The eminence of neutrophil-lymphocyte count ratio in predicting bacteremia for community-acquired infections at an emergency medicine department in a tertiary care setting

Introduction: Emergency medicine by its nature requires shift-work that often follows an erratic and unpredictable pattern. Faced with this ongoing challenge we hypothesized that many ED physicians may have taken steps to minimize their personal sleep deprivation through the use of a pharmacological sleep aid (PSA). The extent and nature of PSA use in this population is not well studied. We sought to describe the use of PSAs amongst practicing ED physicians in a Canadian tertiary-care setting. We also hoped to determine the specific substances being used, their frequency and predictive factors contributing to their use. Methods: A cross-sectional descriptive web-based survey was sent via e-mail to all practicing staff emergency physicians within the Calgary zone of Alberta Health Services. Participation was entirely voluntary and all responses were anonymous. Descriptive statistics were used to assess frequencies and summary measures. Logistic regression was used to explore associations between key variables. Results: Of the 198 eligible ED physicians, 144 (73%) completed the survey. 132 (92%) felt that shift-work negatively affected their ability to sleep and 121(84%) had experienced insomnia at some point in their medical career. 96(67%) ED physicians had used a PSA at some time in their career and 82(57%) were currently using a PSA with any frequency. The most frequent sleep aids currently being used were non-benzodiazepine hypnotics (65%), alcohol (31%) and melatonin (27%). 66(46%) respondents required a prescription for their PSA and 37(56%) of those had obtained a prescription from an ED physician colleague. Physician self-reporting of experience with insomnia was strongly associated with prior use of any PSA (OR 4.0; 95% CI 1.6-10.0) and prior use of non-benzodiazepine hypnotics (OR 14.4; 95% CI 3.2-64.2) There was no statistically significant association between current use of a PSA and physician age, physician gender, number of night shifts worked per month or co-habitation with children. None of the physicians who responded felt that their use of a PSA adversely affected their ability to provide quality patient care. Conclusion: Pharmacological sleep aid use among Canadian ED physicians may be more common than previously assumed. This could have implications for physician wellbeing and performance.

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IMPACT OF THE HUMAN IMMUNODEFICIENCY VIRUS INFECTION ON EMERGENCY MEDICINE DEPARTMENT IN A TERTIARY CARE HOSPITAL IN INDIA

Indian Journal of Medical Microbiology ◽

10.1016/s0255-0857(21)02827-9 ◽

2004 ◽

Vol 22 (3) ◽

pp. 159-165

Author(s):

VD Teja ◽

V Lakshmi ◽

T Sudha

Keyword(s):

Emergency Medicine ◽

Human Immunodeficiency Virus ◽

Virus Infection ◽

Human Immunodeficiency Virus Infection ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Medicine Department ◽

Immunodeficiency Virus ◽

Emergency Medicine Department

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Analysis of adverse drug reactions in a tertiary care emergency medicine department: prevalence, preventability and reporting

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20183490 ◽

2018 ◽

Vol 7 (9) ◽

pp. 1787

Author(s):

Shreya R. Patel ◽

Sapna D. Gupta ◽

Kamlesh P. Patel ◽

Supriya D. Malhotra ◽

Pankaj R. Patel

Keyword(s):

Emergency Medicine ◽

Adverse Drug Reactions ◽

Drug Class ◽

Causality Assessment ◽

Tertiary Care ◽

Negative Consequences ◽

Drug Reactions ◽

Medicine Department ◽

Physician Visits ◽

Emergency Medicine Department

Background: Adverse drug reactions (ADRs) are negative consequences of drug therapy. ADR results in diminished quality of life, increased physician visits, hospitalizations, and even death. Hence a study was planned to detect and analyze ADR encountered in emergency medicine department.Methods: Data was collected over a period of 1 year after taking approval from IRB (Institutional Review Board) and written informed consent from patients. ADRs presenting as a cause of hospital admission or developed during hospitalization were analyzed.Results: A total of 229 ADRs were analyzed. Majority of ADRs were found in the age group of 40-60 Years. The M: F Ratio was 1.10:1. According to Wills and Brown Classification, majority of the ADRs belonged to Type A. According to Hartwig and Siegel classification of severity of ADRs, 18.78% of the ADRs were severe in nature. According to Schumock and Thornton preventability score, majority (64.19%) of the ADRs were not preventable, whereas 17.03% were definitely preventable. 120 (52.40%) of the ADRs were serious in nature Anti-infective were the most common drug class (30.13%) followed by CVS (24.03%) group of drugs. About (57.64%) ADRs fall in the category of probable/likely. Regarding their Outcome, 44.10% of the ADRs were recovered and 43.23% were recovering.Conclusions: Anti-infective were the most reported drug class to cause ADRs in a tertiary care emergency medicine department. Causality assessment according to WHO-UMC and Naranjo’s causality assessment criteria reported to be Probable. Whereas modified Schumock and Thornton scale preventability scale showed that majority were not preventable.

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