Objective: Expanding staff levels is a strategy for hospitals to increase their surge capacity. The aim of this study was to evaluate whether emergency health care workers (HCWs) are willing to work during crises or disasters, and which working conditions influence their decisions.
Methods: HCWs in the emergency departments (EDs) and intensive care units (ICUs) of 5 Dutch hospitals were surveyed about various disaster scenarios.
Objectives: This study aimed to provide new insights into the impact of emergency department (ED) to ICU time on hospital mortality, stratifying patients by academic and nonacademic teaching (NACT) hospitals, and considering Acute Physiology and Chronic Health Evaluation (APACHE)-IV probability and ED-triage scores.
Design, Setting, And Patients: We conducted a retrospective cohort study (2009-2020) using data from the Dutch National Intensive Care Evaluation registry. Patients directly admitted from the ED to the ICU were included from four academic and eight NACT hospitals.
Background: For most acute conditions, the phase prior to emergency department (ED) arrival is largely unexplored. However, this prehospital phase has proven an important part of the acute care chain (ACC) for specific time-sensitive conditions, such as stroke and myocardial infarction. For patients with undifferentiated complaints, exploration of the prehospital phase of the ACC may also offer a window of opportunity for improvement of care.
View Article and Find Full Text PDFObjective: During certain phases of the COVID-19 pandemic, a decrease was observed in emergency department (ED) utilization. Although this phenomenon has been thoroughly characterized for the first wave (FW), second wave (SW) studies are limited. We examined the changes in ED utilization between the FW and SW, compared to 2019 reference periods.
View Article and Find Full Text PDFBackground: For emergency department (ED) patients with suspected infection, a vital sign-based clinical rule is often calculated shortly after the patient arrives. The clinical rule score (normal or abnormal) provides information about diagnosis and/or prognosis. Since vital signs vary over time, the clinical rule scores can change as well.
View Article and Find Full Text PDFBackground: The onset of the COVID-19 pandemic was characterized by rapid increases in Emergency department (ED) patient visits. EDs required an appropriate transformation. The main challenges were: adapting capacity to respond to surges in the number of patient visits, protection of high risk (frontline) staff and the segregation of suspect-COVID-19 patients.
View Article and Find Full Text PDFDisaster Med Public Health Prep
February 2022
Objective: Since the beginning of the coronavirus disease (COVID-19) pandemic, several frontline workers have expressed their concerns about reduced emergency department (ED) utilization. We aimed to examine the changes in ED utilization during the early phase of the COVID-19 pandemic, in a country with a well-developed primary care system.
Methods: A retrospective analysis of ED utilization was performed in 3 Dutch hospitals during a 60-day period, starting on February 15, 2020.
Objective: In clinical prediction/diagnostic rules aimed at early detection of critically ill patients, the respiratory rate plays an important role. We investigated the accuracy and interobserver-agreement of respiratory rate measurements by healthcare professionals, and the potential effect of incorrect measurements on the scores of 4 common clinical prediction/diagnostic rules: Systemic Inflammatory Response Syndrome (SIRS) criteria, quick Sepsis-related Organ Failure Assessment (qSOFA), National Early Warning Score (NEWS), and Modified Early Warning Score (MEWS).
Methods: Using an online questionnaire, we showed 5 videos with a healthy volunteer, breathing at a fixed (true) rate (13-28 breaths/minute).
Objective: Research on serious infections/sepsis has focused on the hospital environment, while potentially the most delay, and therefore possibly the best opportunity to improve quality of care, lies in the prehospital setting. In this study we investigated the prehospital phase of adult emergency department (ED) patients with an infection.
Methods: In this prospective pilot study all adult (≥18y) patients with a suspected/proven infection, based on the notes in the patient's ED chart, were included during a 4-week period in 2017.