scholarly journals Register to donate while you wait: Assessing public opinions of the acceptability of utilizing the emergency department waiting room for organ and tissue donor registration

CJEM ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 622-625 ◽  
Author(s):  
Brittany Ellis ◽  
Michael Hartwick ◽  
Jeffrey J. Perry

ABSTRACTObjectiveOur objectives were to identify barriers to the organ donation registration process in Ontario; and to determine the acceptability of using the emergency department (ED) waiting room to provide knowledge and offer opportunities for organ and tissue donor registration.MethodsWe conducted a paper based in-person survey over nine days in March and April 2017. The survey instrument was created in English using existing literature and expert opinion, pilot tested and then translated into French. Data was collected from patients and visitors in an urban academic Canadian tertiary care ED waiting room. All adults in the waiting room were approached to participate during study periods. We excluded patients who were too ill and required immediate treatment.ResultsThe number of attempted surveys was 324; 67 individuals (20.7%) declined participation. A total of 257 surveys were distributed and five were returned blank. This gave us a response rate of 77.8% with 252 completed surveys. The median age group was 51–60 years old with 55.9% female. Forty-six percent reported their religion as Christian and 34.1% did not declare a religious affiliation. 44.1% were already registered donors. Most participants agreed or were neutral that the ED waiting room was an acceptable place to provide information on donation, and for registration as an organ and tissue donor (83.3% and 82.1%, respectively).ConclusionsIndividuals waiting in the ED are generally supportive of using the waiting room for distributing information regarding organ and tissue donation, and to allow donor registration.

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S72-S72
Author(s):  
B. Ellis ◽  
J.J. Perry ◽  
M. Hartwick

Introduction: Our study objectives were to assess the acceptability of using the emergency department (ED) waiting room to provide knowledge on, and offer opportunities for organ and tissue donor registration; and to identify barriers to the donor registration process in Ontario. Methods: We conducted a paper based in-person survey over nine days for eight hour blocks in March and April 2017. The survey instrument was created in English using existing literature and expert opinion, pilot tested and then translated into French. The study collected data from patients and visitors in an urban academic Canadian tertiary care ED waiting room. All adults in the waiting room were approached to participate during the study periods. Individuals waiting in clinical care areas were excluded, as well as those who required immediate treatment. Results: The number of attempted surveys was 324; 67 individuals (20.7%) refused to partake. A total of 257 surveys were distributed and five were returned blank. This gave us a response rate of 77.8% with 252 completed surveys. The median age group was 51-60 years old with 55.9% female. Forty-six percent were Christian (46.0%) and 34.1% did not declare a religious affiliation. Nearly half of participants (44.1%) were registered organ donors. The majority of participants agreed or were neutral (83.3%) that the ED waiting room was an acceptable place to provide information on organ and tissue donation. Further, 82.1% agreed or were neutral that the ED was an acceptable place to register as an organ donor. Nearly half (47.2%) agreed that they would consider registering while in the ED waiting room. A number of barriers to registering as an organ and tissue donor were identified. The most common were: not knowing how to register (22.0%), a lack of time to register (21.1%), and having unanswered questions regarding organ and tissue donation (18.7%). Conclusion: Individuals waiting in the ED are supportive of using the ED waiting room for distributing information regarding organ and tissue donation, and facilitating organ and tissue donation registration. Developing such a practice could help to reduce some of the identified barriers, including a lack of time and having unanswered questions regarding donation.


CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S31-S32
Author(s):  
J. McCallum ◽  
R. Yip ◽  
S. Dhanani ◽  
I. Stiell

Introduction: A significant gap exists between the number of people waiting for an organ and donors. There are currently 1,628 people awaiting organ donation in Ontario alone. In 2018 to date, 310 donors have donated 858 organs. The purpose of this study was to determine whether there were missed donors in the Emergency Department (ED) and by what percent those missed donors would increase organ donation overall. Methods: This was a health records and organ donation database review of all patients who died in the ED at a large academic tertiary care center with 2 campuses and 160,000 visits per year. Patients were included from November 1, 2014 – October 31, 2017. We collected data on demographics, cause of death, and suitability for organ donation. Data was cross-referenced between hospital records and the provincial organ procurement organization called Trillium Gift of Life Network (TGLN) to determine whether patients were appropriately referred for consideration of donation in a timely manner. Potential missed donors were manually screened for suitability according to TGLN criteria. We calculated simple descriptive statistics for demographic data and the primary outcome. The primary outcome was percentage of potential organ donors missed in the Emergency Department (ED). Results: There were 606 deaths in the ED from November 1, 2014 – October 31, 2017. Patients were an average of 71 years old, 353 (58%) were male, and 75 (12%) died of a traumatic cause. TGLN was not contacted in 12 (2%) of cases. During this period there were two donors from the ED and 92 from the ICU. There were ten missed potential donors. They were an average of 67 years, 7 (70%) were male, and 2 (20%) died of a traumatic cause. In all ten cases, patients had withdrawal of life sustaining measures for medical futility prior to TGLN being contacted for consideration of donation. There could have been an addition seven liver, six pancreatic islet, four small bowel, and seven kidney donors. The ten missed ED donors could have increased total donors by 11%. Conclusion: The ED is a significant source of missed organ donors. In all cases of missed organ donation, patients had withdrawal of life sustaining measures prior to TGLN being called. In the future, it is essential that all patients have an organ procurement organization such as TGLN called prior to withdrawal of life sustaining measures to ensure that no opportunity for consideration of organ donation is missed.


2021 ◽  
pp. 23-26
Author(s):  
Saurabh Shivprasad Kakani ◽  
Saurabh Padiya ◽  
Asmita Surywanshi ◽  
Ejaj Patel

Maxillofacial injuries account for a large group of patients in the emergency department in tertiary care hospital, presenting as an isolated injury or a part of poly trauma. Road trafc accidents are the commonest cause of maxillofacial injuries. Such injuries are clinically important as they cause facial disgurement and thus imposing emotional, morbidity and cosmetic dependence. To observe these fractures and decide appropriate management lines, there is a need for imaging aid. The main purpose of imaging guidance is to nd and characterize the fractures and associated injuries. Aim:Study of prole of multi detector computed tomography in maxillo-facial injury in a tertiary care centre. Materials and methods: The cases coming to the emergency department and then forwarded to department of Radiology, MGM medical college and hospital, Aurangabad for CT scan formed the source of the data and were studied in detail. Detailed history of the cases was taken. Written and informed consent were taken for undergoing CT scan examination. Patients were scanned using 16 slice Toshiba acquilion machine. The data was tabulated and observed and conclusions were made. Results: Total 175 number of patient were included in the study and CT scan for maxillo-facial injuries were conducted. Diagnosis of the maxillofacial injuries were done and the fractures were classied according to age, gender, location and its subsets. According to our study 21-30 years of age group was the most common age group to be involved in maxillo-facial injuries. Frequency of maxillo-facial injuries was found to be more in male than female. Maxillo facial injuries occurred mostly due to road trafc accidents. Orbit was seen as the most common bone to be fractured followed by fracture of maxilla bone. Orbital wall fracture happen to be overall most common bone affected amongst all the other facial bones.


CJEM ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 409-419 ◽  
Author(s):  
Antonia S. Stang ◽  
Stephen B. Freedman ◽  
Angelo Mikrogianakis ◽  
Graham C. Thompson ◽  
Janie Williamson ◽  
...  

ABSTRACTObjectiveTo determine parental experiences and preferences regarding the conduct of pediatric research in an emergency department (ED) setting.MethodsWe conducted a cross-sectional study of parents of children ages 0 – 14 years who visited the ED of a tertiary care children’s hospital. Parents completed a Web-based survey designed to assess perceptions regarding: 1) background/training of research personnel, 2) location and timing of research discussions, and 3) factors influencing their consent/refusal decision.ResultsParents totalling 339 were approached, and 227 (67%) surveys were completed. Overall, 87% (197/227; 95% confidence interval [CI] 83, 92) reported they would be comfortable being approached by a university student to discuss research. This proportion did not change when stratified by the child’s gender, illness severity, or season of visit. Whereas only 37% (84/227; 95% CI 31, 43) of respondents would be comfortable being approached in the waiting room, 68% (154/227; 95% CI 62, 75) would be comfortable if approached in a separate area of the main waiting room. The majority reported comfort with follow-up via email (83%; 188/227; 95% CI 78, 88) or telephone (80%; 182/227; 95% CI 75, 85); only 51% (116/227; 95% CI 44, 57) would be comfortable with a scheduled follow-up visit in the hospital. Participants identified potential complications or side effects as the most common reason for declining consent (69%; 157/227; 95% CI 63, 75).ConclusionsThe majority of parents are comfortable being approached by trained university students, preferably in a separate area of an ED waiting room, and email and telephone follow-ups are preferred over a scheduled re-visit.


Author(s):  
Vrutika H. Shah ◽  
Vidya D. Kharkar

<p class="abstract"><strong>Background: </strong>In recent years, the demand for dermatological consultations in the emergency department has increased. However, most of the publications of dermatological emergencies deal with the general population, without taking into account the changes in frequencies found in young children (ages 0-14 years). Dermatological emergencies in pediatric age group are not uncommon. The aim of our study was to analyse the spectrum of dermatological emergencies in the pediatric age group.</p><p class="abstract"><strong>Methods:</strong> A hospital‑based observational study was conducted at the Department of Dermatology of tertiary care centre, between September 2019 and February 2020. Thirty pediatric patients (age ≤16 years) who had visited Dermatology Outpatient Department (OPD) and emergency department were included in this study.</p><p class="abstract"><strong>Results:</strong> Total thirty patients were included in this study. The male to female ratio was 2:1. The average age of the study was 7.6 years. Maximum cases were in school-aged children (6 to 12 years), which were 12 (40%). The average duration of illness was 36.04 days. The most common condition was inherited conditions (23%) followed by primary cutaneous infections (20%). The cases were divided as 7 (23%) inherited conditions, 6 (20%) cases of infections, 5 (17%) cases each of vasculitis and cutaneous adverse drug reaction and 7 (23%) miscellaneous cases.</p><strong>Conclusions: </strong>Pediatric dermatological emergencies require an interdisciplinary approach for timely intervention. Standardised protocol should be followed in their management to prevent complications like acute skin failure. Early referral of these patients with primary skin conditions to the dermatologists might result in better clinical outcome and decreased mortality. <p> </p>


Author(s):  
Dharmendra Kumar Gupta ◽  
Rajendra Pal Singh ◽  
Ajay Kumar Agarwal ◽  
Shailja Bisht

Background: Emergency services are the back bone of the every hospital, providing 24×7 health care services. Health care workers (HCWs) working in emergency department are always at a greater risk of violence. Factors leading to violence against HCWs need to be addressed to curb these incidents. Aim and objective: To study illness profile of admitted patients through emergency, find out factors leading to violence against health care workers (HCWs) working in emergency, and to recommend development of optimum skills and measures for minimizing violence.Methods: It was a cross-sectional retrospective record and focus group discussion based study. Study included patient of all age group admitted through emergency department in a tertiary care hospital in Uttar Pradesh between 01 August 2019 to 31October 2019. Data was taken from the hospital record and focal group discussion held with casualty medical officers, consultants, senior residents, junior residents, PG students, intern nursing staff and quality department. The information collected was analysed using SPSS version 20.0.Results: Out of 7094 participants, 50.4% were female. Majority of the participants (33%) were 17-32 years of the age group. Most common factor responsible for the violence was poor communication skills followed by harsh voice, poor behavior and death of the patient.Conclusions: Large number of the HCWs working in the emergency department are victims of violence by patients and their relatives. Most of the cases are underreported. There is a need to train doctors in soft skills and handling sensitive situations through appropriate measures for the safety of staff.


2020 ◽  
Vol 2 (2) ◽  
pp. 26-30
Author(s):  
Sneha Pradhananga ◽  
Trishna Shrestha ◽  
Kabita Hada Batajoo ◽  
Manjita Bajracharya

Introduction: Pediatric injury is one of the common emergencies encountered in the emergency department. It is emerging as leading cause of death and disabilities in children. This study aims to analyze the patterns of pediatric injury based on age group, gender, mode, type, place of injury and its outcome. Methods: This is a descriptive cross sectional study conducted in Emergency Department of KIST Medical College and Teaching Hospital from 1st May 2019 to 30th July 2019. A total of 110 patients aged 15 years and below and with history of trauma were included in this study. Results: A hundred and ten pediatric patients presented to emergency with injuries. Majority of pediatric trauma cases belonged to age group 1-5 years (38.2%, n=42) and more frequent in male children (66.4%, n=73) .In both gender, male (45.5%, n=50) and female (17.3%, n=19); fall was most common mode of injury followed by accidental cut injury (7.3%,n=8) in male and road traffic accident (6.4%,n=7) in female. Most of the cases sustained soft tissue injury (32.7%, n=36) followed by cut injury (26.4%, n=29) and fracture (16.4%, n=18). Common place of injury was found to be at home (64.5%, n=71). Majority were discharged (n=100; 90.9%), Nine (8.2 %) were admitted and one expired (0.9 %) expired. Conclusion: Fall injuries are the major mode of injury encountered in both male and female children. Injuries tend to occur more at home than school. Children should be adequately supervised at home and school.  


2017 ◽  
Vol 3 (3) ◽  
pp. 338-343
Author(s):  
Mohammad Didar Khan ◽  
Md. Ibrahim ◽  
Md. Mizanur Rahman Moghal ◽  
Dipti debnath ◽  
Asma Kabir ◽  
...  

Objective: The present epidemiological study was conducted with the objectives of providing an insight into the current use of antidiabetic medications to diabetics and hypertensive diabetics in urban areas and determining how the patient factors influence the prescribing of antidiabetic medications. Methodology: Data of patients of past two years were collected from Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh. The details were entered in the structured patient profile form. Data were statistically analyzed using the Microsoft Excel 2007 software. Result: A total of 958 patient’s data were collected and analyzed of which 632 (65.97 %) were males and 326 (34.03 %) were females. These patients were further categorized based on their age. 330 patients (34.45 %) belonged to the age group 20 – 44 years, 504 (52.61 %) to the age group 45 – 65 years and 124 (12.94 %) to the age group 65 – 80 years. 684 (71.4%) patients out of the 958 patients studied were suffering from coexisting hypertension. Co-existing hypertension was found to be more prevalent in the age group 45 – 65 years (67.69%) and was found more in females (84.04%). Conclusion: Metformin was the oral hypoglycemic which was the highest prescribed. In hypertensive diabetics Metformin and Pioglitazone were most frequently prescribed drugs. Biguanides and Insulin were the most commonly prescribed antidiabetics. A combination of two or more drugs of different classes was prescribed to hypertensive diabetics. It is necessary to have an improved understanding of the etiology and pathophysiology of diabetes to focus on research efforts appropriately.


Author(s):  
Bharti Saraswat ◽  
Ashok Yadav ◽  
Krishna Kumar Maheshwari

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail. Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.


Author(s):  
Anjani Teja Ch ◽  
Ramesh babu K ◽  
Leela subramanyam S ◽  
Janani Y ◽  
Eswar Sai Kiran K ◽  
...  

The descriptive observational study was conducted over six months among inpatients of the orthopaedics department. The aim is to observe the prescribing pattern of drugs, to find out the percentage of analgesics given and most commonly prescribed analgesic, to compare the prescribed drugs whether they are in NLEM, WHO list and calculate DDD/100 Bed-days and to analyze the drugs for WHO prescribing drugs. A total of 250 patients were included in the study. Out of this, 168 were male, and 82 were female. Most of the patients were in the age group of 31-40[45 in number with 18%]. The most common condition was found to fracture [113 in number with 95.2%]. Commonly prescribed drugs were analgesics 447 with 26.76%. Among all the NSAID's, PCM was most commonly prescribed analgesic with 34.4%. The highest no, of drugs was found to be 4drugs/prescription with 24%. Monthly one analgesic was prescribed per prescription with 38.8%. Utilization of analgesics in term of DDD/100 Bed-days was 55.26; Drugs will be evaluated per prescription as per prescribing indicators of WHO was done, the average no. of drugs per prescription was found to be 0.45, percentage of drugs prescribed by generic name was found to be 13.3%, percentage of encounters with antibiotics prescribed were found to be 94.4%, In ratio percentage of drugs prescribed from the national list of essential medicine was found to be 92.6%. This study would help to facilitate better health care delivery.


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