Emergency department visits

Clark S. Bock SA, Gaeta TJ, Brermer BE, Cydulka RK. Camargo CA Mulficenter study of emergency department visits for food allergies. J AUergy Clin Immunol 2004 113 347-352. 

Clark S, Long AA, Gaeta TJ, Camargo CA Jr Mulficenter study of emergency department visits for insect sting allergies. J Allergy Clin Immunol 2005 116 643-649. 

Gaeta TJ. Clark S, Pelletier AJ. Camargo CA National study of US emergency department visits for acute allergic reactions, 1993-2004. Ann Allergy Asthma Immunol 2007 98 360-365. 

Therapy for chronic asthma is directed at suppressing the underlying inflammatory response and normalizing pulmonary function. The goals of treatment for chronic asthma are to (1) prevent chronic and troublesome symptoms (2) maintain normal or near normal pulmonary function (3) maintain normal activity levels, including exercise and other physical activities (4) prevent recurrent exacerbations of asthma and minimize the need for emergency department visits or hospitalizations (5) provide optimal pharmacotherapy with minimal or no adverse effects and (6) meet patients and families expectations of and satisfaction with asthma care.1... 

In persistent asthma, inhaled corticosteroids provide the most comprehensive control of the inflammatory process and are the cornerstone of therapy.2 Inhaled corticosteroids are more effective than cromolyn, leukotriene modifiers, nedocromil, and theophylline in reducing markers of inflammation and AHR, improving lung function, and preventing emergency department visits and hospitalizations due to asthma exacerbations.2,25 The primary... 

Monitor frequency of patient exacerbations. Frequent exacerbations, unscheduled clinic visits, emergency department visits, and hospitalizations due to asthma may indicate a non-adherent patient or the need to step up long-term control medications. 

Ask the patient about the frequency and severity of symptoms, when symptoms occur, and whether or not the symptoms are associated with exposure to known allergens. Ask the patient about previous emergency department visits and hospitalizations due to asthma. 

Perform a brief medical history to determine the time of symptom onset, symptom severity, symptom severity in relation to previous exacerbations, current medications, previous emergency department visits or hospitalizations due to asthma, previous history of respiratory failure, and psychiatric or psychological disorders. 

FIGURE 33-2. Emergency department visits associated with illicit drugs for the third and fourth quarters of 2003. Data from reference 4. 

The term decompensated HF refers to patients with new or worsening signs or symptoms that are usually caused by volume overload and/or hypoperfusion and lead to the need for additional medical care, such as emergency department visits and hospitalizations. 

Intranasal butorphanol may provide an alternative to frequent office or emergency department visits for injectable migraine therapies. Onset of analgesia occurs within 15 minutes of administration. Adverse effects include dizziness, nausea, vomiting, drowsiness, and taste perversion. It also a has the potential for dependence and addiction. 

In chronic stable COPD, pulmonary function tests should be assessed with any therapy addition, change in dose, or deletion of therapy. Other outcome measures include dyspnea score, quality-of-life assessments, and exacerbation rates (including emergency department visits and hospitalizations). 

Prevent recurrent exacerbations of asthma and minimize the need for emergency department visits or hospitalizations... 

Office of Applied Studies, Drug Abuse Warning Network, 2003 Interim National Estimates of Drug-Related Emergency Department Visits. http //www.oas.samhsa.gov/ dawn/2K3interimED.pdf... 

The challenge in such cases is to save the eyes... [21]. Beare [22] reported a series of 64 patients with eye injuries from chemical assaults treated in a specialty eye hospital in London with 20,333 Accident and Emergency Department visits and 29,853 outpatient visits during a 12-month period in 1988 [22]. In 17 eyes of 16 patients, there was a total loss of comeal... 

No specific total amphetamine-use statistics are available. However, according to the year 2000 report of the Drug Abuse Warning Network, there was a 35% increase from 1999 to 2000 in the number of hospital emergency department (ED) cases in which amphetamines were mentioned. DAWN is a national surveillance system that collects data on drug-related emergency department visits. 

Pauley TR, Magee MJ, Cury JD. Pharmacists-managed physician-directed asthma management program reduces emergency department visits. Ann Pharmacother 29 5. 

Cynthia would like to implement a new service that would manage the medications taken by the HMO s heart failure patients. The questions that the HMO is asking include How much will the service cost and Will the interventions conducted by the pharmacist reduce hospitalizations and emergency department visits Cynthia has additional questions Will the interventions I conduct increase my patients health-related... 

Cynthia s objectives are to reduce hospitalizations and emergency department visits by increasing compliance with heart failure medications and educating patients about their disease state and how to make diet and behavioral modifications, as well as improve patients health-related quality of life and satisfaction with care. 

As pertinent variables are identified, it will become clear that some data will be easily obtainable, whereas information on other variables will be extremely difficult to acquire. Pharmacy-related data often are easily retrievable because much of the information can be obtained directly from the pharmacy s prescription computer program (and the patient profiles). Patient demographic information such as gender and age generally is also stored on the pharmacy computer. However, depending on the research question, data from other areas of the health care system may need to be collected as well. For instance, one hypothesis could be that a pharmacy service may result in a reduction in emergency department visits. Pharmacists often do not have access to data on emergency department visits in their own records. 

Emergency department visits. National Center for Health Statistics, Centers for Disease Control and Prevention. (2006). Retrieved June 1, 2006, from http //www.cdc.gov/nchs/fastats/ ervisits.htm... 

New York City. The New York City Department of Public Health and Mental Hygiene collects health indicator data on emergency department visits, retail pharmacy sales, and ambulance dispatch logs, along with one employer s worker absenteeism rates, as part of an integrated, citywide surveillance system (Heffer-nan et al., 2004). 

Prince BS, Goetz CM, Rihn TL, Olsky M. Drug-related emergency department visits and hospital admissions. Am J Hosp Pharm 1992 49 1696-700. 

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