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  • Open Access

    ARTICLE

    Efficient Model for Emergency Departments: Real Case Study

    Mohamed Abdel-Basset1, Abduallah Gamal1, Rehab Mohamed1, Mohamed Abouhawwash2,3,*, Abdulwahab Almutairi4, Osama M. ELkomy1

    CMC-Computers, Materials & Continua, Vol.70, No.2, pp. 4053-4073, 2022, DOI:10.32604/cmc.2022.020048

    Abstract There are several challenges that hospitals are facing according to the emergency department (ED). The main two issues are department capacity and lead time. However, the lack of consensus on performance criteria to evaluate ED increases the complication of this process. Thus, this study aims to evaluate the efficiency of the emergency department in 20 Egyptian hospitals (12 private and 8 general hospitals) based on 13 performance metrics. This research suggests an integrated evaluation model assess ED under a framework of plithogenic theory. The proposed framework addressed uncertainty and ambiguity in information with an efficient manner via presenting the evaluation… More >

  • Open Access

    REVIEW

    Lactate reloaded–reevaluation of the importance of lactate monitoring in the management of adult sepsis in the emergency department

    GABOR XANTUS1,*, BALINT KISS2, GYULA MOLNAR2, CANDICE MATHESON3, V. ANNA GYARMATHY4, PETER L. KANIZSAI5

    BIOCELL, Vol.45, No.3, pp. 445-449, 2021, DOI:10.32604/biocell.2021.014754

    Abstract For about a quarter of a century, monitoring lactate levels and/or lactate clearance has been an unquestionable cornerstone in sepsis management. The elevated lactate level appeared to be an independent predictor of mortality, and the consequent metabolic acidosis was thought to explain a number of pathophysiological changes seen in septic shock. Recent physiological and clinical findings seem to challenge the adverse role of lactic acidosis in sepsis. Evidence suggests that lactate levels are not necessarily directly proportional to either tissue or cellular hypoxia, and conversely, despite high lactate levels, increased peripheral tissue oxygen pressure can be measured in adult patients… More >

  • Open Access

    ARTICLE

    Analysis of adults with congenital heart disease presenting to pediatric emergency departments with arrhythmias

    Shaun Mohan1, Brady S. Moffett2, Wilson Lam2, Caridad de la Uz2, Christina Miyake2, Santiago O. Valdes2, Jeffrey J. Kim2

    Congenital Heart Disease, Vol.12, No.4, pp. 507-511, 2017, DOI:10.1111/chd.12478

    Abstract Objective: As survivors of congenital heart disease (CHD) continue to age, healthcare utilization by this population has increased. It is unknown how often these patients utilize the emergency department (ED) at children’s hospitals and how arrhythmias play a role in their utilization of care.
    Design: Using a retrospective cohort design, the Pediatric Hospital Information System (PHIS) database was investigated and we studied adults (≥18 years) with CHD (ACHD) who presented to pediatric EDs from 2004 to 2014.
    Setting: Tertiary care pediatric hospitals.
    Results: Of the 6310 encounters to pediatric EDs, 1594 (25%) were for arrhythmias. The median age was 21… More >

  • Open Access

    ARTICLE

    Clinic nonattendance is associated with increased emergency department visits in adults with congenital heart disease

    Katherine Awh1,2, Morgan A. Venuti1,2, Lacey P. Gleason1,2, Rachel Rogers3, Srinivas Denduluri1, Yuli Y. Kim1,2

    Congenital Heart Disease, Vol.14, No.5, pp. 726-734, 2019, DOI:10.1111/chd.12784

    Abstract Objective: To determine the prevalence and predictors of nonattendance in an ACHD outpatient clinic, and to examine the relationship between nonattendance and emergency department (ED) visits, hospitalizations, and death.
    Methods: Patients ≥ 18 years who had scheduled appointments at an ACHD outpatient clinic between August 1, 2014 and December 31, 2014 were included. The primary outcome of interest was nonattendance of the first scheduled appointment of the study period, defined as “no-show” or “same-day cancellation.” Secondary outcomes of interest were ED visits, hospitalizations, and death until December 2017.
    Results: Of 527 scheduled visits, 55 (10.4%) were nonattended. Demographic and socioeconomic… More >

  • Open Access

    ARTICLE

    TRISim: A Triage Simulation System to Exploit and Assess Triage Operations for Hospital Managers - Development, Validation and Experiment

    A. Koba yashi1, K. Suginuma2, M. Furui chi1

    CMES-Computer Modeling in Engineering & Sciences, Vol.113, No.2, pp. 117-149, 2017, DOI:10.3970/cmes.2017.113.121

    Abstract Triage is a method for determining the priority of patients’ treatment to improve survival rates. Different triage methods are used in hospitals, and they are applied after performing an evaluation based on standard methods such as the Japan Triage Acuity Scale (JTAS) or Emergency Severity Index (ESI). It is important to consider the characteristics of all the hospitals when assigning triage methods and emergency levels to them; the hospital managers make these decisions. We propose a multi-agent simulation method to support the hospital managers in employing the triage protocols according to their environment. We developed a prototype simulation system called… More >

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