ABSTRACT
This study aims to investigate and address the issue of emergency department (ED) overcrowding, a significant problem worldwide. The study seeks to understand the impacts of ED overcrowding on emergency medical healthcare services and patient outcomes. This systematic review follows the PRISMA flow diagram and the guidelines of the Cochrane Handbook. We systematically reviewed the causes and solutions of emergency department overcrowding. We went through Google Scholar, the National Center for Biotechnology Information, the British Medical Journal, Science Direct, Ovid, Cochrane, the Saudi Journal of Emergency Medicine, Medline, and PubMed as databases. Our criteria were articles done in Saudi Arabia from 2012 to 2022. One hundred and ninety-six (196) research papers were extracted; only 28 articles met our paper inclusion-exclusion criteria. The result of these papers regarding causes, consequences, and solutions was that non-urgent and returned visits lacked knowledge of PHC, triad, and telemedicine services. Prolonged LOS is due to slow bed turnover, laboratory and consultation time, and physical response to the final decision resulting in burnout staff, wrong diagnoses, and management plans. The crowding issues can be resolved by awareness, PHC access, triad systems, and technological and telemedicine services. High demand for emergency treatment should not be a hindrance to quality treatment. Physical, technological, and strategic measures should be put in place to fight the crowding problem in EDs in Saudi Arabia, as it may cause adverse effects such as transmission of diseases and death of patients.
ABSTRACT
Background The emergency department (ED) is the first contact of many individuals who require acute health services. This study was the first to be conducted among patients in different regions of Saudi Arabia to determine patient satisfaction with emergency healthcare services using the Arabic version of the Echelle de Qualité des Soins en Hospitalisation (EQS-H). Methodology This cross-sectional study was conducted among 2,997 patients admitted to the ED in different hospitals in different regions of Saudi Arabia. The study was based on a self-reported questionnaire validated to assess the satisfaction of patients with ED healthcare services called EQS-H. In this study, we used an Arabic version of the questionnaire. Statistical analyses were performed using R version 3.6.3. Results The study was conducted among 2,997 patients (36.7% males and 63.3% females). Regarding region, respondents from the central region represented one-third of the sample (31.7%), followed by respondents from the western, eastern, and southern regions (24.1%, 16.9%, and 14.6%, respectively). Statistical analysis showed that the average percentage score for the clarity of information was significantly higher in the central region than in other regions and was lowest in the eastern region. Individuals aged 26-35 years (B = -2.54 and P < 0.05), male sex (B = -1.63 and P < 0.05), Saudis (B = -3.81 and P < 0.05), longer ED length of stay (LOS) (B = -2.19 and P < 0.001), worse perceived health state, and lower life satisfaction scale scores were significantly associated with lower levels of satisfaction with ED services. Perceived improvement is the strongest predictor of satisfaction. Conclusion Moderate satisfaction levels were reported in both the clarity of information domain and relationship with staff domain among patients admitted to EDs in different regions of Saudi Arabia, with better results in the central region.
ABSTRACT
An 18-year-old male smoker inhaled butane gas out of a pocket lighter with his friend for the purpose of changing his voice. He suddenly collapsed and lost his consciousness. Upon arrival to the Emergency Department, he was found pulseless with a rhythm of ventricular fibrillation. Cardiopulmonary resuscitation (CPR) was initiated according to the advanced cardiac life support (ACLS) protocol for three cycles until return of spontaneous circulation archived. After extubation, the patient was ataxic and had significant memory loss and severe confusion. Days later he improved and was discharged with walking aid for his ataxia and a plan to followup with the neurology team for magnetic resonance imaging (MRI) of the brain and electroencephalogram (EEG) as an outpatient.
ABSTRACT
Spices have been known for their various health activities; however, they also possess the allergic potential for the respiratory system and the skin as they are fine particulate matter. Persons involved in spice agriculture and food industries are at greater risk since they are exposed to a considerable amount of combustible dust, which may be the cause of fire and explosion and adversely affect the health. These workers may experience allergy, long-term and short-term respiratory issues including occupational asthma, dermatitis, etc. Some spices induce T cell-based inflammatory reaction upon contact recognition of the antigen. Antigen Presenting Cells (APC) on binding to the causative metabolite results in activation of macrophages by allergen cytokine interleukin (IL)-12 and tumor necrosis factor-beta (TNF). Cross-reactivity for protein allergens is another factor which seems to be a significant trigger for the stimulation of allergic reactions. Thus, it was imperative to perform a systematic review along with bioinformatics based representation of some evident allergens has been done to identify the overall conservation of epitopes. In the present manuscript, we have covered a multifold approach, i.e., to categorize the spice particles based on a clear understanding about nature, origin, mechanisms; to assess metabolic reactions of the particles after exposure as well as knowledge on the conditions of exposure along with associated potential health effects. Another aim of this study is to provide some suggestions to prevent and to control the exposure up to some extent.
