return. Even when given complete discharge instructions, studies demonstrate that patients have poor retention of the information due to misunderstandings, language barriers, or poor health literacy. This study sought to identify barriers encountered by healthcare workers in providing discharge handouts to emergency department patients. Methods: A bilingual online survey of fifteen questions was shared with Quebec ED staff physicians and residents at the annual conference, and by email correspondence through the Quebec Emergency Medicine Association (AMUQ - L'Association des médecins d'urgence du Québec). Results: There was a total of 126 responses (96 physicians and 30 residents), with a response rate of 22.7% (126/556) and a completion rate of 84.1%. 85.8% (n = 120) responded that they were aware of discharge instructions available in their ED. Most common discharge handouts were concussion/traumatic brain injury and laceration repair. 58.3% of respondents (n = 120) reported having handed out discharge instructions in the last week, 22.5% in the last month, 10.8% within the last 6 months and 5.8% had not given out discharge instructions in the last 6 months. Respondents indicated that the most common barriers to giving out discharge instructions were their difficulty to access and and the time required. 58% of respondents (n = 65) reported handing out discharge handouts less than 50% of the time for conditions that had a discharge handout available at their hospital. Participants reported they would be more likely to give out discharge instructions if they were easier to print and if there was an automatic prompt from the EMR associated with the diagnosis. When asked to rank based on importance (1 = not important to 10 = very important), the majority of respondents thought discharge instructions were very important for patient comprehension, return to ED instructions and managing expectations of the illness (Median 8, Likert scale 1-10, DI 0.29, n = 119). Conclusion: Despite physicians and residents working in the ED believing discharge instructions are important for patient care, handouts are seldom given to patients. The lack of easy availability such as documents automatically available with the prompt of an electronic medical record would likely increase their distribution.

Sign in / Sign up

Export Citation Format

Share Document