Introduction: For survivors of gender-based violence (GBV) seeking care in hospital emergency departments (ED) the need for medical care and safe discharge is acute.
Methods: In this study we evaluated safe discharge needs of GBV survivors following hospital-based care at a public hospital in Atlanta, GA, in 2019 and between April 1, 2020-September 30, 2021, using both retrospective chart review and evaluation of a novel clinical observation protocol for safe discharge planning.
Results: Of 245 unique encounters, only 60% of patients experiencing intimate partner violence (IPV) were discharged with a safe plan and only 6% were discharged to shelters. This hospital instituted an ED observation unit (EDOU) to support GBV survivors with safe disposition. Then, through the EDOU protocol, 70.7% were able to achieve safe disposition, with 33% discharged to a family/friend and 31% discharged to a shelter.
Conclusion: Safe disposition following experience or disclosure of IPV and GBV in the ED is difficult, and social work staff have limited bandwidth to assist with navigation of accessing community-based resources. Through an average 24.3 hours of an extended ED observation protocol, 70% of patients were able to achieve a safe disposition. The EDOU supportive protocol substantially increased the proportion of the GBV survivors who experienced a safe discharge.
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http://dx.doi.org/10.5811/westjem.59072 | DOI Listing |
Intern Med J
January 2025
Department of Respiratory Medicine, The Alfred Health, Melbourne, Victoria, Australia.
Background And Aims: Ward-delivered non-invasive respiratory supports (NIRS) (conventional oxygen therapy (COT), high-flow nasal oxygen (HFNO), continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV)), are often used to treat hospitalised patients with acute respiratory failure (ARF) both in high acuity and general wards. This study aimed to describe the processes of care adopted and examine patient outcomes from a specialist, ward-delivered NIRS service caring for people with COVID-19 in general wards or in a respiratory care unit (RCU).
Methods: A cohort study was undertaken including all consecutive patients admitted to a quaternary hospital with ARF secondary to COVID-19 and requiring ward-delivered NIRS between 28 February 2020 and 18 March 2022.
J Clin Med
January 2025
Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 70-204 Szczecin, Poland.
The objective of this study was to assess the course of rehabilitation of patients hospitalized in the cardiac rehabilitation unit after surgery for acute Stanford type A aortic dissection, extending beyond the ascending aorta, and comparing these findings with those for patients who, after the same type of surgery, had no remaining dissection. The aim was to develop an optimal cardiac rehabilitation model for this patient population, given the lack of clear guidelines. Additionally, the study aimed to evaluate their one-year survival.
View Article and Find Full Text PDFAliment Pharmacol Ther
January 2025
Department of Gastroenterology, East and North Hertfordshire NHS Trust, Hertfordshire, UK.
Background: Acid reflux is a common presentation in primary care leading to a high volume of referrals to endoscopy that are often normal.
Aims: To determine whether a non-endoscopic capsule sponge biomarker test could triage patients with low-risk reflux symptoms, reduce endoscopy waiting lists and identify Barrett's oesophagus in a real-world setting.
Methods: Patients with reflux symptoms on NHS endoscopy waiting lists who were offered a capsule sponge (test group) between February 2021 and August 2022 were included in this national multicentre prospective cohort study and compared with eligible patients on the standard endoscopy pathway (counterfactual group).
J Visc Surg
January 2025
The George Washington University Hospital, Department of Surgery, Washington, DC, United States.
Background: Open inguinal hernia repair (OIHR) can be conducted under either general anesthesia (GA) or local anesthesia (LA). Despite a lack of evidence supporting improved perioperative outcomes, GA is the predominant anesthesia type used in OIHR. Frailty is defined as a clinically recognizable state of age-related increased vulnerability.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Anesthesiology, Yanbian University Hospital, Yanji, Jilin, P.R. China.
Rationale: Patients with atrial fibrillation and a large goiter have high perioperative risks and often cannot tolerate general anesthesia, making it necessary for us to explore new safe and effective anesthesia methods.
Patient Concerns: The patient presented with atrial fibrillation accompanied by rapid ventricular rate, a thrombus attached to the left atrial appendage, and a massive thyroid goiter compressing the airway.
Diagnosis: After the left humerus fracture surgery, the patient's internal fixation loosened and fractured, accompanied by infection, formation of sinus tracts, and suppuration.
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