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Unless your ED is planning an expansion, the amount of space you have to work with is finite. However, as the leadership team at Jersey City (NJ) Medical Center has shown, creative use of that space can significantly improve your department's capacity and help slash wait times and the number of patients who leave without being seen. In less than a year, average wait times went from 3-4 hours to 30 minutes, and the left without being seen (LWBS) rate went from 6% to 1.5%.
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[Editor's note: This article is the first in an ongoing series reviewing the latest findings of the Emergency Department Benchmarking Alliance (EDBA) and how ED managers are addressing the challenges that members have identified. This first article discusses how ED managers are combating steadily increasing volume. The EDBA for 2009 shows increases of 5%-10%. The EDBA findings are significant because they represent feedback from 376 high performing EDs serving 14.8 million patients in the calendar year 2009.]
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[Editor's note: This is the second in what is now scheduled to be a three-part series on reducing violence in the ED, due to breaking news. In last month's article, our experts discussed the importance of a "zero tolerance" policy. In this article, we outline key steps recommended for reducing violence and discuss the importance of having clear procedures when it comes to dealing with patients and their families. Next month we will examine the Sentinel Event Alert just published by The Joint Commission that discusses why the ED is particularly susceptible to episodes of violence, outlines leading causal factors, and provides additional guidance for violence prevention.]
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Terragni et al performed this 4-year-long multicenter randomized controlled trial to determine whether early (6-8 days) vs late (13-15 days) tracheotomy would reduce ventilator-associated pneumonia (VAP) incidence.
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Patients with neuromuscular disease who are intubated and subsequently fail multiple spontaneous breathing trials are often relegated to placement of a tracheo-stomy and continuous mechanical ventilation.
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In this issue: New reports about proton pump inhibitors and the effects of gastric suppression, pioglitazone vs vitamin E for non-alcoholic steatohepatitis, metformin and vitamin B12 deficiency, and FDA Actions.
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Peterson and colleagues at rush university medical Center carried out an observational study of ICU patients' oral nutritional intake in the 7 days following extubation after mechanical ventilation for acute respiratory failure.
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This study sought to determine whether the coagulo-pathy associated with chronic liver disease specifically the elevated International Normalized Ratio (INR) frequently present in patients with advanced disease is protective against venous thromboembolism (VTE) in hospitalized patients.
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Difficult intubations are usually the result of a difficult airway, sometimes anticipated and sometimes not.
