SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Restricted Child with ASD in the Emergency Department: A Critical Integrative Literature Review of ASD Child and Family Experience(Queen's University Belfast, 2024-07-02) Alzubaidi, Salwa; Corkin, DorisBackground: The Emergency Department (ED) serves as a crucial space for urgent medical care, grappling with challenges like overcrowding, extended waiting times, and communication barriers, affecting both patients and professionals globally. Despite efforts, the ED remains strained with medical emergencies. Simultaneously, Autism Spectrum Disorder (ASD) prevalence has risen significantly, leading to increased utilization of ED services by individuals with ASD, who often present with complex needs. Addressing these challenges requires a patient and family-centred approach, emphasizing communication, informed decision-making, and collaboration between healthcare providers and families. However, implementing such an approach in the fast-paced ED environment remains challenging, compounded by varying healthcare providers’ knowledge and attitudes towards neurodevelopmental disorders. Aim: This study aims to highlight ASD children and their families’ experiences in ED settings, identifying specific aspects within the ASD child-ED interaction and provide actionable insights, to meet their needs effectively. Methods: A critical integrative review of literature carried out to characterize the experiences of autistic children in ED, in order to identify ways to enhance their interactions for improved care. Utilizing the PRISMA checklist, a systematic search of five electronic databases and hand searches conducted, for studies published between 2013 and 2023. Eligibility criteria developed based on the PICOS framework, ensuring relevance and quality. Results: Thematic analysis identified four dimensions of experiences in the ED for children with ASD. Insights from each dimension drawn into a roadmap of 6 blocks, informing strategies for improving the ED environment, enhancing staff training, optimizing healthcare delivery, and identifying areas for research to better support the autistic child and their family, throughout their overall experience in the ED. Conclusion: Despite available evidence of resources to enhance ASD care, persistent obstacles and challenges exist, with a pattern of information needed by the family. Data is key and relevant to support the organisation of sources that will enhance the experiences of children and their families within the ED environment.14 0Item Restricted The Effectiveness of Using the HEART Score on Patients Complaining of Chest Pain in The Emergency Department Who Are at Risk of Acute Coronary Syndrome: a systematic review.(Saudi Digital Library, 2023-07-18) Alturbag, May Ali; Bennett, MaggieBackground: Chest pain is one of the most common causes of presentation to the emergency room. The diagnosis of non-ST-elevation acute coronary syndrome is a challenge because this condition doesn't have an easily identifiable electrical pattern like the other main types of heart attacks. The HEART Pathway (history, ECG, age, risk factors, and troponin) is a rapid diagnostic tool that identifies low-risk emergency department patients with chest pain for early discharge without stress testing or angiography. Aim: This systematic review aims to Determine the effectiveness of the HEART score in patients with chest pain who might be suspected of acute coronary syndrome in the Emergency Department. Methodology: Five electronic databases (CHINAL, Medline, PubMed, Cochrane Library, and Web of Science) were searched systematically. A systematic search strategy was formulated with the assistance of an expert librarian. The appraisal tools that are used by RevMan and the Joanna Briggs Institute (JBI) for systematic reviews assess the quality of each study. Results: A total of seven studies are included. Five of the studies were randomised trials; one was quasi-experimental; and the last was an observational cohort study. They looked at the effectiveness of the HEART score to identify low-risk patients who can be safely discharged without stress testing or angiography in the emergency department. Five studies support the implementation of the HEART Pathway, but one caution against the widespread use of the HEART score as the sole determinant of ED disposition, and one study shows that the HEART score was incorrectly calculated for patients, leading to inappropriate risk categorization. Therefore, actions should be taken to improve the score’s use in daily practice. The discussion was based on the HEART Score, and the included studies relate to institutional policy, education, clinical decision-making, and continuing professional development. Conclusions The HEART Pathway reduces objective cardiac testing, shortens stay length, and increases early discharges without major adverse cardiovascular events at 30 days. It supports identifying low-risk patients who can be safely discharged without stress testing or angiography. However, this systematic review found that caution is advised when using the HEART score alone as a standard of care for ED patients with chest pain, as it may be calculated incorrectly.19 0