Emergency Department

Latest Issue of OR Manager
June 2019
Home Periop Nursing > Perioperative Practice > Emergency Department

Imagining the unimaginable: Preparing for mass casualty

The Centers for Medicare & Medicaid Services (CMS) and the Joint Commission require healthcare facilities to have policies and protocols in place for emergency situations and to hold regular practice drills. With natural disasters like hurricanes, floods, or fires, often there is at least some warning—some amount of time to…

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By: Elizabeth Wood
April 22, 2019
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Expect the unexpected: How we recovered operations after Hurricane Harvey

Whatever your facility’s disaster management plan, it needs continual refinement to account for the differences between imagined and real scenarios. Hurricane Harvey, which hit Houston hard on Saturday, August 26, 2017, is a case in point. The storm brought more than 60 inches of rain within a couple of days,…

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By: Elizabeth Wood
April 22, 2019
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Operative volume is essential quality indicator for performing emergent general surgery in elderly

Editor's Note In this study, survival rates for geriatric patients were significantly improved when emergency general surgery procedures were performed at hospitals with higher operative volumes. Of 41,860 surgical procedures evaluated at 200 hospitals, mortality decreased as hospital emergency operative volume increased. For every standardized increase in volume, reduction in…

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By: Judy Mathias
April 18, 2019
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Factors linked to, lessons learned from reduced mortality during military conflicts

Editor's Note The increased use of tourniquets, blood transfusions, and reduced time to surgical treatment (ie, within 1 hour) were the main factors that reduced mortality 44.2% during military conflicts in Afghanistan and Iraq, this study finds. From October 2001 through December 2017, survival increase three-fold among the most critically…

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By: Judy Mathias
April 1, 2019
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Effect of care bundle on emergency laparotomy outcomes

Editor's Note Hospitals should consider adopting a care bundle approach to improve outcomes for emergency laparotomy patients, this study finds. In this analysis of 14,809 patients in 28 hospitals in the UK, reduction in unadjusted mortality (from 9.8% to 8.3%) and length of stay (from 20.1 days to 18.9 days)…

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By: Judy Mathias
March 21, 2019
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ASCA: CMS makes minor changes to Emergency Preparedness requirements for ASCs

Editor's Note The Ambulatory Surgery Center Association (ASCA) on February 26 announced that the Centers for Medicare & Medicaid Services (CMS) released a Memorandum Summary with updates to Appendix Z of the State Operations Manual, which outlines the Emergency Preparedness requirements for CMS providers and suppliers. The primary change that affects…

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By: Judy Mathias
February 26, 2019
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Surgical transfer unit allows patients to bypass ED

There are few things more disheartening for patients than having to board in the emergency department (ED) for long periods while waiting for a bed. ED boarding can also delay treatment and adds to overcrowding and backups. Erlanger Health System, based in Chattanooga, Tennessee, decided to tackle this problem head…

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By: Catherine Spader, RN
February 20, 2019
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Poor access to trauma centers associated with higher prehopital mortality

Editor's Note States with poor access to trauma centers have more deaths before injured patients arrive at the hospital than states with better access, finds this study presented October 22 at the American College of Surgeons 2018 Clinical Congress in Boston. Overall, the largest percentage of trauma deaths occurred before…

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By: Judy Mathias
October 22, 2018
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California fires threaten safety of OR staff

On Monday, July 23, a trailer blew a tire at the intersection of Highway 299 and Carr Powerhouse Road in the Whiskeytown district of Whiskeytown-Shasta-Trinity National Recreation Area in Northern California. As the driver tried to stop, the wheel’s rim scraped against the asphalt and threw some sparks into very…

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By: Judith M. Mathias, MA, RN
September 20, 2018
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Improving patient flow from ED with electronic nursing handoff process

Editor's Note Use of a standardized, electronic nursing handoff communication process resulted in decreased boarding time in the emergency department (ED) and increased bed flow efficiency, this study finds. Before implementation of the electronic nursing handoff process, the average ready to move-to-occupied time was 83.6 minutes. This decreased to 49…

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By: Judy Mathias
August 29, 2018
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