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BMC Emergency Medicine

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https://www.readbyqxmd.com/read/29121883/the-association-of-duration-of-boarding-in-the-emergency-room-and-the-outcome-of-patients-admitted-to-the-intensive-care-unit
#1
Saad Al-Qahtani, Abdullah Alsultan, Samir Haddad, Abdulmohsen Alsaawi, Moeed Alshehri, Sami Alsolamy, Afef Felebaman, Hani M Tamim, Nawfal Aljerian, Abdulaziz Al-Dawood, Yaseen Arabi
BACKGROUND: The demand for critical care beds is increasing out of proportion to bed availability. As a result, some critically ill patients are kept in the Emergency Department (ED boarding) awaiting bed availability. The aim of our study is to examine the impact of boarding in the ED on the outcome of patients admitted to the Intensive Care Unit(ICU). METHODS: This was a retrospective analysis of ICU data collected prospectively at King Abdulaziz Medical City, Riyadh from ED between January 2010 and December 2012 and all patients admitted during this time were evaluated for their duration of boarding...
November 9, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29110718/cardiac-patients-perceptions-of-neighboring-patients-risk-influence-on-psychological-stress-in-the-ed-and-subsequent-posttraumatic-stress
#2
Beatrice Konrad, David Hiti, Bernard P Chang, Jessica Retuerto, Jacob Julian, Donald Edmondson
BACKGROUND: As many as 12% of acute coronary syndrome (ACS) patients screen positive for post-traumatic stress disorder (PTSD) symptoms due to their cardiac event, and emergency department (ED) factors such as overcrowding have been associated with risk for PTSD. We tested the association of patients' perceptions of their proximity to a critically ill patient during ED evaluation for ACS with development of posttraumatic stress symptoms (PSS) in the month after hospital discharge. METHODS: Participants were enrolled in the REactions to Acute Care and Hospitalization (REACH) study during evaluation for ACS in an urban ED...
November 6, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29096608/who-breaches-the-four-hour-emergency-department-wait-time-target-a-retrospective-analysis-of-374-000-emergency-department-attendances-between-2008-and-2013-at-a-type-1-emergency-department-in-england
#3
Niklas Bobrovitz, Daniel S Lasserson, Adam D M Briggs
BACKGROUND: The four-hour target is a key hospital emergency department performance indicator in England and one that drives the physical and organisational design of the ED. Some studies have identified time of presentation as a key factor affecting waiting times. Few studies have investigated other determinants of breaching the four-hour target. Therefore, our objective was to describe patterns of emergency department breaches of the four-hour wait time target and identify patients at highest risk of breaching...
November 2, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29037168/locating-helicopter-emergency-medical-service-bases-to-optimise-population-coverage-versus-average-response-time
#4
Alan A Garner, Pieter L van den Berg
BACKGROUND: New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along the eastern seaboard. The aim of this study was to estimate optimal HEMS base locations within NSW using advanced mathematical modelling techniques. METHODS: We used high resolution census population data for NSW from 2011 which divides the state into areas containing 200-800 people...
October 16, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29029604/trauma-burden-in-tanzania-a-one-day-survey-of-all-district-and-regional-public-hospitals
#5
Hendry R Sawe, Juma A Mfinanga, Khalid R Mbaya, Phillip M Koka, Said S Kilindimo, Michael S Runyon, Victor G Mwafongo, Lee A Wallis, Teri A Reynolds
BACKGROUND: Trauma contributes significantly to the burden of disease and mortality throughout the world, but particularly in developing countries. In Tanzania, there is an enormous research gap on trauma; the limited data available reflects realities in cities and areas with moderately- to highly-resourced treatment centers. Our aim was to provide a description of the injury epidemiology across all of Tanzania. Our data will serve as a basis for future larger studies. METHODS: This is a subgroup analysis of a cross-sectional, prospective study of the clinical epidemiology of patients presenting at all public district and regional hospitals in Tanzania...
October 13, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28974202/weaknesses-and-capacities-affecting-the-prehospital-emergency-care-for-victims-of-road-traffic-incidents-in-the-greater-kampala-metropolitan-area-a-cross-sectional-study
#6
Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani-Zavareh, Amir Nejati, Owais Raza
BACKGROUND: Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA). METHODS: A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire...
October 3, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28854879/identifying-priorities-for-quality-improvement-at-an-emergency-department-in-ghana
#7
Annelies DeWulf, Elom H Otchi, Sari Soghoian
BACKGROUND: Healthcare quality improvement (QI) is a global priority, and understanding the perspectives of frontline healthcare workers can help guide sustainable and meaningful change. We report a qualitative investigation of emergency department (ED) staff priorities for QI at a tertiary care hospital in Ghana. The aims of the study were to educate staff about the World Health Organization's (WHO) definition of quality in healthcare, and to identify an initial focus for building a departmental QI program...
August 30, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28854874/recognition-and-treatment-of-severe-sepsis-in-the-emergency-department-retrospective-study-in-two-french-teaching-hospitals
#8
Philippe Le Conte, Séverin Thibergien, Jean Batiste Obellianne, Emmanuel Montassier, Gilles Potel, Pierre Marie Roy, Eric Batard
BACKGROUND: Sepsis management in the Emergency Department remains a daily challenge. The Surviving Sepsis Campaign (SSC) has released three-hour bundle. The implementation of these bundles in European Emergency Departments remains poorly described. The main objective was to assess the compliance with the Severe Sepsis Campaign 3-h bundle (blood culture, lactate dosage, first dose of antibiotics and 30 ml/kg fluid challenge). Secondary objectives were the analysis of the delay of severe sepsis recognition and description of the population...
August 30, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28851296/design-and-rationale-of-the-procalcitonin-antibiotic-consensus-trial-proact-a-multicenter-randomized-trial-of-procalcitonin-antibiotic-guidance-in-lower-respiratory-tract-infection
#9
David T Huang, Derek C Angus, Chung-Chou H Chang, Yohei Doi, Michael J Fine, John A Kellum, Octavia M Peck-Palmer, Francis Pike, Lisa A Weissfeld, Jonathan Yabes, Donald M Yealy
BACKGROUND: Overuse of antibiotics is a major public health problem, contributing to growing antibiotic resistance. Procalcitonin has been reported to be commonly elevated in bacterial, but not viral infection. Multiple European trials found procalcitonin-guided care reduced antibiotic use in lower respiratory tract infection, with no apparent harm. However, applicability to US practice is limited due to trial design features impractical in the US, between-country differences, and residual safety concerns...
August 29, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28851280/post-traumatic-stress-disorder-and-its-predictors-in-emergency-medical-service-personnel-a-cross-sectional-study-from-karachi-pakistan
#10
Salima Mansoor Kerai, Uzma Rahim Khan, Muhammad Islam, Nargis Asad, Junaid Razzak, Omrana Pasha
BACKGROUND: Emergency medical service (EMS) personnel who work to provide emergency medical care at the scene and during transportation are exposed to various kinds of stressors and are particularly susceptible to developing stress-reactions. This study assesses symptoms of post-traumatic stress disorder and its predictors among the personnel of a selected EMS in Karachi, Pakistan. METHODS: Data were gathered from 518 personnel working in an EMS setting from February to May 2014...
August 29, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28743232/emergency-medical-service-provider-decision-making-in-out-of-hospital-cardiac-arrest-an-exploratory-study
#11
J Brandling, K Kirby, S Black, S Voss, J Benger
BACKGROUND: There are approximately 60,000 out-of-hospital cardiac arrests (OHCA) in the United Kingdom (UK) each year. Within the UK there are well-established clinical practice guidelines that define when resuscitation should be commenced in OHCA, and when resuscitation should cease. Background literature indicates that decision-making in the commencement and cessation of resuscitation efforts in OHCA is complex, and not comprehensively understood. No relevant research from the UK has been published to date and this research study seeks to explore the influences on UK Emergency Medical Service (EMS) provider decision-making when commencing and ceasing resuscitation attempts in OHCA...
July 25, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28709409/misuse-of-emergent-healthcare-in-contemporary-japan
#12
Yasuhiro Kadooka, Atsushi Asai, Aya Enzo, Taketoshi Okita
BACKGROUND: Medical care is obviously an important public service to ensure the health of a nation; however, medical resources are not always used appropriately. 'Convenience-store consultations' and inappropriate ambulance transportation represent instances of such improper use by contemporary Japanese citizens in recent years. This article illustrates two examples of misuse and discusses potential countermeasures by considering factors contributing to these behaviours. MAIN BODY: From both public and medical perspectives, these patient behaviours are problematic, causing potential harm to others, negative consequences to such patients themselves, exhaustion of healthcare staff, and breakdown of emergency medical services...
July 14, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28693491/hypoxia-and-hypotension-in-patients-intubated-by-physician-staffed-helicopter-emergency-medical-services-a-prospective-observational-multi-centre-study
#13
Geir Arne Sunde, Mårten Sandberg, Richard Lyon, Knut Fredriksen, Brian Burns, Karl Ove Hufthammer, Jo Røislien, Akos Soti, Helena Jäntti, David Lockey, Jon-Kenneth Heltne, Stephen J M Sollid
BACKGROUND: The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important quality indicators of care provided by emergency medical services. Excluding cardiac arrests, critical trauma and non-trauma patients remain the two major groups to which helicopter emergency medical services (HEMS) are dispatched. Several studies describe the impact of pre-hospital hypoxia or hypotension on trauma patients, but few studies compare this in trauma and non-trauma patients...
July 11, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28655304/assessment-of-client-satisfaction-on-emergency-department-services-in-hawassa-university-referral-hospital-hawassa-southern-ethiopia
#14
Mesfin Worku, Eskindir Loha
BACKGROUND: Satisfaction refers to a state of pleasure or contentment with an action, event or service, especially one that was previously desired. Regarding to client, satisfaction is the level of happiness that clients experience having used a service. It therefore reflects the gap between the expected service and the experience of the service, from the client's point of view. Information was unavailable regarding the level of satisfaction of patients towards emergency health care servicesat Hawassa University Referral Hospital thatserve a huge catchment area; and this study addressed this gap...
June 27, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28646858/reasons-for-encounter-by-different-levels-of-urgency-in-out-of-hours-emergency-primary-health-care-in-norway-a-cross-sectional-study
#15
Guttorm Raknes, Steinar Hunskaar
BACKGROUND: Frequencies of reasons for encounter (RFEs) in emergency primary care out-of-hours (OOH) services are relevant for planning of capacities as well as to target the training of staff at casualty clinics. We aimed to present frequencies of RFEs in the different organ systems, and to identify the most frequent RFEs at different urgency levels. METHODS: We analyzed data on RFEs in Norwegian OOH services. International Classification of Primary Care (ICPC-2) RFE codes were recorded in all contacts to eight representative OOH casualty clinics in 2014 and 2015 covering 20 municipalities with a total population of 260 196...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28646851/development-of-an-education-campaign-to-reduce-delays-in-pre-hospital-response-to-stroke
#16
Caterina Caminiti, Peter Schulz, Barbara Marcomini, Elisa Iezzi, Silvia Riva, Umberto Scoditti, Andrea Zini, Giovanni Malferrari, Maria Luisa Zedde, Donata Guidetti, Enrico Montanari, Mario Baratti, Licia Denti
BACKGROUND: Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness. METHODS: Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was articulated in two phases: needs assessment and intervention development...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28623905/educational-standards-for-training-paramedics-in-ultrasound-a-scoping-review
#17
Ben Meadley, Alexander Olaussen, Ashleigh Delorenzo, Nick Roder, Caroline Martin, Toby St Clair, Andrew Burns, Emma Stam, Brett Williams
BACKGROUND: Paramedic-performed out-of-hospital ultrasound is a novel skill that has gained popularity in some services in recent years. In this setting point-of care ultrasound (POCUS) can provide additional information that can assist with management and guide transport to the most appropriate facility. We sought to explore the different educational approaches used for training paramedics in ultrasound in the out-of-hospital setting. METHODS: Ovid MEDLINE, EMBASE, EBM Reviews, The Cochrane Library, CINAHL plus, The Monash University Research Repository and the British Thesis Library were searched from the 1(st) of January 1990 to the 6(th) of April 2016...
June 17, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28569134/incidence-and-outcome-of-severe-ante-partum-hemorrhage-at-the-teaching-hospital-yalgado-ou%C3%A3-draogo-in-burkina-faso
#18
Martin Lankoande, Papougnezambo Bonkoungou, Sosthène Ouandaogo, Marcelin Dayamba, Ali Ouedraogo, Francis Veyckmans, Nazinigouba Ouédraogo
BACKGROUND: Hemorrhage is the main cause of maternal death during pregnancy. This study aims to evaluate incidence and outcomes of Severe Ante Partum Hemorrhage (SAPH) during the third trimester of pregnancy prior to delivery. METHODS: Analytical cross-sectional study with prospective data collection during 12 months in Yalgado Ouedraogo Hospital, Ouagadougou, Burkina Faso. In this context SAPH is specifically referring to Ante Partum Hemorrhage (APH) and Intra Partum Hemorrhage (IPH) in the 3rd trimester...
May 31, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28486935/emergency-department-use-and-barriers-to-wellness-a-survey-of-emergency-department-frequent-users
#19
Lauren E Birmingham, Thaddeus Cochran, Jennifer A Frey, Kirk A Stiffler, Scott T Wilber
BACKGROUND: There is no common understanding of how needs of emergency department (ED) frequent users differ from other patients. This study sought to examine how to best serve this population. Examinations of why ED frequent users present to the ED, what barriers to care exist, and what service offerings may help these patients achieve an optimal level of health were conducted. METHODS: We performed a prospective study of frequent ED users in an adult only, level 1 trauma center with approximately 90,000 visits per year...
May 10, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28482805/management-of-potentially-life-threatening-emergencies-at-74-primary-level-hospitals-in-mongolia-results-of-a-prospective-observational-multicenter-study
#20
Naranpurev Mendsaikhan, Davaa Gombo, Ganbold Lundeg, Christian Schmittinger, Martin W Dünser
BACKGROUND: While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level hospitals. METHODS: In this prospective, observational multicenter study, 74 primary level hospitals of Mongolia were included. We determined the capacities of these hospitals to manage medical emergencies. Furthermore, characteristics of patients presenting with potentially life-threatening emergencies to these hospitals were evaluated during a 6 month period...
May 8, 2017: BMC Emergency Medicine
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