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Age, comorbidity, frailty status: effects on disposition and resource allocation during the COVID-19 pandemic

Viewpoint
Nickel CH, Rueegg M, Pargger H, Bingisser R
Swiss Med Wkly. 2020;150:w20269

Three aspects are of utmost importance: first, determination of frailty status (and not just the patient’s age), second, balancing of benefits and harms while considering the most likely outcome taking comorbidity into account, and third, shared decision-making focusing on the individual’s goals of care.

Pain – the fifth vital sign

Viewpoint
Christ M
Swiss Med Wkly. 2020;150:w20215

An encouraging article recently published in Swiss Medical Weekly reported that that the fundamental basis of adequate pain management is available in almost all Swiss emergency departments. What could be valuable next steps for excellent pain management within EDs?

Prevalence and practice of opioid prescription at a Swiss emergency department: 2013–2017

Original article
Gaertner K, Wildbolz S, Speidel V, Exadaktylos AK, Hautz WE, Müller M
Swiss Med Wkly. 2020;150:w20202

Information about the prevalence and characteristics of patients who are taking or receiving opioids and consult an emergency department (ED) may be useful in increasing clinical awareness and in providing data for policymakers.

Availability of advance directives in the emergency department

Original article
Slankamenac K, Rütsche N, Keller DI
Swiss Med Wkly. 2020;150:w20184

Emergency departments are crowded with critically ill patients, many of whom are no longer able to communicate with the emergency staff. The availability of advance directives among Swiss ED patients has not been evaluated.

Let’s talk about violence – more!

Viewpoint
Exadaktylos AK, Müller M
Swiss Med Wkly. 2020;150:w20172

If we are to detect and prevent physical and psychological violence, we must discuss the problems intensively with our patients. Even modest investment might lead to consistent and sustainable changes. We must be determined to fulfill our role in the fight against violence.

Characteristics of emergency department presentations requiring consultation of the national Poisons Information Centre

Original article
Liakoni E, Berger F, Klukowska-Rötzler J, Kupferschmidt H, Haschke M, Exadaktylos AK
Swiss Med Wkly. 2019;149:w20164

According to data from European hospitals, about 1% of all emergency department (ED) admissions are related to poisoning. Poison information centres (PICs) can provide valuable support to ED personnel and help to optimise patient management in such cases.

Pain management policies and reported practices in Swiss emergency departments: a national survey

Original article
Bourgeois M, Carron PN, Ernst S, Exadaktylos A, Guigli Poretti M, Keller D, Meier K, Nickel CH, Rutschmann OT, Sieber R, Steuer S, Tabakovic S, Hugli O
Swiss Med Wkly. 2019;149:w20155

Acute pain is the most common complaint of patients presenting to emergency departments. Effective pain management is a core ED mission, but numerous studies have pointed to insufficient pain treatment or oligoanalgesia.

The capacity of baseline patient, injury, treatment and outcome data to predict reduced capacity to work and accident insurer costs – a Swiss prospective 4-year longitudinal trauma centre evaluation

Original article
Gross T, Morell S, Scholz SM, Amsler F
Swiss Med Wkly. 2019;149:w20144

Return to work after an injury is an important longer-term outcome measure, ­albeit a complicated issue. Information on the relation between baseline patient, injury and treatment data and the longer-term outcomes for the survivors of significant trauma is lacking.

Current prevalence of self-reported interpersonal violence among adult patients seen at a university hospital emergency department in Switzerland

Original article
Douet T, Ohl A, Hügli O, Romain-Glassey N, Carron PN
Swiss Med Wkly. 2019;149:w20147

The emergency department is the usual place of care for victims of violence. Nonetheless, the prevalence of violence remains underestimated in the emergency department, especially as patients do not spontaneously mention that they are victims. Often this is considered shameful, even taboo.

The last decade of symptom-oriented research in emergency medicine: triage, work-up, and disposition

Review article: Biomedical intelligence
Bingisser R, Nickel CH
Swiss Med Wkly. 2019;149:w20141

Symptom-oriented research has become the domain of emergency medicine research, as most other specialities have strongly focused diagnostic and prognostic research on individual disease entities.

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