scholarly journals Epidemiological profile of non-urgent patient visits to emergency department in a tertiary care hospital in South India

2019 ◽  
Vol 7 (1) ◽  
pp. 128
Author(s):  
Arun Anbumani ◽  
Moses Kirubairaj Amos Jegaraj ◽  
Reka Karruppusami
Keyword(s):  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Admission Rate ◽  
Urgent Care ◽  
Minor Trauma ◽  
Care Hospital ◽  
Ed Visits ◽  
Epidemiological Profile

Background: Non-urgent visits to emergency department (ED) form a significant proportion of ED visits. The reasons vary from minor injuries, fever of short duration, parental anxiety, and even serious conditions like myocardial infarctions presenting atypically. Non-urgent visits stress the ED services while prolonged waiting affects the patients. The aim was to study the profile of non-urgent visits to emergency department of a tertiary care hospital in South India.Methods: Prospective and descriptive study of patients aged 15 years and above categorized as non-urgent after triage was conducted. Data such as age, gender, reason for visit, time of presentation during the day, duration of ED stay and need for referral were recorded. Quantitative variables were presented as Mean±SD and frequency with percentage for qualitative variables.Results: Non-urgent visits contributed to 47.1% of total ED visits. Reasons for non-urgent visits were fever (15.4%), vomiting (13.9%), breathlessness (7.6%), minor trauma (7.3%), giddiness (7.0%) and dysuria (5.5%). 80.8% of all non- urgent visits were seen by ED doctor within two hours of being triaged. Most patients were treated for their immediate symptoms and 64.8% needed follow-up out-patient appointments. Admission rate was 1.2%. Majority of non-urgent visits (55.7%) were daytime visits and 13% were after-hours.Conclusions: Non-urgent visits contribute to about half of all ED visits and can stress ED. A local triage guideline is necessary to run these services in ED. Extended general practice or family physician run urgent care can relieve the stress on ED while rendering to patients accessible and affordable care. 

scholarly journals Standing at the edge of mortality; Five-year audit of an emergency department of a tertiary care hospital in a low resource setup

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Sama Mukhtar ◽  
Syed Ghazanfar Saleem ◽  
Saima Ali ◽  
Sarfraz Ahmed Khatri ◽  
Anna Q Yaffee
Keyword(s):  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Healthcare Sector ◽  
Care Hospital ◽  
Delayed Presentation ◽  
Do Not Resuscitate ◽  
Low Resource ◽  
Coronary Syndrome ◽  
Ed Visits

Background & Objective: Understanding the demographics of mortality and its burden in the emergency department of a tertiary care setup can lead to better planning and allocation of resources to streamline process flow. This can be achieved systematically through mortality audit that can identify the loopholes and areas of improvement. Our objective was to characterize the epidemiology of ED mortality in a tertiary care hospital of Karachi, Pakistan. Methods: A five-year retrospective chart review of 322 adult mortalities presenting between January l, 2014 – December 31, 2018 was conducted in the emergency department (ED) of The Indus Hospital (TIH), Karachi. All expiries in ED were included while those brought dead and with do not resuscitate order (DNAR) were excluded. Results: Mortality incidence of 0.076% (7.6/10,000 ED visits in five years) was reported. Amongst 507,759 adult ED visits, 322 mortalities were documented. Mean time lapse before presentation was 44±147 hours and mean length of stay before death was 3.4±2.8 hours. Acute coronary syndrome (ACS) was the predominant cause of death with 109 (33.8%) expiries. Significant association was reported between no history of prior care and high priority (P1) cases (p=0.013). Conclusions: This study identified the contributing factors to adverse outcome such as delayed presentation with systemic gaps in management and unknown disposition. The need to improve these factors at local and national level can lead to improvement in Pakistani healthcare sector. doi: https://doi.org/10.12669/pjms.37.3.3680 How to cite this:Mukhtar S, Saleem SG, Ali S, Khatri SA, Yaffee AQ. Standing at the edge of mortality; Five-year audit of an emergency department of a tertiary care hospital in a low resource setup. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3680 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

VALIDATION OF QUICK COVID SEVERITY INDEX IN COVID PATIENTS ADMITTED THROUGH EMERGENCY DEPARTMENT OF A PRIVATE TERTIARY CARE HOSPITAL IN WEST BENGAL, INDIA

2021 ◽  
pp. 53-55
Author(s):  
Harsimran Singh Das
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Tertiary Care Hospital ◽  
Clinical Status ◽  
Tertiary Care ◽  
Severity Index ◽  
Adult Patients ◽  
Care Hospital ◽  
Oxygen Requirement ◽  
Clinical Tool

Introduction:qCSI (Quick COVID severity index) is a clinical tool established recently post pandemic to predict respiratory failure within 24 hours of admission in COVID-19 patients; respiratory failure being explain as increased oxygen requirement greater than 6L/min by low ow device, high ow device, noninvasive or invasive ventilation to maintain spO2 of greater than or equal to 94%, or death. Aim:To verify and validate the application of the qCSI in Emergency Department in Indian demographic for evidence-based guidance to aid physician decision making in safely dispositioning adult patients with COVID-19 with oxygen requirement less than or equal to 6L/min via low ow devices including nasal cannula and oxygen mask Materials and methods:This is an observational, retrospective study from Emergency Department in a private tertiary care hospital of admitted adult patients with COVID-19 disease. Clinical parameters in qCSI and disposition of 210 patients admitted through Emergency Department included in this study selected randomly was sought on admission and clinical status with level of care 24 hours following admission was recorded and compared with prediction based on qCSI from a period of 1 May 2020 to 31 October 2020. Result:We found that19(9.0%) patients Initial qCSI Score was Low, 80(38.1%) patients Initial qCSI Score was Low-intermediate, 84(40.0%) patients Initial qCSI Score was High-intermediate and 27(12.9%)patients Initial qCSI Score was High.qCSI Score after 24 hours 16(11.4%) patients were Low, 43(30.7%) patients were Low-intermediate, 63(45.0%) patients was High-intermediate and 18(12.9%) patients was High.Out of 210(100.0%) patients, 70 (33.3%) patients were critically ill. Conclusion:In conclusion these data show that the quick COVID-19 Severity Index provides easily accessed risk stratication relevant to Emergency Department provider.

scholarly journals Clinico-epidemiological profile of patients admitted with Plasmodium vivax malaria in a tertiary care hospital, Delhi

2018 ◽  
Vol 5 (12) ◽  
pp. 5420 ◽  
Author(s):  
Geeta Yadav ◽  
Geeta Pardeshi ◽  
Neelam Roy
Keyword(s):  
Plasmodium Vivax ◽  
Severe Malaria ◽  
Vivax Malaria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
Care Hospital ◽  
Who Criteria ◽  
Epidemiological Profile ◽  
Safdarjung Hospital

Background: Malaria is an important public health problem in India. Severe and complicated forms of malaria are usually associated with Plasmodium falciparum species. But recently published literature suggests that Plasmodium vivax infection also presents as severe malaria. The objective was to study clinical and epidemiological profile of patients with P. vivax malaria admitted in Safdarjung hospital.Methods: A record based retrospective study was conducted in Vardhman Mahavir Medical College & Safdarjung Hospital, a tertiary care hospital in Delhi. Data were collected from all case records with ICD 10 codes for Malaria (B50-B54) for the year 2011 obtained from Medical Records Department, Safdarjung Hospital and analyzed using SPSS 21.0.Results: A total of 147 case records which had information about the test results for type of malaria infection were reviewed. Out of 147, 89 (60.5%) had P. vivax malaria. Of the 89 patients with P. vivax malaria, 47 (53%) were children and 63 (70.7%) were males. A peak in the number of inpatients was seen in September with median duration of hospital stay of 4 days and case fatality rate of 9%. A total of 56 (63%) patients had one or more severe manifestations of malaria as per WHO criteria. The most common severe manifestation was bleeding 27 (30%) followed by impaired consciousness 18 (20%).Conclusions: In more than half of the malaria patients admitted at the tertiary care centre the diagnosis was P. vivax malaria. Of them 63% patients had severe malaria as per WHO criteria.

Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan

2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Syed Ghazanfar Saleem ◽  
Saima Ali ◽  
Nida Ghouri ◽  
Quratulain Maroof ◽  
Muhammad Imran Jamal ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Patient Perception ◽  
Care Hospital ◽  
Structured Interviews ◽  
Privacy Concerns ◽  
Creative Commons ◽  
Privacy And Confidentiality ◽  
And Behavior

Background and Objective: Maintaining privacy and ensuring confidentiality with patients is paramount to developing an effective patient-provider relationship. This is often challenging in over-crowded Emergency Departments (EDs). This survey was designed to explore patients’ perceptions on maintenance of privacy and confidentiality and their subsequent interactions with providers in a busy tertiary care hospital in Karachi. Methods: Trained nursing staff conducted structured interviews with 571 patients who presented to The Indus Hospital (TIH) ED from January to December 2020. All patients were 14 years of age or older, could speak and understand Urdu, and provide informed consent. Patients were asked about their perceptions of privacy and confidentiality in the ED and whether this affected their interactions with providers. Results: Respondents were primarily men (64%) under the age of 45 (62%) presenting for the first time (49%). The majority of patients felt that privacy and confidentiality were maintained, however 10% of patients reported that they had rejected examination due to privacy concerns and 15% of patients reported that they had changed or omitted information provided to a provider due to confidentiality concerns. There was correlation between privacy and confidentiality concerns and patient-provider interactions (p<0.0001). Conclusions: Despite the often over-crowded and busy environment of the ED, patients generally felt that privacy and confidentiality were maintained. Given the correlation between perception and behavior and the importance of an effective patient-provider relationship, particularly in the acute setting when morbidity and mortality is high, initiatives that focus on maintaining privacy and confidentiality should be pursued. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785 How to cite this:Saleem SG, Ali S, Ghouri N, Maroof Q, Jamal MI, Aziz T, et al. Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan. Pak J Med Sci. 2022;38(2):351-355.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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