New research shows link between extended GP surgery hours and fewer A&E visits
Research from University of Manchester shows link between extended GP hours and fewer A&E visits, but cost savings may not outweigh benefits.
Emergency Medicine
Articles tagged with Emergency Medicine
ERs after Obamacare: More patients, fewer on-call specialists
In Illinois, average monthly ER visits increased by 5.7% after Obamacare's implementation. In Massachusetts, availability of on-call specialists declined significantly between 2005 and 2014.
You want shorter ER stays? Bring in the nurses
A nurse-initiated protocol to improve timeliness of care can significantly decrease ER stays for patients with certain conditions, including fever and hip fractures. The study found that average length of stay was reduced by almost 4 hours by implementing such a protocol.
Seniors with more continuity of care use the ER less
A study of over 3 million Medicare patients found that seniors with higher continuity of care had 20% lower risk of emergency department visits and hospitalizations. Maintaining a relationship with one doctor can help avoid such situations.
Study examines 'weekend effect' in emergency surgery patients
A new study assessed the 'weekend effect' in emergency general surgery patients, revealing a significant reduction in mortality rates from 5.4% to less than 2.9% over 15 years. The study found great improvements in outcomes overall and notable differences in care provided within the week and at the weekend.
Having primary care physician may not be enough to reduce ED visits by vulnerable groups
A small study found that people with disabilities were more likely to use emergency departments even when they had access to primary health care. The researchers suggest that increased access to mobility clinics with specialized support staff and equipment may be part of the solution.
Study finds Medicaid expansion did not increase emergency department use
Researchers found no increase in emergency department visits in states that expanded Medicaid compared to those that didn't. However, Medicaid expansion led to a 27% increase in Medicaid-paid emergency department visits and a 31% decrease in uninsured visits.
Alternative insurance expansions under ACA linked to better access, use of care
Two insurance expansion approaches under ACA associated with increased outpatient and preventive care, reduced emergency department use, and improved self-reported health. The Medicaid expansion and alternative private option were linked to gains in coverage, primary care access, and reduced out-of-pocket spending.
Latin-American, Caribbean health systems need more investment as populations age
The study found that despite progress toward universal coverage, citizens still reported gaps in primary care organization, financing, and delivery in six Latin American and Caribbean countries. People with better experiences at the primary care level were less likely to say their health system needed major reforms.
Medicaid expansion under ACA linked with better health care for low-income adults
A new study found that Medicaid expansion under the Affordable Care Act led to increased primary and preventive care, reduced emergency department visits, and improved quality of care for low-income adults in Kentucky and Arkansas. The findings suggest that how states expand coverage may not be as important as expanding coverage itself.
August Health Affairs
A recent study in Health Affairs highlights critical primary care shortcomings in Latin American countries, including high rates of skipping needed care and emergency department usage. The findings emphasize the urgent need for attention to address these gaps as populations continue to age.
Street Norco looks like the real thing but really, really isn't
A new street drug combining fentanyl and U-47700 is being marketed as 'Norco' in Central California, posing a significant threat to users. The synthetic opioid's toxicity led to an unexpected cluster of fatal deaths in the area.
Freestanding emergency departments expanding rapidly but access questions remain
The study found that freestanding EDs are concentrated in areas with higher incomes, private insurance rates, and hospital ED presence. This suggests that they may not be expanding access to underserved populations as initially thought.
Small rise in booze duty could cut violence-related emergency visits by 6,000 a year
A small rise in alcohol prices could significantly reduce violence-related injuries in England and Wales, with an estimated 6,000 fewer emergency care visits per year. The study suggests that reforming the current alcohol taxation system would be more effective at reducing violence than minimum unit pricing.
Small rise in booze duty might cut violence-fueled emergency department visits by 6,000/year
Research suggests a small increase in alcohol duty may reduce violence-related emergency department visits by 6000 annually. Lower on-trade and off-trade prices are associated with higher attendance rates.
GW researchers create conceptual model for acute, unscheduled care
Researchers from GW University developed a conceptual model for acute, unscheduled care, identifying issues with current care delivery and proposing ways to improve it. The model incorporates social determinants and care-seeking decisions to optimize outcomes and reduce costs.
High blood pressure by itself is not necessarily an emergency
Visits to emergency departments for hypertension increased by 64% between 2002 and 2012, despite a decline in hospitalizations. Aggressive home monitoring may be driving patients to ERs without other emergency conditions. Mortality rates were low, with less than 1% of patients dying within 90 days.
Are we giving up on cardiac arrest patients too soon?
A new study by the University of Arizona suggests that physicians should not predict outcomes for comatose cardiac arrest patients too soon. The study found that many patients wake up longer than expected after being rewarmed from therapeutic hypothermia treatment, with some even regaining consciousness five or seven days after admission.
App improves knowledge, skills in neonatal resuscitation in workers in Ethiopia
A mobile app improved knowledge and skills in neonatal resuscitation among Ethiopian healthcare workers, but did not significantly reduce perinatal mortality. The app trained workers on managing obstetric and neonatal emergencies through animated videos and local language voiceovers.
Safety-net hospitals remain vital resource for minority patients following health reform
After health insurance reform, minority-serving hospitals in Massachusetts saw a significant increase in minority discharges, with 62% of 'safety-net hospital users' continuing to receive care at these facilities. The study suggests that interventions like raising Medicaid reimbursement rates could benefit these vital resources.
What will it take to protect hospital patients from UTIs? National effort shows promise
A national effort showed that reducing catheter use and UTIs can be achieved through training and tools, saving money and suffering. By the end of an 18-month program, UTI rates dropped by a third in general wards, while catheter use decreased.
Primary care is point of entry for many kids with concussions
A study found that nearly 82% of children with concussion initially sought care through primary care, rather than the emergency department. This highlights the importance of training primary care clinicians in concussion diagnosis and management.
Excessive drinkers, high income households pay majority of state alcohol tax increases
Researchers found that excessive drinkers would pay nearly $3 in $4 of the increased cost of alcohol following state alcohol tax increases. In contrast, non-excessive drinkers would pay less than $10 per year, regardless of hypothetical tax increase amounts.
Educational debt for emergency medicine bigger than average mortgage
The study found that emergency medicine residents carry an average of $212,000 in educational debt, surpassing the national average mortgage of $168,000. This debt significantly impacts their career decisions and overall financial well-being.
Help is just a phone call away -- telephone CPR improves cardiac arrest outcomes
A University of Arizona study found that implementing a Telephone Cardiopulmonary Resuscitation (TCPR) program significantly increases survival rates and favorable outcomes for patients who experienced out-of-hospital cardiac arrests. The program, which includes guidelines-based protocols, TCPR training, and quality improvement, result...
Shortages in nation's drug supply persist despite federal efforts
Despite federal legislation, Yale researchers found that shortages for acute-care drugs used to treat critically ill patients have increased since the passage of FDASIA. The median duration of these shortages was approximately eight months, posing risks of medical error and reduced effectiveness.
Dexamethasone for asthma in the ER: Better compliance, nearly equal effectiveness
A study published in Annals of Emergency Medicine found that dexamethasone was effective in treating mild to moderate asthma in ER patients with only slightly higher relapse rates compared to a 5-day course of prednisone. The single-dose medication eliminates prescription adherence barriers such as forgetfulness and cost.
Food allergies of low-income kids are poorly managed
A new study by Northwestern Medicine reveals that low-income families spend 2.5 times more on emergency department and hospitalization costs for children with food allergies, highlighting a significant gap in preventive care and access to special foods and epinephrine auto-injectors.
When it comes to a child's weight in the ER, mama knows best
A systematic review found that parents generally provide the most accurate estimates of their children's body weight in emergency departments. Length-based methods, such as the Broselow Tape, were the next most accurate, but still had limitations.
Patients triaged as nonurgent in ED get diagnostics, procedures, admitted
A study of nonurgent ED visits found that diagnostic services and procedures were provided in a significant percentage of cases, suggesting potential overuse or uncertainty among patients and healthcare professionals. The findings also highlighted similarities between nonurgent and urgent visit symptoms and diagnoses.
Shorter times to blood transfusion associated with decreased death risk in trauma patients
A study by University of Cincinnati researchers found that trauma patients receiving blood quickly after severe injuries have a decreased death risk. The delay in blood transfusion increased the chances of death, with each 10-minute delay resulting in higher mortality rates.
Stanford trial shows paper tape can help prevent foot blisters
A new study led by Grant Lipman found that applying paper tape to blister-prone areas before exercise prevented both incidence and frequency of foot blisters. The tape, commonly used for wound treatment, is mildly adhesive and doesn't tear blisters if they occur.
Scant evidence to back locating primary care services in emergency/urgent care
A review of 20 studies found little evidence that co-located primary care services can curb patient demand or improve emergency department throughput. In fact, set-up costs often outweigh marginal savings, and diverting patients to primary care may not be cost-effective.
Can your fitness tracker save your life in the ER?
A recent case report found that a patient's activity tracker and smartphone helped identify the onset time of his atrial fibrillation, allowing for timely electrical cardioversion. The device provided critical information to medical providers, enabling more effective treatment decisions.
How to spot elder abuse and neglect in the ER: Things are not always as they seem
Emergency physicians face a growing challenge as the Baby Boomer generation ages; they need to balance documenting findings and referring patients with their obligations to prevent misunderstandings. Two studies highlight the importance of a team-based approach, including social workers and law enforcement, to identify elder abuse.
Mismatched expectations most common reason for patients not completing HPV vaccine series
A new study found that conflicting expectations between parents and medical providers about scheduling follow-up appointments is the most common reason for patients not completing the HPV vaccine series. Researchers suggest improving education and dialogue between providers and parents to increase vaccination completion rates.
Parents of premature babies get confidence boost from home-from-hospital project
Researchers found that a parent-orientated discharge planning process, known as the Train-to Home intervention, can increase parental confidence in caring for their baby. The project resulted in fewer visits to emergency departments after going home and reduced healthcare costs after discharge from hospital.
Self-harming youngsters put at risk by 'cycle of shame'
A study at the University of Exeter found that young people who self-harm only seek emergency hospital care when their injuries are too serious or when complications arise. They experience punitive treatment and intense negative emotions, reinforcing feelings of shame and self-loathing.
Four signs that a geriatric ER patient should be admitted to the hospital
Patients over 65 with cognitive impairment, discharge plan changes, and abnormal vital signs are at increased risk of ICU admission or death within 7 days. Abnormal vital signs like low blood pressure and high heart rate can lead to catastrophic events for discharged patients.
Better way to treat abscesses: Add antibiotic to conventional approach
A new method of treating abscesses has been discovered, which involves adding an antibiotic to the conventional approach, resulting in improved recovery rates and reduced risk of MRSA infection spread. The study found that 93% of patients who took the antibiotic were cured, compared to 86% who received a placebo.
Children's Hospital Colorado experts publish article on the 2014 enterovirus D68 outbreak
Researchers studied the 2014 EV-D68 outbreak, finding that confirmed infections grossly underestimates the true burden on children's hospitals. The study highlights the importance of resource utilization monitoring in future unexpected outbreaks.
People in world's poorest countries missing out on surgery
A study published in the Bulletin of the World Health Organization found that an estimated 312.9 million surgeries took place globally in 2012, with only 30% of operations occurring in low-income countries representing 71% of the global population.
Colorado visitors using marijuana more likely to end up in emergency room
A study by Northwestern University found that out-of-state visitors to Colorado's marijuana dispensaries are increasingly visiting the emergency room, with a 109% increase in 2014 compared to 2012. Adverse side effects of cannabis use include anxiety, hallucinations, and cardiovascular issues.
Ketamine for the difficult-to-sedate ER patient
A study published in Annals of Emergency Medicine found ketamine to be an effective and safe sedation agent for patients with acute behavioral disturbances who do not respond to traditional methods. Only 10% of patients treated with ketamine required additional sedation or failed to achieve sedation within a set time frame.
First European advice launched for deadly acute heart failure
The European Society of Cardiology has launched the first European advice on emergency care for patients with acute heart failure. The guidance highlights that mortality from acute heart failure is even higher than from a heart attack, and that care lags 30 years behind standard treatment pathways for heart attacks.
Emergency visits by youth for mental health, addiction rise by 32 percent over 6 years
A study found a significant increase in mental health-related emergency department visits, hospitalizations, and office-based services among children and youth in Ontario, Canada. Anxiety disorders were the most common reason for these visits, accounting for 47% of the total increase.
Researcher warns US could see substantial impact of Zika virus
Zika virus, a mosquito-borne disease, can cause microcephaly in infants and mild flu-like symptoms in adults and children. The US is at risk of introduction, particularly with the presence of Aedes species mosquitoes in many states.
Study assesses how to avoid unnecessary acute admission to hospital
A study has identified a series of innovations that can help hospitals reduce unnecessary acute admissions. The research found that early patient assessment by senior staff played a central role in reducing admissions, with different approaches used across four hospitals in the south west of England. Patients were generally happy with ...
Patients admitted as weekend emergencies significantly older and more disabled
A study of 536 patients found that those admitted as medical emergencies at weekends are significantly older and more physically incapacitated than weekday admissions. The researchers suggest this may explain the higher death toll for weekend hospital admissions.
Recovery position may curb hospital admission rate of unconscious kids
Research shows that placing a child in the recovery position after losing consciousness can lower hospital admission rates. However, most parents do not use this method and instead resort to potentially dangerous manoeuvres like shaking, slapping, or blowing on the face.
Young people after Obamacare: Some ER visits down, others way up
A study found that emergency department visits for young adults decreased by 0.5 percent following the implementation of the Affordable Care Act, while visits for mental illnesses increased significantly. However, there was a notable decrease in ER visits for complications of pregnancy among this age group.
Socio-economic status may impact care of children with epilepsy
Children with lower socio-economic status have reduced access to neurology visits and increased emergency department visits due to transportation and employment barriers. These disparities highlight the need for additional support to reduce costly hospitalizations and improve specialist care access.
Palliative care initiated in the ED associated with improved quality of life
A randomized clinical trial found that ED-initiated palliative care consultations improved quality-of-life scores and median survival without shortening survival. The study suggests that ED visits can provide a unique opportunity for improved access to palliative care.
How to improve cardiac arrest survival in 3 easy steps
Emergency physicians propose three interventions to improve cardiac arrest survival rates: developing a national OHCA registry, encouraging bystander CPR, and fostering high-performance CPR. The authors argue that inadequate research funding is a significant problem, hindering efforts to reduce mortality rates.
US emergency departments face serious drug shortages
A new study reveals a sharp increase in drug shortages affecting emergency care in the US, from 26 to 123, a 373% rise from 2008 to 2014. Life-threatening medications are particularly affected, leaving emergency department physicians without necessary treatments for critical patients.
Temple study finds opioid prescribing guideline significantly decreases prescription rates
A Temple University study found that an opioid prescribing guideline significantly decreased prescription rates for minor conditions and chronic noncancer pain in acute care settings. The guideline was implemented in January 2013 and resulted in a high degree of statistical significance across all age groups and complaint categories.
Most patients still prescribed opioids after nonfatal overdose, study finds
A study by Boston Medical Center found that nearly 3,000 individuals with chronic pain who experienced a nonfatal opioid overdose continued to be prescribed opioids, with 70% receiving prescriptions from the same provider. Patients who took high dosages were twice as likely to have another overdose at two years of follow-up.
Vanderbilt study finds hypertension-related visits to emergency rooms on rise in US
A Vanderbilt University Medical Center study found that 25% of emergency department visits involve patients with hypertension, with a 20% increase since 2006. Uncontrolled hypertension is a significant cause of death in the US, and lifestyle factors such as medication adherence and exercise can help manage the condition.
Almost three-quarters of weekend emergency care caseload linked to booze
A large inner city hospital in England found that almost three-quarters of weekend emergency care cases are linked to excess alcohol intake, resulting in significant costs for urban emergency care departments. The analysis, published online, reveals substantial costs for treating alcohol-related cases, with an annual bill of £1 million.
Alcohol aromatherapy eases nausea in the ER
A randomized controlled trial found that isopropyl alcohol nasal inhalation reduced nausea scores by half and improved patient satisfaction compared to saline solution. The remedy has potential to alleviate symptoms of nearly five million emergency patients annually.