Overcrowding with associated delays in patient care is a problem faced by emergency departments (EDs) worldwide. ED overcrowding can be the result of poor ED department design and prolonged throughput due to staffing, ancillary service performance, and flow processes. As such, the problem may be addressed by process improvements within the ED. A broad body of literature demonstrates that ED overcrowding can be a function of hospital capacity rather than an ED specific issue. Lack of institutional capacity leads to boarding in the ED with resultant ED crowding. This is a problem not solvable by the ED and must be addressed as an institution-wide problem. This paper discusses the causes of ED overcrowding, provides a brief overview of the drastic consequences, and discusses possible cures that have been successfully implemented.
Crowding ; Emergencies ; Emergency Service, Hospital ; Patient Care ; Patient Safety

Aged ; Cognition ; Cognitive Dysfunction/therapy* ; Female ; Humans ; Male ; Mental Status and Dementia Tests ; Middle Aged ; Pilot Projects

Introduction: Dizziness is a common symptom experienced by patients undergoing hemodialysis. There have been some studies that show inhalation aromatherapy to be a simple and non-invasive way in reducing several symptoms including nausea and vomiting. This study aimed to determine if the use of key lime oil inhalation aromatherapy is effective as an adjunct to nursing interventions in reducing the duration of dizziness experienced by patients during hemodialysis. Methods : This was a randomized, placebo-controlled trial which assessed the efficacy of key lime oil inhalation aromatherapy in the relief of dizziness. The participants were asked to rate their dizziness using the Modified Borg Rating Scale for Dizziness before and after intervention and were timed until the dizziness was completely relieved. Results : The key lime inhalation aromatherapy and control groups were comparable, including their bast!ine dizziness ratings. Key lime inhalation aromatherapy alleviated dizziness in a significantly shorter time (4.8 vs 22.7 minutes, p = 0.03). Conclusion Key lime inhalation aromatherapy is effective as an adjunct treatment for dizziness experienced by patients during hemodialysis.
Renal Dialysis ; Dizziness

Dyslipidemia is a cardiovascular risk factor that is increasing in prevalence in the country. The need to treat and manage elevated cholesterol levels, both pharmacologic and non-pharmacologic, is of utmost importance. Different medical societies and groups bonded together to formulate the 2020 Philippine Clinical Practice Guidelines for dyslipidemia. The group raised nine clinical questions that are important in dyslipidemia management. A technical working group analyzed the clinical questions dealing with non-pharmacologic management, primary prevention for both non-diabetic and individuals with diabetes, familial hypercholesterolemia, secondary prevention, adverse events of statins and the use of other lipid parameters as measurement of risk for cardiovascular disease. Randomized controlled trials and meta-analyses were included in the GRADE-PRO analysis to come up with the statements answering the clinical questions. The statements were presented to a panel consisting of government agencies, members of the different medical societies, and private institutions, and the statements were voted upon to come up with the final statements of the 2020 practice guidelines. The 2020 CPG is aimed for the Filipino physician to confidently care for the individual with dyslipidemia and eventually lower his risk for cardiovascular disease.
Dyslipidemias ; Hyperlipoproteinemia Type II ; Diabetes Mellitus