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Managing Families With Multiple Children in the ED

Managing Families With Multiple Children in the ED

It is not uncommon for families to bring multiple children to the ED for evaluation at a single visit. These children often require fewer ED resources than patients presenting individually. “Non-urgent visits can become a significant obstacle to throughput and optimal use of the ED,” says Ilene Claudius, MD. These patients tend to have lower triage acuity and low hospital admission rates when compared with the general patient population. Assessing Urgent Care Needs In the Western Journal of Emergency Medicine, Dr. Claudius and colleagues had a study published that examined the actual need for urgent interventions in children of families registering multiple patients at once and compared these findings with families that registered single patients. Using a retrospective chart review, the investigators considered five interventions to be critical (admission, subspecialty consultation, performance of procedures, IV fluid administration, and observation for more than 6 hours). A sample of 83 patients from 41 families that registered multiple children was compared with 248 singleton controls. Only 4.8% of patients from families registering multiple children required critical ED interventions, compared with a 32.5% rate observed for families registering just one child. “While many children required medical care, our study showed that the vast majority of care that was required by families registering multiple children could have been rendered in a primary care setting,” says Dr. Claudius. “Families presenting with multiple children as patients mainly fell into a non-urgent category in terms of need for ED resource use.” A Continuing Problem The concept of patients using EDs as primary care has been well established in published research. “In many cases, parents may realize that...
Grading the Nation’s Support for Emergency Care

Grading the Nation’s Support for Emergency Care

Since 2006, the American College of Emergency Physicians (ACEP) has periodically released a state-by-state report card on America’s emergency care environment. In 2014, the third installment of the report card was released. “The information from ACEP’s report card provides clinicians with data on how well emergency care is supported in the United States,” says Jon Mark Hirshon, MD, MPH, PhD, FACEP, who served as chair of the task force that directed the development of the report card. ACEP’s most recent report card forecasts an expanding role for EDs under the Affordable Care Act (ACA) and describes the harm that is being done from fewer resources and greater demands. It measures conditions and policies under which emergency care is being delivered rather than the quality of care that is being provided by hospitals and emergency providers. The report card grades states on 136 measures in five categories, including: Most EDs Scored Poor Grades According to the 2014 report card, the continued failure of state and national policies to support emergency care is endangering patients who require emergent and urgent care. Overall, the United States received a near-failing D+ grade. In a breakdown of the five categories of the report card, the nation received a D- in the access to emergency care category; a C- in the medical liability environment and disaster preparedness categories; and a C in the quality and patient safety category as well as the public health and injury prevention category. The District of Columbia ranked first in the nation with a B- grade, a mark that surpassed Massachusetts, which held the top spot in the 2009 report...
The Contenders

The Contenders

Biologists spent ten years trying to map the structure of the elusive Mason Pfizer Monkey Virus, a problem that could unlock the cure for AIDS. The Contenders solved it in three weeks. Using the online puzzle game Fold It, scientists are enlisting video gamers to solve real- world problems. Source: GE Focus...
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