Active clinical trials for "Emergencies"

Head trauma is a frequent reason for consultation in the emergency room. The CT scan is the reference examination allowing rapid management of the patient. However, CT examinations are among the diagnostic examinations with the highest exposure to ionizing radiation. The study investigators have previously implemented "ultra-low dose" (ULD) acquisitions for several pathologies with an effective dose level similar to that of a standard radiographic examination. These ULD acquisitions are now routinely used in our clinical practice for explorations of the thorax, spine, pelvis and proximal femurs, extremities. This study expands these ULD acquisitions to skull CT for detecting traumatic intracranial lesions. The study investigators hypothesize that it would be possible to search for intracranial lesions in patients with head trauma using ULD protocols, thereby reducing the doses delivered to the patient while maintaining sufficient image quality for the diagnosis.

Randomised clinical trial, single-center, blinded assessment, controlled with standard practice with two-group parallel design. Eligible patients are those assisted and transferred suffering from ST-Elevation myocardial infarction in an Advanced Life Support ambulance from an public Emergency Medical Service in the Cadiz area (Spain). Experimental group will watch an ad hoc design multimedia content in a tablet (video with sound and subtitles) during the transfer and control group will be assisted as standard procedures. Main outcome variables will be conformed by patient reported outcomes (anxiety State, pain and comfort) and patient experience (transfer experience).

Acute kidney injury (AKI) is a common diagnosis in the emergency department (ED), and urinary tract obstruction is a contributing cause that requires rapid diagnosis and therapeutic management. This observational study aims at assessing the accuracy of point-of-care ultrasound (POCUS), performed by the emergency physician (EP) for the detection of dilatation or distension of the kidney secondary to urinary tract obstruction, in emergency department patients presenting with acute kidney injury (AKI). Participants will undergo a bedside POCUS of the urinary tract by the EP followed by central imaging evaluation by a radiologist (either ultrasound or renal computed tomography (CT) or both). Researchers will compare both diagnosis. Study hypothesis is that trained emergency physicians can rapidly and reliably diagnose renal tract obstruction at POCUS in the context of AKI.

Aim: To assess what proportion of all patients over the age of 75 who seek care at the emergency department have palliative care needs and whether these are documented in the patient's medical record. Data collection and analysis: Patients over 75 years of age who seek care in an emergency department and are classified as triage 2-4 during initial triage are assessed by a researcher. Patients with dementia or other cognitive dysfunction will be excluded. Two types of data collection are included 1) Swedish Palliative care guide (S-PCG) documents that the researcher fills in together with the patient, 2) data from the patient's medical record, this data is collected according to a special assessment template. Data from the medical record will be collected after the patient left the emergency department. Data collection is ongoing until 300 patients have been included in the study. Data will be analyzed using descriptive statistics. Implications: The percentage of previously undetected/documented palliative care needs in emergency departments is relevant for prioritizing general palliative care within e.g. housing for the elderly and primary care S-PCG can be relevant to increase the level of knowledge at these care facilities. If it turns out that many patients have palliative care needs that are not met in the emergency department, health care structures need to ensure that these patients receive help at the right level of care. This would likely mean that the number of emergency visits and hospital admissions (with suffering and reduced quality of life as a result) can be reduced.

The emotional and work changes of the staffs and the on-site counter staffs will have a certain impact during this pandemic period. Because a large number of critically ill patients are obstructive in emergency and critical care uint. It will induce a huge impact on the deployment of medical team manpower The purpose of this study is to understand the situation of emergency and intensive care unit personnel after covid-19 infection. It will help the hospital superintendent to understand the impact of emotional adjustment on its own work, understand the emotional situation of on-site personnel, future planning and r deployment.

Dyspnea is a frequent reason for referral to emergency departments, leading to a 30-day mortality rate of up to 10% and a 3-month rehospitalization rate of over 30%. Multiple etiologies, as well as poor performance of clinical examination and chest radiography, lead to a diagnostic error rate of nearly 30% at the end of emergency department care. These diagnostic errors lead to rehospitalization and an excess mortality rate of more than 50% compared to patients with a correct initial diagnosis, which is explained in particular by the use of inappropriate therapies. Lung ultrasound is a rapid, non-irradiating, non-invasive, inexpensive, reproducible imaging test that can be used at the bedside. It has a better diagnostic performance than chest radiography, commonly performed in emergency departments.The immediate benefit of lung ultrasound for the most common diagnoses in emergency medicine has already been demonstrated. From an organizational point of view, a few studies have shown a benefit of lung ultrasound in reducing the time spent in emergency departments and the number of additional examinations necessary for the final diagnosis. However, there is no data in the literature on the longer term impact of its use in the emergency department. The primary objective is to evaluate the impact of performing lung ultrasound in terms of 3-month mortality and rehospitalization as part of the diagnostic process for patients admitted to the emergency department with dyspnea.

French health insurance data indicate that approximately 15% of ambulatory antibiotic consumption is generated by hospital prescriptions. This extra-hospital consumption represents a greater volume than intra-hospital consumption. To date, hospital indicators of good antibiotic use do not include this outpatient dimension. This study will provide a snapshot of the proportion of ambulatory antibiotics generated by emergencies and analyze compliance with management recommendations.This study will serve as a basis for developing indicators of outpatient antibiotic consumption generated by hospital activity and for identifying specific intervention targets aimed at the misuse situations that have been highlighted. This study will be carried out in the form of a repeated survey on a given day (4 days, one across each season), carried out by the local mobile antibiotic therapy team, using a standardized grid. The survey will concern all the medical records of the patients visiting any emergency department on the days of the survey. The evaluation of antibiotic therapies prescribed in discharge orders will be carried out in accordance with local management recommendations by the site investigator (infectious disease and/or emergency medicine specialist), who will assess whether the prescription is in accordance with the recommendations or not.

This is a prospective, observational study of patients presenting to the emergency departments at 9 EMERGEncy ID NET sites. The objectives of the proposed study are to: Describe the range and proportion of infectious agents in synovial fluid as detected by standard C&S and investigational PCR testing, i.e., Biofire® Film Array® Bone and Joint Infection (BJI) Panel, Describe the epidemiology of patients receiving diagnostic arthrocentesis and those diagnosed with septic arthritis in the emergency department (ED), Determine the prevalence of septic arthritis in US ED patients presenting with an atraumatic painful swollen joint, and Determine the clinical (history and physical examination) and laboratory characteristics of septic arthritis. Study coordinators screen the ED log for adult patients presenting with joint pain and whose treating physician ordered an arthrocentesis. After confirming eligibility, study coordinators approach the patient to explain the study, and present the written consent form. If the patient agrees to participate and consent, the study coordinator completes an enrollment data collection using patient and treating physician interview to gather responses. After enrollment, the study coordinator will ensure that approximately 0.3-1.0 mL of leftover synovial fluid is saved and stored in a freezer for shipment to a central laboratory (Truman Medical Center hospital laboratory, Kansas City, MO) for testing. Approximately 30 days after enrollment, study coordinators complete an electronic medical record (EMR) review.

This is an observational retrospective single-center study (CHRU of Nancy) in patients cared for acute dyspnea by a medical team of the emergencies of the CHRU of Nancy. The main purpose of the study is to evaluate the outcome of patients cared for acute dyspnea by a medical team of emergencies of CHRU of Nancy.

Today's population is living longer than prior generations. Senior patients, defined as 65 years or older, are therefore increasing in number, and representing a larger number of hospitalized patients. Thus, assessing and addressing the needs of the growing number of older ER users is essential. The overall objective of the study is to examine the feasibility and the epidemiology of two screening tools ("Programme de Recherche sur l'Intégration des Services pour le Maintien de l'Autonomie" (PRISMA-7) and Emergency Room Evaluation and recommendations (ER2)) used in the Emergency Room of Jewish General Hospital to screen older patients (i.e.; ≥65 years) at risk of adverse health events. A prospective observational cohort design will be used for the study's two phases; phase 1- assessment and phase 2- assessment as well as recommendations.