Study Objectives: Race and sex disparities in health care have been previously documented in the literature. A contributing factor may be "unconscious bias"-the concept that patients may be treated differently due to social stereotypes a provider is unaware they are acting upon. This effect may be more pronounced in busy and stressful environments such as the emergency department. Socioeconomic status and other social determinants of health likely also contribute to disparities in care. Our study objective was to describe patterns in emergency care surrounding race and sex demographics. Subjective measurements included patient satisfaction surveys rating provider empathy and quality of visit. Objective measurements included admission rates and length of stay (LOS). Methods: A descriptive secondary analysis of prospective data collected at a tertiary academic level 1 trauma center emergency department was performed from July to August 2018. All comers were included. A non-physician research assistant asked the patient or family member to complete a survey rating physicians on courtesy, listening, concern for comfort, informed on care, treatment of pain, time waiting, and overall visit. Patient demographics, length of stay, and patient disposition were recorded. Results: 204 patients responded overall. Median satisfaction scores in nearly all categories ranged from 4 (good) to 5 (very good). Median White LOS was 192 minutes vs non-white LOS of 185.5 minutes, Black LOS was 207 minutes. White discharge rate was 47.9% vs 75.6% non-White overall, Black discharge rate was 80%, and Hispanic discharge rate was 74.1%. Male discharge rate was 60.7% vs 58.3% female. Complete Median LOS and % admission rate by race and sex are reported in Table 1. Conclusion: Patient satisfaction scores were comparable across both race and sex. Median LOS and discharge rate by sex was comparable. LOS for Black demographic patients was 15 minutes longer than White patients and 21.5 minutes longer than non-White patients. This may be meaningful particularly given a high discharge rate of 80% for Black patients. Non-White patients overall had a much higher discharge rate from the emergency department compared to White patients. Possible factors for this large difference include lack of insurance, access to primary care, health literacy, and Female (n ¼ 115) 193 (0-582) Discharged: 67 (58.3%) Admit Floor: 48 (41.7%) Volume 76, no. 4s : October 2020 Annals of Emergency Medicine S59 Research Forum Abstracts Conclusion: Given comparable findings in the presence and distribution of abnormalities between POCUS and chest CT, POCUS may be a viable alternative to chest CT for diagnosis and risk stratification in patients with suspected COVID-19.
Introduction: Research conducted in the department of emergency over the past years has shown that ultrasound in the patient's bedside can improve care in the hospital's department of emergency. The purpose of this study was to examine the learning of the BLUE protocol in the emergency medicine resident.Material & Methods: This study was designed as a qualitative study of pretest and posttest type that was conducted on emergency medical assistants who were employed in teaching hospitals of Iran University of Medical Sciences. In this study, sampling was done as a whole. In this study, patients' data was collected through pre-designed questionnaires. Then, after teaching the theory and practice of sonography by faculty of emergency medicine, the learning curve of ultra-sonographies performed by the assistants were studied separately until they reached the full competencies and confirmed by the corresponding professor.Results: In this study, a total of 85 emergency medical assistants were evaluated in terms of education and chest sonography (blue protocol) learning. The agreement between the performance of each assistant and the corresponding teacher was evaluated in 23 consecutive steps for assessing Lung sliding, determining the lung profile, and also identifying the B lines, and eventually identifying the complication in 747 patients with a mean age of 48.2 ± 6.1 which required pulmonary examination. The agreement rate increased by 0.09, 0.43, 0.08, and 0.371 respectively. There was a significant difference in the statistical analysis of the mean changes in the blue protocol. In the study of changes in the mean of the agreement coefficients, we reduced these changes and the average of the total coefficients of the agreement was increasing the convergence coefficient.Conclusion: The course of lung ultrasonography in the patient's bedside, according to the BLUE protocol, in the emergency medicine resident shows that during the training, the experience of the assistants has been increased and the professors are close to recognizing the BLUE protocol profiles.
Conclusion: Given comparable findings in the presence and distribution of abnormalities between POCUS and chest CT, POCUS may be a viable alternative to chest CT for diagnosis and risk stratification in patients with suspected COVID-19.
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