Characteristics of Presentations to the Emergency Department following Attempted Suicide with Drugs

A relatively high proportion of attempted suicides employ self-poisoning with medication. Data from emergency department presentations can help to identify possible risk drug classes and provide a basis for preventive measures. This retrospective analysis included cases presenting at the emergency department of the University Hospital of Bern, Switzerland, from May 2012 to August 2016, after attempted suicide with drugs. We excluded attempted suicides with only alcohol or other non-medical substances. During the study period, there were 488 cases (466 patients) of attempted suicide with medical substances. The median patient age was 33 years (range 16–93) and 354 (73%) cases were female. The most commonly involved substances/drug classes were benzo-diazepines (n = 167, 34%), neuroleptics (n = 114, 23%) and paracetamol (n = 111, 23%). A total of 231 (47%) cases employed only a single substance. Common symptoms included somnolence (n = 245, 50%), tachycardia (n = 119, 24%) and nausea/vomiting (n = 76, 16%). In most cases, the poisoning was of minor severity (n = 231, 47%) and the patients were admitted to a psychiatric hospital (n = 264, 54%). Important preventive measures may include careful monitoring for suicidal behaviour when prescribing psychotropic drugs, in addition to restrictions in pack size. Efforts should also be made to enhance the awareness of health professionals qualified to prescribe or supply paracetamol.

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Knowledge of health professionals in transfusion and transfusion safety in Morocco

E3S Web of Conferences ◽

10.1051/e3sconf/202131901069 ◽

2021 ◽

Vol 319 ◽

pp. 01069

Author(s):

Fatna EL Mehdaoui ◽

Abdelmajid Soulaymani ◽

Malika EL Khiari ◽

Soukaina Benissa Laghawati ◽

Raouf Alami

Keyword(s):

Health Professionals ◽

Preventive Measures ◽

Training Programs ◽

University Hospital ◽

Lung Edema ◽

Allergic Reactions ◽

Ibn Sina ◽

Knowledge And Skills ◽

The University

Objective: To evaluate the knowledge of transfusion and transfusion safety among health professionals. Materials and method: 47 volunteers, working at the University Hospital Ibn Sina in Rabat of Morocco, answered a survey on knowledge, skills in transfusion and transfusion safety. Results: 68% of the participants were female against 32% male, 85.11% were aged 20-30 years. 77% had a seniority of less than 5 years. 57% were nurses and 42% doctors. According to these participants, allergic reactions and hyperthermia occur with 85.11% after a transfusion, 57.45% mentioned lung edema. 80.85% of the participants stated that immunological and infectious risks are the main risks occurring after transfusion. 25.53% did not know that there were preventive measures for transfusion risks, 8.51% stated that there were none. 72.34% of the staff stated that hemovigilance is based on transfusion surveillance. For 68.09% reporting transfusion events, informing recipients and monitoring them after transfusion are the main tools of hemovigilance. 27.66% of the participants were aware of the transfusion regulations and 53.19% were not. Only 41% had received training in blood transfusion. 91.49% of the participants wanted to develop their transfusion knowledge and competence. Conclusion: Heterogeneity of knowledge and skills in transfusion is raised among these professionals, as well as a great motivation to improve their knowledge and the development of their skills in the field of transfusion. Thus, the development of training programs remains an urgent need for health professionals to further improve their knowledge and ensure the safety and quality of blood transfusions.

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THE RECOGNITION AND MANAGEMENT OF PAEDIATRIC SEPSIS IN THE UNIVERSITY HOSPITAL OF WALES (UHW) EMERGENCY DEPARTMENT (ED)

10.26226/morressier.57d034d0d462b80292383477 ◽

2016 ◽

Author(s):

Stephen Mullen

Keyword(s):

Emergency Department ◽

University Hospital ◽

The University

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A machine learning approach for identification of gastrointestinal predictors for the risk of COVID-19 related hospitalization

10.1101/2021.08.27.21262728 ◽

2021 ◽

Author(s):

Peter Liptak ◽

Peter Banovcin ◽

Robert Rosolanka ◽

Michal Prokopic ◽

Ivan Kocan ◽

...

Keyword(s):

Machine Learning ◽

Emergency Department ◽

Random Forest ◽

Gastrointestinal Symptoms ◽

Machine Learning Algorithms ◽

Important Predictor ◽

University Hospital ◽

Home Based ◽

Severity Of The Disease ◽

The University

Background and aim: COVID-19 can be presented with various gastrointestinal symptoms. Shortly after the pandemic outbreak several machine learning algorithms have been implemented to assess new diagnostic and therapeutic methods for this disease. Aim of this study is to assess gas-trointestinal and liver related predictive factors for SARS-CoV-2 associated risk of hospitalization. Methods: Data collection was based on questionnaire from the COVID-19 outpatient test center and from the emergency department at the University hospital in combination with data from inter-nal hospital information system and from the mobile application used for telemedicine follow-up of patients. For statistical analysis SARS-CoV-2 negative patients were considered as controls to three different SARS-CoV-2 positive patient groups (divided based on severity of the disease). Results: Total of 710 patients were enrolled in the study. Presence of diarrhea and nausea was significantly higher in emergency department group than in the COVID-19 outpatient test center. Among liver enzymes only aspartate transaminase (AST) has been significantly elevated in the hospitalized group compared to patients discharged home. Based on random forest algorithm, AST has been identified as the most important predictor followed by age or diabetes mellitus. Diarrhea and bloating have also predictive importance although much lower than AST. Conclusion: SARS-CoV-2 positivity is connected with isolated AST elevation and the level is linked with the severity of the disease. Furthermore, using machine learning random forest algo-rithm, we have identified elevated AST as the most important predictor for COVID-19 related hos-pitalizations.

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Separating the wheat from the chaff – COVID-19 in a German emergency department: A Case-control study

10.21203/rs.3.rs-37052/v2 ◽

2020 ◽

Author(s):

David Fistera ◽

Dirk Pabst ◽

Annalena Härtl ◽

Benedikt Michael Schaarschmidt ◽

Lale Umutlu ◽

...

Keyword(s):

Emergency Department ◽

Health Care Systems ◽

University Hospital ◽

Nasopharyngeal Swab ◽

Workflow Model ◽

Manchester Triage System ◽

Efficient Management ◽

Care Systems ◽

To Come ◽

The University

Abstract Background: COVID-19 pandemia is a major challenge to worldwide health care systems. Whereas the majority of disease presents with mild symptoms that can be treated as outpatients, severely ill COVID-19 patients and patients presenting with similar symptoms cross their ways in the Emergency Department. Especially the variety of symptoms is challenging with primary triage. Are there parameters to distinguish between proven COVID-19 and without before? How can a safe and efficient management of these inpatients be achieved?Methods: We conducted a retrospective analysis of 314 consecutive inpatient patients who presented with possible symptoms of COVID-19 in a German emergency department between March and April 2020 and were tested with a SARS-Cov-2 nasopharyngeal swab. Clinical parameters, Manchester Triage System categories and lab results were compared between patients with positive and negative test results for SARS-Cov-2. Furthermore, we present the existing COVID-19 workflow model of the university hospital in Essen which proved to be efficient during pandemia.Results: 43 of the 314 patients (13.7%) were tested positive for COVID-19 by SARS-Cov-2 nasopharyngeal swab. We did not find any laboratory parameter to distinguish safely between patients with COVID-19 and those with similar symptoms. Dysgeusia was the only clinical symptom that was significantly more frequent among COVID-19 patients. Conclusion: Dysgeusia seems to be a typical symptom for COVID-19, which occurred in 14% of our COVID-19 patients. However, no valid parameters could be found to distinguish clinically between COVID-19 and other diseases with similar symptoms. Therefore, early testing, a strict isolation policy and proper personal protection are crucial to maintain workflow and safety of patients and ED staff for the months to come.Trial registration: URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021675

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Prevalence of abuse of alcohol and other drugs among injured drivers presenting to the emergency department of the University Hospital of Modena, Italy

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2005.04.010 ◽

2005 ◽

Vol 80 (1) ◽

pp. 135-138 ◽

Cited By ~ 27

Author(s):

Daniele Giovanardi ◽

Carmela Nives Castellana ◽

Stefania Pisa ◽

Brunella Poppi ◽

Diego Pinetti ◽

...

Keyword(s):

Emergency Department ◽

University Hospital ◽

The University ◽

Alcohol And Other Drugs

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Patterns and Results of Triage Advice Before Emergency Department Visits Made by Patients With Cancer

JCO Oncology Practice ◽

10.1200/op.20.00617 ◽

2021 ◽

pp. OP.20.00617

Author(s):

Arthur S. Hong ◽

Hannah Chang ◽

D. Mark Courtney ◽

Hannah Fullington ◽

Simon J. Craddock Lee ◽

...

Keyword(s):

Emergency Department ◽

Acute Care ◽

Emergency Department Visits ◽

University Hospital ◽

Urgent Care ◽

Telephone Triage ◽

Patients With Cancer ◽

Oncology Care ◽

Ed Visits ◽

The University

PURPOSE: Patients with cancer undergoing treatment frequently visit the emergency department (ED) for commonly anticipated complaints (eg, pain, nausea, and vomiting). Nearly all Medicare Oncology Care Model (OCM) participants prioritized ED use reduction, and the OCM requires that patients have 24-hour telephone access to a clinician, but actual reductions in ED visits have been mixed. Little is known about the use of telephone triage for acute care. METHODS: We identified adults aged 18+ years newly diagnosed with cancer, linked to ED visits from a single institution within 6 months after diagnosis, and then analyzed the telephone and secure electronic messages in the preceding 24 hours. We coded interactions to classify the reason for the call, the main ED referrer, and other attempted management. We compared the acuity of patient self-referred versus clinician-referred ED visits by modeling hospitalization and ED visit severity. RESULTS: From 2011 to 2018, 3,247 adults made 5,371 ED visits to the university hospital and self-referred to the ED 58.5% of the time. Clinicians referred to outpatient or oncology urgent care for 10.3% of calls but referred to the ED for 61.3%. Patient self-referred ED visits were likely to be hospitalized (adjusted Odds Ratio [aOR], 0.89, 95% CI, 0.64 to 1.22) and were not more severe (aOR, 0.75, 95% CI, 0.55 to 1.02) than clinician referred. CONCLUSION: Although patients self-referred for six of every 10 ED visits, self-referred visits were not more severe. When patients called for advice, clinicians regularly recommended the ED. More should be done to understand barriers that patients and clinicians experience when trying to access non-ED acute care.

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Practices for rational use of blood components in a universitary hospital

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.61.04.355 ◽

2015 ◽

Vol 61 (4) ◽

pp. 355-361

Author(s):

Sydney Correia Leão ◽

Mariana Araújo Bezerra Gomes ◽

Mila Cintra de Azevedo Aragão ◽

Iza Maria Fraga Lobo

Keyword(s):

Comparative Analysis ◽

Health Professionals ◽

Educational Program ◽

University Hospital ◽

Theoretical Knowledge ◽

Blood Transfusions ◽

Significant Gain ◽

Blood Components ◽

Post Intervention ◽

The University

SummaryObjective:to produce improvements in transfusion practices through the implementation of an educational program for health professionals in a university hospital.Methods:this is an interventional and prospective study, with pre- and postanalysis of an educational intervention. The research was developed at the University Hospital of the Universidade Federal de Sergipe, involving participation of health professionals in the stage of training, during the month of February 2011, in addition to the monitoring of blood transfusions performed in the preand post-intervention periods. Transfusion practices were investigated upon request for transfusion or devolution of unused blood components. Knowledge of health professionals was assessed based on the responses to a questionnaire about transfusion practices.Results:during the educative campaign, 63 professionals were trained, including 33 nurses or nursing technicians and 30 physicians. Among the doctors, there was a statistically significant gain of 20.1% in theoretical knowledge (p=0.037). Gain in the nursing group was even higher: 30.4% (p=0.016). The comparative analysis of transfusion request forms showed a non-significant decrease from 26.7 to 19.5% (p=0.31) in all forms with incomplete information. We also observed a statistically significant improvement in relation to the filling of four items of transfusion request.Conclusion:there was a significant improvement of the entire process related to blood transfusions after interventional project conducted in February 2011.

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Infectious diseases and the use of antibiotics in outpatients at the emergency department of the University Hospital of León, Nicaragua

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2008.07.010 ◽

2009 ◽

Vol 13 (3) ◽

pp. 349-354 ◽

Cited By ~ 5

Author(s):

C. den Engelsen ◽

C. van der Werf ◽

A.J. Matute ◽

E. Delgado ◽

C.A.M. Schurink ◽

...

Keyword(s):

Emergency Department ◽

Infectious Diseases ◽

University Hospital ◽

The University

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Children’s poisoning profile during the Covid-19 pandemic – Experience of Hassan II University Hospital in Fez, MOROCCO

E3S Web of Conferences ◽

10.1051/e3sconf/202131901077 ◽

2021 ◽

Vol 319 ◽

pp. 01077

Author(s):

Amrani Hanchi Sahar ◽

Hoummani Hasnae ◽

Mourabiti Hajar ◽

Chebaibi Mohammed ◽

Chaouki Sana ◽

...

Keyword(s):

Emergency Department ◽

Pediatric Emergency ◽

University Hospital ◽

Accidental Poisoning ◽

Pediatric Emergency Department ◽

Neurological Signs ◽

Snake Bites ◽

Scorpion Stings ◽

The University ◽

Evolutionary Aspects

Introduction. —The Covid-19 pandemic and the containment situation, has generated enormous risks for children. Indeed, with the closure of schools, children, forced to stay at home, found themselves in permanent contact with dangerous products (drugs, disinfectants, plants) exposing them to accidental poisoning. Objective. —To describe the epidemiological, clinical and evolutionary aspects of the cases of pediatric intoxications in the UHC during the period of Covid-19, in order to assess the repercussions of this pandemic on the profile of these intoxications, in terms of number and incriminated products. Material and method. — This is a retrospective descriptive comparative study of intoxication cases admitted to the pediatric emergency department of the University Hospital of Fez spread over 2 years; from March 1, 2019 to February 2021; comparing intoxications admitted during the period of Covid-19 with the previous year. Results. — The emergency department recorded 132 cases of intoxication during the Covid-19 period (compared to 104 cases in 2019). Fez was always the most concerned city (66.21% against 69.02% in 2019). The cases emanated from the urban environment in (58.78%). The accidental circumstance was the most frequent, with an increase from 77.88% in 2019 to 82.02%. The rate of cases of envenomation that consulted was almost similar; children are more exposed to scorpion stings (73.52%) than snake bites. The analysis of incriminated products was marked by the increase of Caustics (20.38% in 2019 to 24.24% in 2020), and the decrease of pesticides (19.41% in 2019 to 13.63%). The symptomatology was dominated by neurological signs in 25.75% of cases, followed by respiratory disorders (18.18%). The evolution was favorable in 95.46%, and death occurred in 4.54% of cases compared to 3.84% in2019. The Covid-19 pandemic has changed the use of antidotes.

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