Ep 250 - Monthly Round Up September 2024 - Patient Experience in the ED, Dirty Adrenaline, and More!
Nov 20, 2024
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This conversation dives into patient experiences in emergency departments, tackling issues like autonomy loss and unmet expectations. Practical suggestions for enhancing comfort and communication are explored. The hosts discuss a fascinating study on dirty adrenaline drips, shedding light on remote inotrope management. They also examine the nuances of arterial blood pressure monitoring in pre-hospital scenarios. Lastly, there's a celebration of the resilience and fulfillment found within the emergency medicine community.
Improving patient experience in emergency departments can be achieved through better communication, effective signage, and simple amenities that address patient comfort.
The study on a 'dirty adrenaline drip' illustrates the need for context-aware medical practices, especially in remote settings, while emphasizing patient safety.
Deep dives
Understanding Patient Experience
Patient autonomy in the emergency department is significantly impacted as many patients feel a loss of control over their situation upon arrival. This loss often stems from insufficient communication about their treatment and the ongoing processes, exacerbated by the time pressures faced by medical staff. Patients reported feelings of vulnerability when confronting serious health issues within the chaotic environment of the emergency department, highlighting the emotional toll of their experiences. Recognizing these challenges can guide healthcare providers in improving patient interactions and fostering a more supportive atmosphere.
Basic Improvements for Patient Care
Simple changes can greatly enhance the patient's experience within the emergency department, starting with effective signage and information dissemination. A recent initiative introduced QR codes to provide patients with context as they move through different care areas, facilitating understanding and reducing anxiety. Additionally, basic amenities such as availability of power sockets and measures to alleviate boredom can significantly impact patient satisfaction. Such straightforward improvements not only address patient needs but can be implemented at relatively low costs.
Innovative Use of Adrenaline in Remote Care
An observational study from Central Australia discusses an innovative approach to managing hypotensive patients in remote settings using an adrenaline drip mixed with fluid. This method allows for effective management of blood pressure until retrieval teams can provide further medical care. While the technique, referred to humorously as a 'dirty adrenaline drip,' demonstrates success in increasing systolic blood pressures, it’s crucial to approach it thoughtfully in more stable environments like emergency departments. This highlights the importance of adapting practices based on context and resource availability while ensuring patient safety.
Shared Decision-Making in Emergency Care
The use of CT scans in patients suspected of subarachnoid hemorrhage beyond the traditionally accepted six-hour window shows promising accuracy, promoting discussions around shared decision-making. This evidence supports extending the diagnostic window, potentially reducing unnecessary lumbar punctures and unnecessary admissions. Clinicians can now engage patients more effectively by discussing probabilities and possible outcomes, fostering a collaborative approach to care decisions. The transparent exchange of information helps patients actively participate in their healthcare journey, ultimately enhancing their experience.
In this episode of the St Emlyn's podcast, Iain Beardsell and Simon Carley discuss various facets of emergency medicine.
They highlight a study on patient experience in emergency departments, focusing on issues like loss of autonomy, unmet expectations, and vulnerability. Suggestions for improvement include better communication, effective signage, and patient comfort.
The podcast also covers a 'dirty adrenaline drip' study from Australia, emphasizing remote inotrope management.
The episode wraps up with reflections on the positives of emergency medicine and the importance of maintaining enthusiasm and mastery in the field.
00:00 Introduction
01:08 Patient Experience in the Emergency Department
02:33 Improving Patient Experience: Practical Tips
04:05 Qualitative Studies in Healthcare
06:43 Dirty Adrenaline Drip: A Practical Insight
10:44 Emergency Endoscopy for Caustic Ingestions
14:15 Subarachnoid Hemorrhage Diagnosis: The S.H.E.D. Study
18:14 Arterial Blood Pressure Monitoring in Pre-Hospital Settings
24:18 Reflections on Emergency Medicine as a Career
27:41 Conclusion
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