Open Access Emergency Medicine : OAEM最新文献

{"title":"Prevalence of Motorcycle Accidents and Its Associated Factors Among Road Traffic Accident Patients in Hawassa University Comprehensive Specialized Hospital, 2019.","authors":"Zewdie Oltaye,&nbsp;Ephrem Geja,&nbsp;Alelign Tadele","doi":"10.2147/OAEM.S291510","DOIUrl":"https://doi.org/10.2147/OAEM.S291510","url":null,"abstract":"<p><strong>Background: </strong>Road traffic damages were amongst the central causes of passing away, hospitalization, disability, and low socioeconomic status. About 1.3 million lethal road traffic damages and 20-50 million nonfatal damages happened consequently of road traffic accidents every year globally. Motorcycles are a small subsection of all motor vehicles significantly over-represented in total motor vehicle accidents and lead to a great rate of deaths and disabilities.</p><p><strong>Objective: </strong>The study aimed to assess the prevalence of motorcycle accident and associated factors among road traffic accident patients in Hawassa University Comprehensive Specialized Hospital, Hawassa city, Ethiopia in 2019.</p><p><strong>Methods and materials: </strong>The health institution/hospital-based retrospective cross-sectional study design was applied and a systematic random sampling technique was implemented to select the sample size of 274 patient's cards from January 2018 to January 2019. The data were entered and analyzed on SPSS 20.</p><p><strong>Results: </strong>From 274 patients' medical records reviewed in the study period, 151 (55.1%) injuries were due to motorcycle accident. In a multiple logistic regression analysis, age, sex, high speed, and types of roads showed significant association with motorcycle accidents.</p><p><strong>Conclusion: </strong>The prevalence of motorcycle accidents was the main cause of injuries among others, which was 55.1%. Motorcycle accidents occurred mainly in males and in people with the age category of 20-29 years. Age, sex, high speed, and type of road were significantly associated with a motorcycle accident.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"213-220"},"PeriodicalIF":1.5,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/8f/oaem-13-213.PMC8197589.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39237595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and Heparin.","authors":"Hideto Shiraki,&nbsp;Koji Morishita,&nbsp;Mitsuhiro Kishino,&nbsp;Keita Nakatsutsumi,&nbsp;Koichiro Kimura,&nbsp;Tsuyoshi Shirai,&nbsp;Masahiro Ishizuka,&nbsp;Yasunari Miyazaki,&nbsp;Junichi Aiboshi,&nbsp;Yasuhiro Otomo","doi":"10.2147/OAEM.S302732","DOIUrl":"https://doi.org/10.2147/OAEM.S302732","url":null,"abstract":"<p><strong>Background: </strong>Anticoagulant therapy for patients with severe coronavirus disease (COVID-19) pneumonia is considered to improve the hypercoagulable and inflammatory state. However, bleeding complications should also be considered.</p><p><strong>Case presentation: </strong>A 77-year-old man with a history of falls was diagnosed with COVID-19. Owing to his severe condition, he was intubated and transferred to our hospital for intensive care. Favipiravir, tocilizumab, unfractionated heparin, and ART-123 were administered to treat COVID-19 and manage the antithrombotic prophylaxis for paroxysmal atrial fibrillation (Af). On the 6th day after admission, a hematoma was noted on the left chest wall. Computed tomography (CT) revealed multiple hematomas, including hematomas on his chest wall and obturatorius internus muscle. Emergency angiography transcatheter embolization (TAE) was performed. The patient was transferred to another hospital 23 days after TAE, without complications.</p><p><strong>Conclusion: </strong>Our findings show that anticoagulation therapy and a history of falls induced multiple hematomas in a COVID-19 patient and that the condition was managed with TAE. When anticoagulants are considered in the management of Af and COVID-19 associated coagulopathy, it is necessary to closely monitor potential bleeding complications.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"207-211"},"PeriodicalIF":1.5,"publicationDate":"2021-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/ca/oaem-13-207.PMC8163723.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39055537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of Traumatic Dental Injuries Among Adults.","authors":"Anupama Ramachandran,&nbsp;Sulthan Ibrahim Raja Khan,&nbsp;Manal Al-Maslamani,&nbsp;Jagan Kumar Baskaradoss","doi":"10.2147/OAEM.S311113","DOIUrl":"https://doi.org/10.2147/OAEM.S311113","url":null,"abstract":"<p><strong>Background: </strong>The etiology, presentation and management of traumatic dental injuries (TDIs) vary significantly between the adult and the younger population. Most epidemiological studies on TDIs have focused on the pediatric age group. This study aims to report and compare the distributions of TDIs among adults in a sub-population in India.</p><p><strong>Methods: </strong>This prospective observational study was performed on 1562 consecutively selected patients (1218 males and 344 females) from a university dental hospital in India, between July 2014 and June 2018. The clinical examinations were performed by a single trained and calibrated endodontist. Only TDIs to anterior teeth were recorded (canine to canine in the maxilla and mandible) and classified using a modified version of the World Health Organization's (WHO's) classification. Periapical and panoramic radiographs were taken for all the subjects.</p><p><strong>Results: </strong>A total of 1562 patients aged between 20 and 73 years, with a mean age of 36 years, were examined during the study period. The total number of teeth with TDIs was 3044. Males (78%) clearly outnumbered the females (22%) in all the age groups. The most common type of injury occurring in both the genders is uncomplicated crown fractures (male=31.0% and female=36.6%). Avulsion injuries are more likely to be seen by a dentist within 1 hour post-trauma. About two-third of the TDIs were caused by road traffic accidents (RTAs) followed by falls in about 20% of the patients.</p><p><strong>Conclusion: </strong>Uncomplicated crown fracture was the most commonly observed type of TDI, and RTAs were the primary cause of TDI.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"201-206"},"PeriodicalIF":1.5,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/0e/oaem-13-201.PMC8149273.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39025032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Push-to-Talk Application as an Inter-Professional Communication Tool in an Emergency Department During the COVID-19 Pandemic.","authors":"Osama Kentab,&nbsp;Khaled Soliman,&nbsp;Ahmad AAl Ibrahim,&nbsp;Abdulaziz Alresseeni,&nbsp;Khalid Aljohani,&nbsp;Muna Aljahany","doi":"10.2147/OAEM.S308804","DOIUrl":"https://doi.org/10.2147/OAEM.S308804","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effects of using a smartphone-based push-to-talk (PTT) application on communication, safety, and clinical performance of emergency department (ED) workers during the COVID-19 outbreak.</p><p><strong>Design: </strong>An observational, cross-sectional study.</p><p><strong>Setting: </strong>ED in an academic medical center.</p><p><strong>Participants: </strong>All ED staff members, including physicians (consultants, specialists, residents, and interns), nurses, emergency medical services staff, technicians (X-ray), and administration employees.</p><p><strong>Interventions: </strong>Eligible participants (n=128) were invited to fill out an online questionnaire 30 days after using a PTT application for sharing instant voice messages during the COVID-19 outbreak.</p><p><strong>Main outcome measures: </strong>Self-reported data related to communication, implementation of personal protective measures, and clinical performance at the ED were collected and analyzed on a 5-item Likert scale (from 5 [strongly agree] to 1 [strongly disagree]). Also, the proportions of favorable responses (agree or strongly agree) were calculated.</p><p><strong>Results: </strong>Responses of 119 participants (51.3% females, 58.8% nurses, and 34.5% physicians; 90.4% received at least one notification per day) were analyzed. The participants had favorable responses regarding all domains of communication (between 63.0% and 81.5%), taking precautionary infection control measures (between 49.6% and 79.0%), and performance (between 55.5% and 72.3%). Receiving fake and annoying alerts and application breakdowns were the lowest perceived limitations (between 12.5% and 21.0%).</p><p><strong>Conclusion: </strong>The assessed PTT application can be generalized to other departments and hospitals dealing with patients with COVID-19 to optimize staff safety and institutional preparedness.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"189-199"},"PeriodicalIF":1.5,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/ba/oaem-13-189.PMC8144178.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39025031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Use, Perceived Barriers, and Learning Preference of Point of Care Ultrasound (POCUS) in the Emergency Medicine in Qatar - A Mixed Design.","authors":"Khalid Bashir,&nbsp;Aftab Mohammad Azad,&nbsp;Ayman Hereiz,&nbsp;Mohammed Talha Bashir,&nbsp;Maarij Masood,&nbsp;Amr Elmoheen","doi":"10.2147/OAEM.S304153","DOIUrl":"https://doi.org/10.2147/OAEM.S304153","url":null,"abstract":"<p><strong>Introduction: </strong>Point of care ultrasound (POCUS) has been a part of emergency medicine (EM) training for almost two decades. EM training program has a very broad and rigorous POCUS curricula which, in several cases, does not translate to routine application in clinical settings. This study therefore sought to compare the indications, utilization, barriers, and preferred POCUS educational method in a large Middle Eastern academic EM.</p><p><strong>Methodology: </strong>A validated questionnaire was emailed to 50 EM faculties between April and May 2019. Volunteer faculty members partook in a semi-structured interview to better understand the indications, current use, barriers, and preferred learning method. Responses were anonymous, and data were analyzed with descriptive statistics.</p><p><strong>Results: </strong>This was a mixed design study. 30/50 (60%) of faculty responded to the survey, with a mean age of 39.2 years and a mean number of years in practice, 13.1. 55% (n=28) completed POCUS training in less than five years, while 45% completed more than five years ago and 5% never completed it. Forty percent of EM physicians were trained in Africa, while 55% were qualified in Asia and 5% completed their training in Europe. The indications and frequently performed procedures were consistent with the previous research. The common barrier reported was lack of time, lack of credentialing, lack of quality assurance, and national guidelines. The majority of the faculty preferred a blended learning approach for POCUS.</p><p><strong>Conclusion: </strong>POCUS perceived barriers to its full use include time constraints, lack of national guidelines, and credentialing (awarding POCUS qualifications) of the faculty. Blended learning appears to be the preferred approach towards acquiring the knowledge and skills of POCUS.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"177-182"},"PeriodicalIF":1.5,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/48/oaem-13-177.PMC8140913.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39020434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Life Saving Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) with Open Groin Technique.","authors":"Panu Teeratakulpisarn,&nbsp;Phati Angkasith,&nbsp;Parichat Tanmit,&nbsp;Chaiyut Thanapaisal,&nbsp;Supatcha Prasertcharoensuk,&nbsp;Narongchai Wongkonkitsin","doi":"10.2147/OAEM.S311421","DOIUrl":"https://doi.org/10.2147/OAEM.S311421","url":null,"abstract":"<p><p>A 53-year-old male pedestrian was hit by a car and arrived at our hospital with a blunt abdominal injury and hemorrhagic shock. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) was performed in a timely fashion using the open groin technique in the emergency room. The procedure resulted in rapid improvement of hemodynamic status while the bleeding source was controlled. Recently, REBOA is a proper adjunctive procedure in major non-compressible torso hemorrhage patients. The procedure requires a portable X-ray or fluoroscopic machine in the ER to confirm the balloon's position. This method has likely limited the use of REBOA in developing countries. The procedure with open groin technique, using anatomical landmarks and physiologic change to confirm the position of the balloon, has been developed to address these concerns. Here we report on the treatment's success with this technique and believe that it can benefit trauma patient care.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"183-188"},"PeriodicalIF":1.5,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/1d/oaem-13-183.PMC8140941.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39020435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Postoperative Unfavorable Outcome and Associated Factors in Patients with Appendicitis: A Cross-Sectional Study.","authors":"Wolde Melese Ayele","doi":"10.2147/OAEM.S305905","DOIUrl":"https://doi.org/10.2147/OAEM.S305905","url":null,"abstract":"<p><strong>Purpose: </strong>Appendicitis is surgical emergency that might need removal of the inflamed appendix. Unless treated, appendicular abscess, perforation, and even death might be the unfavorable outcomes. Hence, this study was aimed to investigate the unfavorable outcomes and associated factors among appendicitis operated patients.</p><p><strong>Patients and methods: </strong>A total of 300 patients who operated for appendicitis from September 1 2019 to August 30 2020 were studied using a retrospective cross-sectional study. Data were collected by using a checklist. Epi-data and SPSS version 25 were used for data entry and analysis, respectively. Binary logistic regression model was used to identify independent factors. A p<0.05 was used to set the statistical significance of factors.</p><p><strong>Results: </strong>Among 300 patients who were operated for acute appendicitis, 36 (12%) developed unfavorable outcomes. Though one death because of sepsis was recorded, wound infection was the main postoperative disorder. Female (AOR=0.49; 95% CI: 0.13-0.074), living outside the hospital setting (AOR= 0.49; 95% CI: 0.13-0.074), duration of illness before arrival at the hospital (1-3 days (AOR= 1.67; 95% CI: 1.34-8.37) and ≥4 days (AOR=5.38; 95% CI: 1.63-7.69)), more than 3 days hospital stay (AOR= 3.21; 95% CI: 2.06-8.10), and mass in the right lower quadrant (AOR= 6.01; 95% CI: 2.11-14.50) were the independent predictors of unfavorable outcomes of appendicitis treatment.</p><p><strong>Conclusion: </strong>In this study, unfavorable outcome of acute appendicitis was high. More than one-tenth of appendicitis cases developed unfavorable outcomes. Living outside the hospital setting area, long duration of illness before arrival at the Hospital, more than 3 days hospital stay, and mass in the right lower quadrant were the risk factors, while females were less likely to have unfavorable outcomes of appendicitis. Therefore, closely working with patients who have abdominal pain and increasing their awareness about acute appendicitis will improve the operation outcome.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"169-176"},"PeriodicalIF":1.5,"publicationDate":"2021-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3c/a4/oaem-13-169.PMC8112252.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38978705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Point-of-Care Ultrasound for Arthrocentesis Among Emergency Medicine Residents.","authors":"Josie Acuna,&nbsp;Adrienne Yarnish,&nbsp;Elaine Situ-LaCasse,&nbsp;Richard Amini,&nbsp;Srikar Adhikari","doi":"10.2147/OAEM.S305762","DOIUrl":"https://doi.org/10.2147/OAEM.S305762","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study is to determine if EM resident physicians are able to successfully utilize POCUS to perform an arthrocentesis in the ED. This is a retrospective review of ED patients who received an ultrasound-guided or ultrasound-assisted arthrocentesis performed in the ED over a 6-year period by an EM resident physician.</p><p><strong>Methods: </strong>This was a retrospective review of ED patients who received an ultrasound-guided or ultrasound-assisted arthrocentesis performed in the ED over a 6-year period by an EM resident physician. An ED POCUS database was reviewed for POCUS examinations where an arthrocentesis was performed. Electronic medical records were then reviewed for demographic characteristics, history, physical examination findings, ED course, additional imaging studies, and the impact of the POCUS study on patient care and disposition.</p><p><strong>Results: </strong>A total of 101 POCUS examinations of patients were included in the final analysis. The POCUS examinations and procedures were performed by 59 different EM residents at various levels of training. Overall, 92.1% (93/101) of the procedures were successful. When assessing for image quality, 98/101 (97%) had recognizable structures at minimum. The majority of the patients (84/101, 83.2%) received additional imaging of the affected joint. In the minority of cases (23/101, 22.8%), the ultrasound-assisted approach was utilized, while 78/100 (77.2%) utilized the ultrasound-guided approach. For the studies that utilized the ultrasound-guided approach, the quality of needle visualization was determined to be \"good\" 40/78 (51.3%).</p><p><strong>Conclusion: </strong>EM resident physicians are able to utilize POCUS to perform an arthrocentesis in the ED. Further research is encouraged to determine whether having residents utilize POCUS to perform an arthrocentesis has a significant impact on outcomes and patient care.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"161-167"},"PeriodicalIF":1.5,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/a4/oaem-13-161.PMC8057836.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38821723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Altitude Pulmonary Edema in Ohio at an Elevation of 339 Meters.","authors":"Christina Walker,&nbsp;Benjamin Miner,&nbsp;Todd Bolotin","doi":"10.2147/OAEM.S297752","DOIUrl":"https://doi.org/10.2147/OAEM.S297752","url":null,"abstract":"<p><strong>Background: </strong>HAPE (High-Altitude Pulmonary Edema) is a life-threatening form of high-altitude illness caused by noncardiogenic pulmonary edema. It has been most commonly reported in individuals who live at lower elevations and travel to elevations above 2500 m, typically in those who do so without any acclimatization. It can also occur in residents of high altitudes who descend to lower altitudes and then return to their native altitude without acclimatization. HAPE is more common in individuals with a history of prior HAPE, very rapid rates of ascent, upper respiratory illness, extreme exertion and cold environmental temperatures, Down's Syndrome, obesity and congenital pulmonary anomalies.</p><p><strong>Case presentation: </strong>Our case discusses a patient presenting to an emergency department in Ohio with severe respiratory distress, hypoxia and a radiograph that showed pulmonary edema without cardiomegaly. Additional history revealed the patient had recently returned from Breckenridge, Colorado (an elevation of approximately 2926 m). The diagnosis of HAPE was recognized and he was appropriately treated. He was educated and will not be returning to high altitude without acclimatization in the future.</p><p><strong>Conclusion: </strong>Upon literature review, there has never been a prior documented case of a patient in Ohio with HAPE. Providers must consider altitude illness when evaluating travelers from high altitude destinations, even when traveling to a very low altitude like Ohio, as symptoms may be unresolved by descent alone. This case emphasizes the importance of obtaining relevant historical data including a travel history. It also emphasizes the importance of avoiding early closure of the diagnostic process by only considering common conditions. Finally, the case emphasizes the potential danger of anchoring bias to previously encountered conditions.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"151-153"},"PeriodicalIF":1.5,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4a/62/oaem-13-151.PMC8020123.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25573635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Provider in Triage and Its Effect on Left without Being Seen Rate at a Community Trauma Center.","authors":"Maria Sember,&nbsp;Chad Donley,&nbsp;Matthew Eggleston","doi":"10.2147/OAEM.S296001","DOIUrl":"https://doi.org/10.2147/OAEM.S296001","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency department (ED) overcrowding is a nationally recognized problem and multiple strategies have been proposed and implemented with varying levels of success. It has caused patients to present to the ED but leave without being seen (LWBS). These patients suffer delayed diagnosis, delayed treatment, and ultimately increased morbidity and mortality. In efforts to decrease the number of patients who leave without being seen, one proposed solution is to place a provider in triage to evaluate these patients at the initial point of contact.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on patient's presenting to the Emergency Department from October through January for the years 2013 through 2017. A list of all patient dispositions for each study month was analyzed and compared for the 4 consecutive years with the implementation of an Advanced Practice Provider (APP) in triage.</p><p><strong>Results: </strong>A total of 2162 patients dispositioned as LWBS during the entire study period of October 2013 through January 2017 were enrolled in the analysis. After implementation of a provider in triage, there was a 39% overall decrease (95% CI 0.005) in patients who left the ED before completion of treatment. There was a 69% reduction (95% CI 0.005) in patients who left before seeing the provider in triage. After seeing the provider, we saw an 83% reduction (95% CI<0.001) in LWBS. Overall, our initial LWBS rate was found to be 5%, and after implementation of a provider in triage that rate decreased to 1%.</p><p><strong>Discussion: </strong>The addition of a provider in triage decreased our LWBS rate from 5% to 1%. The addition of a provider in triage also helped identify sick patients in the waiting room and helped facilitate more rapid assessment of ED patients on arrival.</p>","PeriodicalId":503614,"journal":{"name":"Open Access Emergency Medicine : OAEM","volume":"13 ","pages":"137-141"},"PeriodicalIF":1.5,"publicationDate":"2021-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/de/oaem-13-137.PMC8018550.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25565801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}