RESUMEN
13% of the Danish population have tattoos and of these, 16% regret. In this case report, a 26-year-old woman presented to an accident and emergency department with blisters after laser removal of a tattoo on her lower leg. The blisters were only located at the laser-treated area of the tattoo, and they were successfully treated with local steroid class 3 and sun protection. Laser removal of tattoos is often associated with blistering and other painful skin reactions.
Asunto(s)
Vesícula/etiología , Rayos Láser/efectos adversos , Tatuaje , Adulto , Vesícula/tratamiento farmacológico , Femenino , Humanos , Pierna/patología , Dolor/etiologíaRESUMEN
BACKGROUND: We assessed the 30-day risk of readmission and mortality among patients receiving an International Classification of Diseases 10th edition diagnosis of medical observation and evaluation (Z03*) following admission to an acute medical admission unit (AMAU), stratified on any further specification of diagnosis during hospital stay. METHODS: We used Central Denmark's (Midt)-Electronic Patient Journal to identify patients with a Z03*-diagnosis among patients admitted to the AMAU, Aarhus University Hospital Nørrebrogade from April 2012 to March 2013, and noted any specification of diagnosis. Patients were followed from hospital discharge until death, emigration, or completion of 30 days follow-up. RESULTS: Of 409 patients with an initial Z03* diagnosis at the AMAU, 55% (n = 226) received a more specific discharge diagnosis after transferral to other departments. Among patients discharged to home with a Z03*-diagnosis, 30% were readmitted within 30 days, while the corresponding figure was 23% for patients receiving a specific diagnosis (p = 0.06). In contrast, corresponding figures for 30-day mortality were 3% for Z03*-diagnosed patients and 10% for those who obtained a specific diagnosis (p = 0.003). CONCLUSIONS: Patients diagnosed with Z03* at hospital discharge have a substantially lower 30-day mortality, but a higher readmission-rate, compared to patients who obtain a specific diagnosis during the entire hospital stay.
Asunto(s)
Enfermedad Aguda/mortalidad , Readmisión del Paciente/estadística & datos numéricos , Anciano , Dinamarca/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Alta del Paciente/estadística & datos numéricos , Estudios Prospectivos , Espera Vigilante/estadística & datos numéricosRESUMEN
BACKGROUND: Crowding in the emergency department (ED) has been studied intensively using complicated non-generic methods that may prove difficult to implement in a clinical setting. This study sought to develop a generic method to describe and analyse crowding from measurements readily available in the ED and to test the developed method empirically in a clinical setting. METHODS: We conceptualised a model with ED patient flow divided into separate queues identified by timestamps for predetermined events. With temporal resolution of 30 min, queue lengths were computed as Q(t + 1) = Q(t) + A(t) - D(t), with A(t) = number of arrivals, D(t) = number of departures and t = time interval. Maximum queue lengths for each shift of each day were found and risks of crowding computed. All tests were performed using non-parametric methods. The method was applied in the ED of Aarhus University Hospital, Denmark utilising an open cohort design with prospectively collected data from a one-year observation period. RESULTS: By employing the timestamps already assigned to the patients while in the ED, a generic queuing model can be computed from which crowding can be described and analysed in detail. Depending on availability of data, the model can be extended to include several queues increasing the level of information. When applying the method empirically, 41,693 patients were included. The studied ED had a high risk of bed occupancy rising above 100 % during day and evening shift, especially on weekdays. Further, a 'carry over' effect was shown between shifts and days. CONCLUSIONS: The presented method offers an easy and generic way to get detailed insight into the dynamics of crowding in an ED.
Asunto(s)
Aglomeración , Servicio de Urgencia en Hospital/estadística & datos numéricos , Modelos Teóricos , Listas de Espera , Adolescente , Adulto , Anciano , Ocupación de Camas/estadística & datos numéricos , Femenino , Hospitales Universitarios/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Admisión y Programación de Personal , Estudios Prospectivos , Factores de Tiempo , Adulto JovenRESUMEN
The first Danish Society for Emergency Medicine (DASEM) recommendations for the use of clinical ultrasound in emergency departments has been made. The recommendations describes what DASEM believes as being current best practice for training, certification, maintenance of acquired competencies, quality assurance, collaboration and research in the field of clinical US used in an ED.
Asunto(s)
Certificación/métodos , Educación Médica Continua/métodos , Medicina de Emergencia/educación , Servicio de Urgencia en Hospital , Sociedades Médicas , Traumatología/educación , Heridas y Lesiones/diagnóstico por imagen , Dinamarca , Humanos , UltrasonografíaRESUMEN
The Danish health care system is undergoing a major reorganisation, resulting in fewer emergency departments (ED) with consultants in attendance 24/7. This questionnaire-based study evaluates the status of the reorganisation with emphasis on physician attendance and recruitment. 76% of the EDs are not staffed by consultants 24/7, 51% report difficulties in recruiting qualified personnel and 33% report problems connected to retaining them. 71% believe that a specialty in emergency medicine could help solve these problems. Danish EDs do not comply with the visions of the reorganisation plan.