Article
Emergency Medicine
Haili Gregory, Morgan Cantley, Chara Calhoun, Gregory A. Hall, Andrew J. Matuskowitz, Kyle A. Weant
Summary: The study aimed to quantify and characterize medication errors in patients discharged from the Emergency Department, revealing an error rate of 16.5% in 20,498 errors identified among 19,126 prescriptions. Prescription errors varied among different prescribers, with Emergency Medicine residents having more errors in directions, and Non-Emergency Medicine residents having more errors in quantity and refills.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Pediatrics
Amy W. Bryl, Nicole Demartinis, Marc Etkin, Kathryn A. Hollenbach, Jeannie Huang, Seema Shah
Summary: This quality improvement initiative effectively reduced opioid doses prescribed weekly from the pediatric emergency department, while minimizing return visits and reports of poor pain control.
Editorial Material
Medicine, General & Internal
Jonathan A. A. Edlow, Peter J. J. Pronovost
Summary: This viewpoint offers 3 insights in response to the AHRQ report on diagnostic errors made in US emergency departments: focus on the delivery systems instead of individuals, establish ways to set definitions and assess error rates, and design safe delivery systems to prevent errors.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Emergency Medicine
Elisabeth H. Wynia, Dena M. Lowing, Eric J. Pan, Jon W. Schrock
Summary: This study investigated the trends in pediatric opioid prescriptions by emergency medicine physicians over the last ten years, assessing the adequacy of pain control and the risk of opioid-related adverse events. The findings showed a significant shift towards non-opioid pain management regimens for pediatric fracture patients, as the prescription rates declined over the study period without an increase in the rate of inadequate pain control requiring a return to the emergency department.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Allergy
Joanna S. Cohen, Chisom Agbim, Michael Hrdy, Mary E. Mottla, Monika K. Goyal, Kristen Breslin
Summary: This study found that only approximately half of pediatric emergency department discharged patients filled their EAI prescriptions after discharge, and there was no significant association between filling rates and patient sociodemographic characteristics.
ALLERGY AND ASTHMA PROCEEDINGS
(2021)
Article
Pediatrics
Suzan Mazor, Michelle L. Barrett, Corinne Shubin, Shannon Manzi, COMMITTEE PEDIAT EMERGENCY MED
Summary: Although most health care services can be provided in the medical home, children will be referred to the emergency department (ED) for a variety of conditions. Obtaining medications after ED visits can be challenging due to lack of access, affordability, and understanding. Judiciously dispensing medications at ED discharge from the outpatient pharmacy can help overcome these barriers and improve medication adherence. Routine follow-up visits to the primary care provider medical home are recommended after emergency care encounters.
Article
Emergency Medicine
Mikel Olabarri, Elene Lejarzegi Anakabe, Silvia Garcia, Ane Intxauspe Maritxalar, Javier Benito, Santiago Mintegi
Summary: By analyzing 1509 cases of IV ketamine administration for analgesia and sedation in pediatric emergency departments, this study found that pediatric emergency physicians who are not anesthesiologists can safely administer IV ketamine for reducing fractures. Prior use of opioids is not associated with greater risk for respiratory adverse events after ketamine use.
Article
Emergency Medicine
Michael Hrdy, Monika K. Goyal, Gia M. Badolato, Joanna S. Cohen
Summary: Little is known about the prescription filling of pain medicine for children. This study aimed to investigate demographic and clinical factors associated with differences in opioid prescription fill rates after discharge from the pediatric emergency department. The results showed that less than half of the opioid prescriptions were filled. Age, insurance status, and race/ethnicity were not significantly associated with prescription filling rates. Patients with sickle cell disease were more likely to fill prescriptions, while patients without an identified primary care provider were less likely to fill prescriptions.
JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Pediatrics
Niloufar Paydar-Darian, Anne M. Stack, Diana Volpe, Megan J. Gerling, Annie Seneski, Matthew A. Eisenberg, Eileen Hickey, Katie Toomey Lindsay, Laura Moriarty, Joel D. Hudgins, Francine Falvo, Elyse N. Portillo, Jessica K. Creedon, Catherine E. Perron
Summary: The implementation of a standardized discharge process successfully eliminated discharge-related events without increasing hospital stay or return visits.
Article
Emergency Medicine
Batool Hussain, Nirupama Kannikeswaran, Reny Mathew, Rajan Arora
Summary: This study evaluated the return visits and outcomes related to Advanced Practice Providers (APPs) in a pediatric emergency department (PED). The results showed that the rate of APP-related return visits was low and associated with good outcomes. The majority of return visits were due to the progression of illness and medication-related issues, while diagnostic errors accounted for a minority of the return visits.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Multidisciplinary Sciences
Joseph Langham, Sherita Holmes, Janet Figueroa, Srikant Iyer, Sarah Lazarus, Scott Gillespie, Carmen Sulton
Summary: The study found that non-White pediatric patients in our institution were prescribed fewer opioid medications upon discharge for upper extremity fractures. There was no statistically significant difference in the odds of receiving an opioid prescription between non-White and White patients. Among patients requiring sedation for fracture reduction, non-White patients had lower odds of receiving an opioid prescription.
Article
Pediatrics
Dania Takagi, Saharon Less Elazari, Ayelet Shles, Hadas Yechiam, Dana Schujovitzky, Ehud Rosenbloom
Summary: This study found that transferring pediatric orthopedic cases to the pediatric emergency department resulted in a significant improvement in pain management for children, with a higher percentage receiving analgesic treatment and a more adequate treatment for pain severity. The pediatric emergency department also administered sedation more frequently, especially for dislocated fractures. Despite these improvements, complications and other factors such as length of stay and surgery rates were similar between the two departments.
EUROPEAN JOURNAL OF PEDIATRICS
(2022)
Article
Multidisciplinary Sciences
Mona Anzan, Monira Alwhaibi, Mansour Almetwazi, Tariq M. Alhawassi
Summary: Medication prescribing errors (PEs) are common in the emergency department (ED), with various human and systems-related factors playing a role in their development. Further training for residents and improved communication among healthcare professionals may help reduce the risk of PEs in the ED setting.
Article
Pediatrics
Meaghann S. Weaver, Haavi Morreim, Lydia H. Pecker, Rachel O. Alade, David J. Alfandre
Summary: This article discusses a conflict regarding discharge planning for a febrile infant in the emergency department. The physician believes discharge would be unsafe, while the child's mother prefers to monitor her son closely at home. Commentators assess the case from different perspectives and prioritize a high-quality informed consent process.
Article
Pediatrics
Monica K. Lieng, James P. Marcin, Parul Dayal, Daniel J. Tancredi, Morgan B. Swanson, Sarah C. Haynes, Patrick S. Romano, Ilana S. Sigal, Jennifer L. Rosenthal
Summary: The study found an association between pediatric readiness in emergency departments and the occurrence of potentially avoidable transfers (PATs). Certain components of pediatric readiness were identified as modifiable risk factors that can help reduce PATs. Higher pediatric readiness scores were linked to lower odds of PATs in both injured and noninjured children.
JOURNAL OF PEDIATRICS
(2021)