UMEM Educational Pearls - By Heidi Teague

Title: Impact of Prolonged ED Stays on Mortality and Morbidity in Elderly Patients

Posted: 6/29/2024 by Heidi Teague, MD (Updated: 11/22/2024)
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Prioritizing the timely admission of older patients from the emergency department (ED) to appropriate wards is essential to reduce adverse events, such as falls and infections, and to decrease the duration of hospital stays. Recent cohort studies, both observational and prospective, have demonstrated that elderly patients who experienced prolonged or overnight stays in the ED had a higher in-hospital mortality rate compared to those who were admitted earlier to inpatient care. Efficient patient flow and early admission from the ED to appropriate wards are crucial strategies for improving survival rates and reducing morbidity among older patients.

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Title: Palliative Care in the Emergency Department

Category: Misc

Posted: 3/26/2024 by Heidi Teague, MD (Updated: 3/30/2024)
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Advancements in complex illness management have led to an increasing number of patients surviving longer, with subsequent development of end-stage organ disease, cancer, and dementia. EDs are encountering patients with more complex medical needs who present with challenging complaints such as functional loss, bounce-back visits for uncontrolled symptoms, and caregiver fatigue. ACEP underscored the importance of advancing access to palliative care in 2013 and is one of its top five measures in the Choosing Wisely campaign, aimed at minimizing unwarranted and excessive medical interventions. Proactive symptom management, including promptly addressing pain, dyspnea, nausea, and other distressing symptoms, as well as goals of care conversations, and early referral to hospital and outpatient palliative services can enhance patient and caregiver comfort and quality of life.