Part 1 of this 2-article series reviews serious moral problems created by emergency department (ED) crowding. In this second part of the series, we identify and describe operational and financial barriers to resolving the crisis of ED crowding, along with a variety of institutional and public policy strategies proposed or implemented to overcome those barriers. Finally, the article evaluates 2 additional actions designed to address the problem of ED crowding, namely, distribution of a warning statement to ED patients and implementation of a "reverse triage" system for safe early discharge of hospital inpatients.
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http://dx.doi.org/10.1016/j.annemergmed.2008.09.024 | DOI Listing |
Trials
December 2024
Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Background: Vancomycin, an antibiotic with activity against methicillin-resistant Staphylococcus aureus (MRSA), is frequently included in empiric treatment for community-acquired pneumonia (CAP) despite the fact that MRSA is rarely implicated in CAP. Conducting polymerase chain reaction (PCR) testing on nasal swabs to identify the presence of MRSA colonization has been proposed as an antimicrobial stewardship intervention to reduce the use of vancomycin. Observational studies have shown reductions in vancomycin use after implementation of MRSA colonization testing, and this approach has been adopted by CAP guidelines.
View Article and Find Full Text PDFBMC Oral Health
December 2024
Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Background: Endodontic emergencies, often presented as acute pain or swelling, constitute a substantial challenge in dental practice. While effective management emphasizes prompt intervention, antibiotics are typically indicated only when systemic signs and symptoms are present. There is limited research exists on evaluating the knowledge and clinical approach of dental practitioners in managing endodontic emergencies from our region of the world.
View Article and Find Full Text PDFBMC Pediatr
December 2024
Department of Clinical Laboratory, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, NO 136 Zhongshaner Road, Yuzhong Distrit, Chongqing, 400014, China.
Objectives: Neonatal necrotizing enterocolitis (NEC) is a common intestinal disease that threatens the lives of newborns and is characterized by ischemic necrosis of the small intestine and colon. As early diagnosis of NEC improves prognosis, the identification of new or complementary biomarkers is of great importance. In this study, we evaluate the diagnostic value of CCL3 in NEC and compare its effectiveness with other commonly used biomarkers, such as procalcitonin (PCT) and C-reactive protein (CRP).
View Article and Find Full Text PDFAcad Radiol
December 2024
Department of Radiological Sciences, University of California Irvine, Orange, CA 92868. Electronic address:
Background: Multidose iodinated contrast media (ICM) injectors have shown promise in reducing ICM waste. This study aims to evaluate the impact of patient volume on ICM waste reduction in multidose injectors.
Methods: CT studies performed over one-year period with a multidose injector at our emergency CT unit.
Australas Emerg Care
December 2024
Graduate School of Health, Faculty of Health, University of Technology, Sydney, NSW, Australia.
Background: Effective staff-to-staff and patient-provider communication in the Emergency Department (ED) is essential for safe, quality care. Routine wearing of Personal-Protective-Equipment (PPE) has introduced new challenges to communication. We aimed to understand the perspectives of ED staff about communicating while wearing PPE, and to identify factors contributing to communication success, breakdown, and repair.
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