Ultrasound for children with broken arms: Accurate, faster, less painful than X-rays

Point-of-Care Ultrasound (POCUS) assessment of distal forearm injuries in children is accurate, timely, and associated with low levels of pain and high caregiver satisfaction | ScienceDaily

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There are many goals when managing children with suspected fractures of the arm. These include being fast and accurate in the diagnosis, not causing more pain and limiting exposure to radiation. Achieving these goals can result in high rates of caregiver satisfaction. Dr. Poonai’s study suggests that POCUS may be a viable alternative to x-ray with respect to diagnostic accuracy, cost effectiveness, pain, caregiver satisfaction, and procedure duration.

Read the full overview via ScienceDaily here

The original research article is available here

Why do patients seek primary medical care in emergency departments?

MacKichan, F. (2017) BMJ Open. 7:e013816

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Objectives: To describe how processes of primary care access influence decisions to seek help at the emergency department (ED).

Conclusions: This study provides important insight into the implicit role of primary care access on the use of ED. Discourses around ‘inappropriate’ patient demand neglect to recognise that decisions about where to seek urgent care are based on experiential knowledge. Simply speeding up access to primary care or increasing its volume is unlikely to alleviate rising ED use. Systems for accessing care need to be transparent, perceptibly fair and appropriate to the needs of diverse patient groups.

Read the full article here

Blood Withdrawal from Intravenous Catheters by ED Nurses: Comparison of Two Practices

Nazaretian, H.H. et al. Journal of Emergency Nursing | Published online: 25 April 2017

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Problem: Laboratory tests are essential to diagnosis and treatment in the emergency department, but they can result in prolonged waiting times for patients, multiple needle pricks, and complaints about pain and discomfort. The goal of this project is to assess if a change in the blood collection process will lead to any improvement and benefit in care delivered with regard to time, patient comfort, and cost.

Implications for Practice: Allowing registered nurses to withdraw blood with the start of a peripheral intravenous line will significantly reduce length of stay and costs and enhance patient experience in the emergency department at American University of Beirut Medical Center.

Read the full abstract here

Role of Resilience in Mindfulness Training for First Responders

Kaplan, J.B. et al. Mindfulness | Published online: 19 April 2017

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First responders are exposed to critical incidents and chronic stressors that contribute to a higher prevalence of negative health outcomes compared to other occupations. Psychological resilience, a learnable process of positive adaptation to stress, has been identified as a protective factor against the negative impact of burnout.

Read the full article here

Predicting morphine related side effects in the ED

Bounes, V. et al. (2017) The American Journal of Emergency Medicine. 35(4) pp. 531-535

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Image source: Vaprotan – Wikimedia // CC BY-SA 3.0

Study objectives: Morphine is the reference treatment for severe acute pain in an emergency department. The purpose of this study was to describe and analyse opioid-related ADRs (adverse drug reactions) in a large cohort of emergency department patients, and to identify predictive factors for those ADRs.

Conclusion: Serious morphine related ADRs are rare and unpredictable. Prophylactic antiemetic therapy could be proposed to patients with history of travel sickness and history of nausea or vomiting in a postoperative setting or after morphine administration.

Read the full abstract here

Predicting morphine related side effects in the ED

Bounes, V. et al. (2017) The American Journal of Emergency Medicine. 35(4) pp. 531-535

800px-morphine_vial

Image source: Vaprotan – Wikimedia // CC BY-SA 3.0

Study objectives: Morphine is the reference treatment for severe acute pain in an emergency department. The purpose of this study was to describe and analyse opioid-related ADRs (adverse drug reactions) in a large cohort of emergency department patients, and to identify predictive factors for those ADRs.

 

Conclusion: Serious morphine related ADRs are rare and unpredictable. Prophylactic antiemetic therapy could be proposed to patients with history of travel sickness and history of nausea or vomiting in a postoperative setting or after morphine administration.

Read the full abstract here

 Emergency hospital care for children and young people

What has changed in the past 10 years? | QualityWatch

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Image source: QualityWatch

This short research summary explores how children and young people’s use of emergency care has changed over the past 10 years and seeks to understand what this might mean for care quality.

Emergency care across the NHS in England is under great pressure. The number of people attending Accident & Emergency (A&E) departments is at an all-time high demand for beds is also at record levels and the four-hour A&E target (of seeing 95 per cent of patients arriving at A&E within four hours) has not been met since July 2013.

Discussion of the pressures on emergency care within the NHS tends to focus predominantly on older people. This is understandable – the over 65s account for the majority of emergency bed days in NHS hospitals, stay longer in A&E than the rest of the population and are more likely to be admitted to hospital in an emergency.

However, children and young people – defined as people under the age of 25 – are also frequent users of emergency care, attending A&E more frequently than the adult population. Their healthcare needs can be very different from adults, meaning they often require specialist support, and – like older people – they can be particularly vulnerable and dependent on carers.

Download the full report here