Nav: Home

Canadian pediatric emergency department crowding not linked to death, serious adverse outcomes

June 10, 2019

Visiting a crowded pediatric emergency department in Canada may increase the likelihood of being hospitalized but is not linked to delayed hospitalization or death in children, according to research in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.181426

Emergency department overcrowding is a problem in North America and has been associated with increased illness, death and lower patient and physician satisfaction.

"Although we found no significant association between overcrowding and hospital admission within 7 days or death within 14 days after discharge from hospital, we saw an increase in admissions among the sicker children and in return visits from kids who were less sick, with increasing degree of crowding" says Dr. Quynh Doan, BC Children's Hospital, and research director, Pediatric Emergency Medicine, University of British Columbia, Vancouver, BC.

The multicentre study analyzed more than 1.9 million pediatric emergency department visits at 8 hospitals in British Columbia, Alberta, Manitoba and Ontario over 5 years between 2010 and 2014.

"Possible explanations include a delay in timely initiation of medical interventions that could lead to deterioration requiring hospital admission; alternatively, clinicians may respond to emergency department crowding with rising levels of caution in their disposition decision-making," write the authors.

In a related commentary http://www.cmaj.ca/lookup/doi/10.1503/cmaj.190610, Drs. Alexander Moylan and Ian Maconochie, Department of Emergency Medicine, Imperial College Healthcare NHS Trust, United Kingdom, write, "there is no evidence that the trend of increasing attendances at pediatric emergency departments is reversing."

"Research into tools such as evidence-based early warning systems to support departments in providing safe care in the most demanding situations must support efforts to adapt to this challenge," the commentary authors conclude.

"The impact of pediatric emergency department crowding on patient and health care system outcomes: a multicentre cohort study" is published June 10, 2019.

Researchers in the UK developed a computer-aided National Early Warning Score (cNEWS) to determine if it could enhance the accuracy of predicting sepsis.

"The main advantage of these computer models is that they are designed to incorporate data that exist in the patient record, can be easily automated and place no extra burden on the hospital staff to collect additional information," says Professor Mohammed A. Mohammed, University of Bradford, Bradford, United Kingdom.

The cNEWS score can trigger screening for sepsis usually within 30 minutes of admission once routinely collected information has been electronically entered into the patient's medical record.

"These risk scores should support, rather than replace, clinical judgment. We hope they will heighten awareness of sepsis with additional information on this serious condition," says Professor Mohammed.

cNEWS may now be introduced carefully into hospitals with appropriate information technology infrastructure and evaluated.

"Computer-aided National Early Warning Score to predict the risk of sepsis following emergency medical admission to hospital: a model development and external validation study" is published April 8, 2019.
-end-


Joule Inc.

Related Sepsis Articles:

After decades of little progress, researchers may be catching up to sepsis
After decades of little or no progress, biomedical researchers are finally making some headway at detecting and treating sepsis, a deadly medical complication that sends a surge of pathogenic infection through the body and remains a major public health problem.
Study changes guidelines for sepsis management
University of Arizona Health Sciences researcher ends debate among physicians regarding sepsis management.
Improving outcomes for sepsis patients
More than 1 million sepsis survivors are discharged annually from acute care hospitals in the United States.
Genes linked to death from sepsis ID'd in mice
Bacteria in the bloodstream can trigger an overwhelming immune response that causes sepsis.
Identifying therapeutic targets in sepsis' cellular videogame
Exciting new research has defined the chain of molecular events that goes awry in sepsis, opening up opportunities for new treatments to fight the condition that affects more than a million Americans each year and kills up to a third of them.
KAIST identifies the cause of sepsis-induced lung injury
A KAIST research team succeeded in visualizing pulmonary microcirculation and circulating cells in vivo with a custom-built 3D intravital lung microscopic imaging system.
New computer-aided model may help predict sepsis
Can a computer-aided model predict life-threatening sepsis? A model developed in the UK that uses routinely collected data to identify early symptoms of sepsis, published in CMAJ, shows promise.
Sepsis a leading cause of death in US hospitals but many deaths may not be preventable
A research team at Brigham and Women's Hospital has comprehensively reviewed the characteristics and clinical management of patients who died with sepsis.
How common, preventable are sepsis-associated deaths in hospitals?
This study estimates how common sepsis-related deaths are in hospitals and how preventable those deaths might be.
Antidepressant could stop deadly sepsis, study suggests
An antidepressant drug used to treat obsessive-compulsive disorder could save people from deadly sepsis, new research suggests.
More Sepsis News and Sepsis Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Risk
Why do we revere risk-takers, even when their actions terrify us? Why are some better at taking risks than others? This hour, TED speakers explore the alluring, dangerous, and calculated sides of risk. Guests include professional rock climber Alex Honnold, economist Mariana Mazzucato, psychology researcher Kashfia Rahman, structural engineer and bridge designer Ian Firth, and risk intelligence expert Dylan Evans.
Now Playing: Science for the People

#541 Wayfinding
These days when we want to know where we are or how to get where we want to go, most of us will pull out a smart phone with a built-in GPS and map app. Some of us old timers might still use an old school paper map from time to time. But we didn't always used to lean so heavily on maps and technology, and in some remote places of the world some people still navigate and wayfind their way without the aid of these tools... and in some cases do better without them. This week, host Rachelle Saunders...
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at Radiolab.org/donate.