ABSTRACT
Objective@#The number of elderly people visiting emergency rooms is rapidly increasing. Fever is one of the common complaints of patients who come to the emergency room, and it is often difficult to determine its cause in elderly patients only through basic examinations and tests. This study sought to verify the relationship between computed tomography and emergency department revisits of febrile elderly patients. Methods: This study is a retrospective medical record analysis study. Patients who came to our emergency room between September 2016 and September 2019, aged 65 years or more, and with body temperature higher than 37.8°C at the time of presentation or during their stay in the emergency room were enrolled. Patient age, sex, vital signs at triage, laboratory tests, whether computed tomography (CT) was conducted or not were analyzed. The primary outcome was set as revisits to the emergency department within 72 hours after discharge, due to any reason. @*Results@#Three thousand two hundred and forty patients were enrolled and of these 289 patients revisited the emergency department (ED). In the revisit (-) group, CT was performed on 44.09% of patients and 54.67% of patients in the revisit (+) group thus showing a statically significant difference. @*Conclusion@#This study showed that in elderly patients with fever presenting to the ED, patients who underwent a CT had 1.558 higher odds of revisit to the ED compared to patients who did not undergo a CT. From this result, it should be considered that the decision to discharge the febrile elderly patients based on the results of CT examination may not be appropriate.
ABSTRACT
Objective@#The number of elderly people visiting emergency rooms is rapidly increasing. Fever is one of the common complaints of patients who come to the emergency room, and it is often difficult to determine its cause in elderly patients only through basic examinations and tests. This study sought to verify the relationship between computed tomography and emergency department revisits of febrile elderly patients. Methods: This study is a retrospective medical record analysis study. Patients who came to our emergency room between September 2016 and September 2019, aged 65 years or more, and with body temperature higher than 37.8°C at the time of presentation or during their stay in the emergency room were enrolled. Patient age, sex, vital signs at triage, laboratory tests, whether computed tomography (CT) was conducted or not were analyzed. The primary outcome was set as revisits to the emergency department within 72 hours after discharge, due to any reason. @*Results@#Three thousand two hundred and forty patients were enrolled and of these 289 patients revisited the emergency department (ED). In the revisit (-) group, CT was performed on 44.09% of patients and 54.67% of patients in the revisit (+) group thus showing a statically significant difference. @*Conclusion@#This study showed that in elderly patients with fever presenting to the ED, patients who underwent a CT had 1.558 higher odds of revisit to the ED compared to patients who did not undergo a CT. From this result, it should be considered that the decision to discharge the febrile elderly patients based on the results of CT examination may not be appropriate.
ABSTRACT
Background@#It is important to communicate accurately in the emergency department. Due to COVID-19 pandemic, a mask is mandatory to protect medical staffs and patients from infectious diseases, and the mask is known to disturb speech intelligibility. The objective of this study is to find out if a transparent mask can affect communication. @*Methods@#: We conducted a randomized pre- and post-test trial with 40 participants in a real emergency room environment. The reader puts on a mask and read aloud sentences which are frequently used between medical staffs and patients or among medical staffs. The type of mask was randomly assigned to the reader which was transparent or non-transparent. Frequently used 5 sentences between medical staffs and patients and 5 sentences among medical staffs from prepared 100 sentences were randomly selected and recited. Participants were told to write down the sentences they heard. Each sentence written down was graded 0 or 1. After writing down 10 sentences, reader puts on another type of mask and the same experiment was done. The order of transparenton-transparent mask was randomly allocated to each participant. @*Results@#: In frequently used sentences between medical staffs and patient, average score with a transparent mask was 4.88, and with a non-transparent mask was 4.50(p=0.001). In frequently used sentences among medical staffs, average score with a transparent was 4.77, and with a non-transparent mask was 4.05(p<0.001). @*Conclusions@#This study showed the transparent mask improves speech intelligibility when communicating in an emergency room.