"free-standing emergency"

PURPOSE: To identify technologist-controlled factors to decrease dose and improve image quality and evaluate their use during computed tomography (CT) kidney stone examinations. METHODS: Online scholarly databases were searched to acquire peer-reviewed, published articles involving methods of optimizing radiation dose during CT. These articles were reviewed, and the technologist-controlled factors identified were protocol selection, patient centering in the bore, and scan length...

OBJECTIVE: To determine the effectiveness of dry hydrogen peroxide (DHP) in reducing environmental bioburden in occupied areas. DESIGN: Prospective environmental cohort study. SETTING: The study was conducted in 2 tertiary-care hospitals and 1 free-standing emergency department. INTERVENTION: Environmental air and surface sites were cultured before and after continuous deployment of DHP systems in targeted hospital areas...

AUDIENCE: This scenario was developed to educate emergency medicine residents on the diagnosis and management of ventricular tachycardia (VT) that is refractory to single dose anti-arrhythmic management. BACKGROUND: Electrical storm, defined as three or more episodes of sustained VT, ventricular fibrillation, or appropriate shocks from an implantable cardioverter defibrillator within 24 hours,1 has a mortality rate up to 14% in the first 48 hours.2 Ventricular tachycardia may present in a heterogenous fashion, not only with stable versus unstable clinical presentations, but also with different electrocardiographic morphologies and etiologies...

BACKGROUND: Freestanding emergency departments (FSEDs) have generated improved hospital metrics, including decreased ED wait times and increased patient selection. Patient outcomes and process safety have not been evaluated. This study investigates the safety of FSED virtual triage in the emergency general surgery (EGS) patient population. METHODS AND PROCEDURES: A retrospective review evaluated all adult EGS patients admitted to a community hospital between January 2016 and December 2021 who either presented at a FSED and received virtual evaluation from a surgical team (fEGS) or presented at the community hospital emergency department and received in-person evaluation from the same surgical group (cEGS)...

OBJECTIVES: This study explored design solutions that can help clinicians manage work-related stress, pursue mindful work, and practice relaxation and coping strategies. BACKGROUND: Clinicians are experiencing burnout at increasingly higher rates, leading to compromised patient care. While self-care and stress management strategies are shown to be effective in healthcare settings, little is known about how the design of healthcare settings can facilitate these strategies...

We present the case of an aggressive male patient who was unable to be successfully sedated with conventional medications in the ED and ultimately required intubation to ensure the safety of the patient himself and the staff. After admission to the ICU, he was found to have atrophy of the frontal and bilateral lobes secondary to a traumatic brain injury (TBI) 19 years prior. Managing the patient required collaboration with the intensivist, hospitalist, and psychiatry and neurology teams for 10 months, and he was refused admission to multiple psychiatric facilities due to safety concerns because of his high level of aggression and unpredictability...

Transient global amnesia (TGA) is a rare self-limited syndrome characterized primarily by anterograde amnesia. It shares multiple characteristics with a transient ischemic attack and ischemic stroke, which carry a more ominous outlook. There is a debate with respect to what is sufficient for ruling out more serious pathologies. Additionally, there is data that challenge the historical view that TGA is a benign condition requiring no long-term management. Here, we present the case of a 70-year-old female who was admitted to a free-standing emergency room with confusion, memory loss, and hypertensive crisis that was diagnosed as TGA...

BACKGROUND: Pediatric pain-related complaints continue to be a common presenting factor of most emergency departments (EDs). Studies have shown that several barriers in assessing and treating pediatric pain exist, including nursing knowledge regarding appropriate pain level assessment. OBJECTIVE: This quality improvement study aimed to provide and evaluate specific education regarding pediatric pain management for free-standing ED triage nurses to expedite medication administration during the triage phase of an ED visit...

PURPOSE: The diagnostic yield of computed tomographic pulmonary angiography (CTPA) for pulmonary embolism varies in the literature, and very little data is available regarding community-based systems. This study evaluates the yield of CTPA for pulmonary embolism across a variety of patient care settings in a community-based healthcare system, providing relevant benchmarks for potential quality improvement efforts. METHODS: This retrospective study included data collected from three sites within a single community-based healthcare system, including a tertiary care level 1 trauma center, an urban community hospital, and a suburban free-standing emergency department...

BACKGROUND: Our regional trauma organization, which comprises 7 trauma centers, 30 acute care hospitals and free-standing emergency departments, and 42 emergency medical services agencies, conducted possibly the largest mass-casualty drill to date, totaling 445 victims at 3 sites involving 11 hospitals and 25 agencies and organizations. METHODS: The drill was preceded by a tabletop exercise 4 months beforehand called Operation Continued Care Full-Scale Exercise, which consisted of simulated terrorist events at 3 sites to wound 445 moulaged patients...

Tertiary hospitals are increasingly called on by smaller hospitals and free-standing emergency rooms (ERs) to provide surgical care for complex patients. This study assesses patients transferred to an acute care surgery service. The ER and transfer center logs, as well as billing data, were reviewed for 12 months for all cases evaluated by acute care surgery. The charts were reviewed for demographics, comorbidities, and outcomes. A total of 111 transferred patients with complete data were identified, with 59 transferred from another hospital and 52 from a free-standing ER...

No abstract text is available yet for this article.

BACKGROUND: Intermittent treatment of acute lower acuity situations has come to be defined as urgent rather than emergent care. The location of urgent care delivery has been shifting from exclusively hospital or office settings to other community locales. AIMS: To review the concept of urgent care and the new models of health care delivery in the niche between hospitals and primary care. To highlight the roles of urgent care in Israel and compare these roles with those in other countries...

No abstract text is available yet for this article.

A transport request was received from a free-standing emergency facility to transport a morbidly obese man with a ruptured abdominal aortic aneurysm (AAA). Weather conditions at the time prohibited rotor-wing transfer, so ground transport was arranged. The patient was a 58-year-old man being worked up for a possible back injury. During the evaluation, the patient had an episode of supraventricular tachycardia (SVT) with associated hemodynamic instability. Although the SVT corrected without intervention, the patient remained hemodynamically unstable...

OBJECTIVE: To determine the factors that allow patients with community-acquired pneumonia who are at high risk of mortality (risk classes IV and V) to be treated at home. DESIGN: A prospective, observational study. SETTING: Six hospitals and one free-standing emergency room in Edmonton, Alberta. PARTICIPANTS: The present study included 2354 patients in risk classes IV and V who had a diagnosis of pneumonia made by an emergency room physician or an internist...

No abstract text is available yet for this article.

This analysis of the overall market position of free-standing emergency care was based on a telephone survey of 300 randomly chosen households in a southeastern metropolitan area. Results show that consumer preferences for cost and convenience create a strong market for free-standing emergency facilities. Emergicare centers are in an ideal situation to capture the market for acute and minor emergency care. To be worthwhile, the emergency room in a more comprehensive ambulatory care facility should serve as a feeder of new patients and be profitable in its own right...

No abstract text is available yet for this article.

No abstract text is available yet for this article.