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BMC Emergency Medicine

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https://www.readbyqxmd.com/read/28486935/emergency-department-use-and-barriers-to-wellness-a-survey-of-emergency-department-frequent-users
#1
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
#2
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
https://www.readbyqxmd.com/read/28476098/developing-quality-indicators-for-the-care-of-patients-with-musculoskeletal-injuries-in-the-emergency-department-study-protocol
#3
Kirsten Strudwick, Anthony Bell, Trevor Russell, Melinda Martin-Khan
BACKGROUND: Musculoskeletal injuries are a common presentation to the Emergency Department (ED). The quality of care provided is important to the patients, clinicians, organisations and purchasers of care. In the context of the increasing burden of musculoskeletal disease, quality of care needs to occur despite financial impacts, variations in care, and pressure to reach time-based performance measures. This study aims to develop a suite of evidence-based quality indicators (QI) which will provide a measure of the quality of care for patients with musculoskeletal injuries in the ED...
May 5, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28441939/estimation-of-the-severity-of-breathlessness-in-the-emergency-department-a-dyspnea-score
#4
Tibor Gondos, Viktor Szabó, Ágnes Sárkány, Adrienn Sárkány, Gábor Halász
BACKGROUND: Dyspnea is a frequent complaint in emergency departments (ED). It has a significant amount of subjective and affective components, therefore the dyspnea scores, based on the patients' rating, can be ambiguous. Our purpose was to develop and validate a simple scoring system to evaluate the severity of dyspnea in emergency care, based on objectively measured parameters. METHODS: We performed a double center, prospective, observational study including 350 patients who were admitted in EDs with dyspnea...
April 26, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28335736/the-association-of-emergency-department-presentations-in-pregnancy-with-hospital-admissions-for-postnatal-depression-pnd-a-cohort-study-based-on-linked-population-data
#5
Fenglian Xu, Elizabeth A Sullivan, Roberto Forero, Caroline S E Homer
BACKGROUND: To investigate the impact of presenting to an Emergency Department (ED) during pregnancy on postnatal depression (PND) in women in New South Wales (NSW), Australia. METHOD: An epidemiological population-based study using linked data from the NSW Emergency Department Data Collection (EDDC), the NSW Perinatal Data Collection (PDC) and the NSW Admitted Patients Data Collection (APDC) was conducted. Women who gave birth to their first child in NSW between 1 January 2006 and 31 December 2010 were followed up from pregnancy to the end of the first year after birth...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28330460/sepsis-recognition-in-the-emergency-department-impact-on-quality-of-care-and-outcome
#6
Marius Morr, Alexander Lukasz, Eva Rübig, Hermann Pavenstädt, Philipp Kümpers
BACKGROUND: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED). METHODS: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28330440/prevalence-and-predictors-of-intra-abdominal-hypertension-and-compartment-syndrome-in-surgical-patients-in-critical-care-units-at-kenyatta-national-hospital
#7
A Muturi, P Ndaguatha, Daniel Ojuka, A Kibet
BACKGROUND: Intra-abdominal hypertension (IAH) affects almost every organ sytem.If it is not detected early and corrected, mortality would be high. The prevalence of IAH and abdominal compartment syndrome (ACS) at Kenyatta National Hospital (KNH) critical care units is not known. The aim of this sudy was to determine the prevalence and factors associated with development of IAH/ACS among critically ill surgical patients. METHODS: This was a cross sectional descriptive study involving surgical patients in critical care units at KNH, carried out from March 2015 to October 2015...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28284181/aerial-medical-evacuation-of-health-workers-with-suspected-ebola-virus-disease-in-guinea-conakry-interest-of-a-negative-pressure-isolation-pod-a-case-series
#8
Jean-Michel Dindart, Olivier Peyrouset, Romain Palich, Abdoul Bing, Richard Kojan, Solenne Barbe, Souley Harouna, Nikki Blackwell
We report 4 cases of Health Workers (HW) suspected of having contracted Ebola Virus Disease (EVD), transported from the Alliance for International Medical Action (ALIMA) Ebola Treatment Centre (ETC) in N'Zerekore, Guinea to the Treatment Centre for Carers run by the medical corps of the French army in Conakry, the capital of Guinea, which was established on 17 January 2015 and closed on 7 July 2015. In total more than 500 HWs have died from EVD since the epidemic began. This mortality has had significant effects on the ability of local services to respond appropriately to the disaster...
March 11, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28274221/effectiveness-of-a-community-paramedic-led-health-assessment-and-education-initiative-in-a-seniors-residence-building-the-community-health-assessment-program-through-emergency-medical-services-chap-ems
#9
G Agarwal, R Angeles, M Pirrie, F Marzanek, B McLeod, J Parascandalo, L Dolovich
BACKGROUND: Seniors living in subsidized housing have lower income, poorer health, and increased risk for cardiometabolic diseases and falls. Seniors also account for more than one third of calls to Emergency Medical Services (EMS). This study examines the effectiveness of the Community Health Assessment Program through EMS (CHAP-EMS) in reducing blood pressure, diabetes risk, and EMS calls. METHODS: Paramedics on modified duty (e.g. injured) conducted weekly, one-on-one drop-in sessions in a common area of one subsidized senior's apartment building in Hamilton, Ontario...
March 9, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28253848/improved-recognition-of-ineffective-chest-compressions-after-a-brief-crew-resource-management-crm-training-a-prospective-randomised-simulation-study
#10
Leopold Haffner, Moritz Mahling, Alexander Muench, Christoph Castan, Paul Schubert, Aline Naumann, Silke Reddersen, Anne Herrmann-Werner, Jörg Reutershan, Reimer Riessen, Nora Celebi
BACKGROUND: Chest compressions are a core element of cardio-pulmonary resuscitation. Despite periodic training, real-life chest compressions have been reported to be overly shallow and/or fast, very likely affecting patient outcomes. We investigated the effect of a brief Crew Resource Management (CRM) training program on the correction rate of improperly executed chest compressions in a simulated cardiac arrest scenario. METHODS: Final-year medical students (n = 57) were randomised to receive a 10-min computer-based CRM or a control training on ethics...
March 3, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28228127/a-review-of-enhanced-paramedic-roles-during-and-after-hospital-handover-of-stroke-myocardial-infarction-and-trauma-patients
#11
Darren Flynn, Richard Francis, Shannon Robalino, Joanne Lally, Helen Snooks, Helen Rodgers, Graham McClelland, Gary A Ford, Christopher Price
BACKGROUND: Ambulance paramedics play a critical role expediting patient access to emergency treatments. Standardised handover communication frameworks have led to improvements in accuracy and speed of information transfer but their impact upon time-critical scenarios is unclear. Patient outcomes might be improved by paramedics staying for a limited time after handover to assist with shared patient care. We aimed to categorize and synthesise data from studies describing development/extension of the ambulance-based paramedic role during and after handover for time-critical conditions (trauma, stroke and myocardial infarction)...
February 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28228110/a-nationwide-survey-of-first-aid-training-and-encounters-in-norway
#12
Håkon Kvåle Bakke, Tine Steinvik, Johan Angell, Torben Wisborg
BACKGROUND: Bystander first aid can improve survival following out-of-hospital cardiac arrest or trauma. Thus, providing first aid education to laypersons may lead to better outcomes. In this study, we aimed to establish the prevalence and distribution of first aid training in the populace, how often first aid skills are needed, and self-reported helping behaviour. METHODS: We conducted a telephone survey of 1000 respondents who were representative of the Norwegian population...
February 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28122490/erratum-to-factors-affecting-the-exposure-vulnerability-and-emergency-medical-service-capacity-for-victims-of-road-traffic-incidents-in-kampala-metropolitan-area-a-delphi-study
#13
Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani-Zavareh, Amir Nejati, Stephen Kasiima
No abstract text is available yet for this article.
January 25, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28103818/a-qualitative-study-to-identify-barriers-to-deployment-and-student-training-in-the-use-of-automated-external-defibrillators-in-schools
#14
Line Zinckernagel, Carolina Malta Hansen, Morten Hulvej Rod, Fredrik Folke, Christian Torp-Pedersen, Tine Tjørnhøj-Thomsen
BACKGROUND: Student training in use of automated external defibrillators and deployment of such defibrillators in schools is recommended to increase survival after out-of-hospital cardiac arrest. Low implementation rates have been observed, and even at schools with a defibrillator, challenges such as delayed access have been reported. The purpose of this study was to identify barriers to the implementation of defibrillator training of students and deployment of defibrillators in schools...
January 19, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28068917/emergency-department-presentations-for-atrial-fibrillation-and-flutter-in-alberta-a-large-population-based-study
#15
Rhonda J Rosychuk, Michelle M Graham, Brian R Holroyd, Brian H Rowe
BACKGROUND: Atrial fibrillation or flutter (AFF) are not infrequent presenting problems in Emergency Departments (ED); however, little is known of the pattern of these presentations. This study provides a description of AFF presentations and outcomes after ED discharge in Alberta. METHODS: Provincial administrative databases were used to obtain all primary ED encounters for AFF during 1999 to 2011 for patients aged >35 years. Data extracted included demographics, ED visit timing, and subsequent visits to non-ED settings...
January 10, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28061754/factors-affecting-the-exposure-vulnerability-and-emergency-medical-service-capacity-for-victims-of-road-traffic-incidents-in-kampala-metropolitan-area-a-delphi-study
#16
Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani Zavareh, Amir Nejati, Stephen Kasiima
BACKGROUND: The Kampala Metropolitan Area (KMA) is the fastest developing region in Uganda. Over recent years, this has placed exponential demand on the road sector, which consequently has contributed to rapid growth in motorized vehicles which, predisposes the region to a high risk of road traffic incidents (RTIs). A number of concerted road safety and post-crash management measures to respond to RTIs in the KMA in particular and Uganda as a whole have been undertaken. However, there is a need to greatly improve the measures by better identifying the factors influencing the exposure, vulnerability and emergency medical service (EMS) capacity for RTI victims...
January 7, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27927189/prehospital-critical-care-for-out-of-hospital-cardiac-arrest-an-observational-study-examining-survival-and-a-stakeholder-focused-cost-analysis
#17
Johannes von Vopelius-Feldt, Jane Powell, Richard Morris, Jonathan Benger
BACKGROUND: Survival rates from out-of-hospital cardiac arrest (OHCA) remain low, despite remarkable efforts to improve care. A number of ambulance services in the United Kingdom (UK) have developed prehospital critical care teams (CCTs) which attend critically ill patients, including OHCA. However, current scientific evidence describing CCTs attending OHCA is sparse and research to date has not demonstrated clear benefits from this model of care. METHODS: This prospective, observational study will describe the effect of CCTs on survival from OHCA, when compared to advanced-life-support (ALS), the current standard of prehospital care in the UK...
December 7, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27912757/the-sydney-triage-to-admission-risk-tool-start-to-predict-emergency-department-disposition-a-derivation-and-internal-validation-study-using-retrospective-state-wide-data-from-new-south-wales-australia
#18
Michael M Dinh, Saartje Berendsen Russell, Kendall J Bein, Kris Rogers, David Muscatello, Richard Paoloni, Jon Hayman, Dane R Chalkley, Rebecca Ivers
BACKGROUND: Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Emergency Department to assist with triage, patient flow and clinical decision making. METHODS: This was a retrospective analysis of State-wide Emergency Department data in New South Wales, Australia. Adult patients (age ≥ 16 years) were included if they presented to a Level five or six (tertiary level) Emergency Department in New South Wales, Australia between 2013 and 2014...
December 3, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27894249/brief-compression-only-cardiopulmonary-resuscitation-training-video-and-simulation-with-homemade-mannequin-improves-cpr-skills
#19
Gregory K Wanner, Arayel Osborne, Charlotte H Greene
BACKGROUND: Cardiopulmonary resuscitation (CPR) training has traditionally involved classroom-based courses or, more recently, home-based video self-instruction. These methods typically require preparation and purchase fee; which can dissuade many potential bystanders from receiving training. This study aimed to evaluate the effectiveness of teaching compression-only CPR to previously untrained individuals using our 6-min online CPR training video and skills practice on a homemade mannequin, reproduced by viewers with commonly available items (towel, toilet paper roll, t-shirt)...
November 29, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27835981/testing-a-videogame-intervention-to-recalibrate-physician-heuristics-in-trauma-triage-study-protocol-for-a-randomized-controlled-trial
#20
Deepika Mohan, Matthew R Rosengart, Baruch Fischhoff, Derek C Angus, Coreen Farris, Donald M Yealy, David J Wallace, Amber E Barnato
BACKGROUND: Between 30 and 40 % of patients with severe injuries receive treatment at non-trauma centers (under-triage), largely because of physician decision making. Existing interventions to improve triage by physicians ignore the role that intuition (heuristics) plays in these decisions. One such heuristic is to form an initial impression based on representativeness (how typical does a patient appear of one with severe injuries). We created a video game (Night Shift) to recalibrate physician's representativeness heuristic in trauma triage...
November 11, 2016: BMC Emergency Medicine
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