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The use of a cardiac MRI in the observation unit at Wake Forest University Baptist Medical Center in Winston-Salem, NC, resulted in lower cost at the hospital of about $588 per patient because 79% were managed without admission, according to a study published online in the Annals of Emergency Medicine.
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Citing anticipated benefits for patient care, for caregiver health, and for the bottom line, Emory Healthcare in Atlanta has put a limit on overtime hours for its nurses, including those in its two EDs.
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The management team in the ED at in St. Clair Hospital in Pittsburgh, PA, calls it "managing by walking around." They say it has been one of the keys to their continual improvement in patient satisfaction.
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The bad news: Most ED experts believe that health care reform will only exacerbate the steady growth of volume in the nation's EDs. The good news: ED managers have several weapons in their arsenals to help keep patients flowing through and out of their departments.
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While some publications have focused on the restriction of Propofol use by ED physicians and nurses under new rules issued in December 2009 by the Centers for Medicare and Medicaid Services (CMS), many observers say the issue is much larger, and that it deals with who can administer what ED providers consider procedural sedation and what CMS considers anesthesia.
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The authors set out to compare arterial and central venous blood gases (ABG and VBG, respectively), to evaluate the utility and accuracy of a predefined algorithm for adjusting VBG pH and pCO2 to approximate that of ABG, and to define clinical scenarios where a VBG may not be a useful substitute for an ABG.
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In this secondary analysis of data from a study on the pre-extubation prediction of post-extubation work of breathing in patients recovering from acute respiratory failure, Mehta and colleagues sought to determine whether the size of a patient's endotracheal tube (ETT) affected respiratory rate, tidal volume, and other "weaning parameters" commonly measured during spontaneous breathing and used to predict successful extubation.
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