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International Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/30022394/a-qualitative-study-of-the-determinants-of-adherence-to-nice-falls-guideline-in-managing-older-fallers-attending-an-emergency-department
#1
Helen McEwan, Richard Baker, Natalie Armstrong, Jay Banerjee
BACKGROUND: The National Institute for Health and Care Excellence (NICE) 2004 Falls guideline was developed to improve the assessment and management of falls and prevention of future falls. However, adherence to the guideline can be poor. As emergency departments (EDs) are usually consulted by older adults (aged 65 and over) who experience a fall, they provide a setting in which assessments can be conducted or referrals made to more appropriate settings. The objective of this study was to investigate how falls are managed in EDs, reasons why guideline recommendations are not always followed, and what happens instead...
July 18, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29882065/emergency-medicine-clerkship-curriculum-in-a-high-income-developing-country-methods-for-development-and-application
#2
Arif Alper Cevik, Elif Dilek Cakal, Fikri M Abu-Zidan
BACKGROUND: The published recommendations for international emergency medicine curricula cover the content, but exclude teaching and learning methods, assessment, and evaluation. We aim to provide an overview on available emergency medicine clerkship curricula and report the development and application experience of our own curriculum. METHODS: Our curriculum is an outcome-based education, enriched by e-learning and various up-to-date pedagogic principles. RESULTS: Teaching and learning methods, assessment, and evaluation are described...
June 7, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29881904/migraine-with-extensive-skin-markings-a-case-report
#3
Sabrina Berdouk, Sobia Khan
BACKGROUND: Migraines are a commonly seen complaint in the emergency department, but migraines with extensive skin markings have rarely been reported and so the cause is still unknown. CASE PRESENTATION: We report a 28-year-old Pakistani male complaining of recurrent migraines that are now associated with skin markings that appear on his forehead and last for a few days and then disappear on their own. A diagnosis of migraines with cutaneous markings was made. An MRI was done on the patient and showed normal results...
June 7, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29846823/elevated-blood-pressure-and-illness-beliefs-a-cross-sectional-study-of-emergency-department-patients-in-jamaica
#4
Taneisha T Wilson, Jean Williams-Johnson, Maxine Gossel-Williams, Elizabeth M Goldberg, Rainford Wilks, Shuvra Dasgupta, Georgiana M Gordon-Strachan, Eric W Williams, Philip D Levy
BACKGROUND: Elevated blood pressure (BP) is common among emergency department (ED) patients. While some data exist on the association between ED BP and hypertension (HTN) in the USA, little is known about this relationship in Afro-Caribbean nations. The aim of the study was to evaluate the relationship between elevated systolic BP in the ED and a previous diagnosis of HTN, accounting for potential factors that could contribute to poor HTN control among those with a previous diagnosis: socioeconomic status, health-seeking behavior, underlying HTN illness beliefs, medication adherence, and perceived adherence self-efficacy...
May 30, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29802505/rate-of-bacteremia-in-the-hemodialysis-patient-presenting-to-the-emergency-department-with-fever-a-retrospective-chart-review
#5
Nicholas Villalon, Neda Farzan, Kathryn Freeman
BACKGROUND: Infectious disease is the second most common cause of death in patients receiving hemodialysis (HD). When presenting to the emergency department (ED) with fever, it remains a diagnostic challenge to distinguish patients with potentially life-threatening bacterial infections from those with less significant causes of fever. The primary goal of this study was to determine the rate of bacteremia in HD patients presenting to the ED with fever. The secondary goal of this study was to identify any independent risk factors associated with bacteremia in the febrile HD patient...
May 25, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29799604/frequency-of-return-visits-to-the-emergency-department-in-patients-discharged-following-hypoglycemia-episodes
#6
David P Betten, David J Castle, Mary J Hughes, Jason N Henney
BACKGROUND: In-hospital observation is typically recommended for patients who present to the emergency department with symptomatic hypoglycemia who are taking oral diabetes medications or long acting insulin. Individuals considered to be at low risk of further hypoglycemic episodes by treating providers are however on occasion discharged to home when a low suspicion of recurrence and close observation is available. We describe the frequency of hypoglycemia recurrence requiring further emergency department evaluation who have been recently discharged from the emergency department and are taking oral diabetes medications or long-acting insulin...
May 24, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29797111/ems-providers-do-not-use-foam-for-education
#7
Joshua Bucher, Colleen Donovan, Jonathan McCoy
BACKGROUND: Free open access to medical education (FOAM, #FOAM) is the free availability of educational materials on various medicine topics. We hope to evaluate the use of social media and FOAM by emergency medical services (EMS) providers. METHODS: We designed an online survey distributed to EMS providers with questions about demographics and social media/FOAM use by providers. The survey was sent to the American College of Emergency Physicians (ACEP) EMS Listserv of medical directors and was asked to be distributed to their respective agencies...
May 24, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29704128/prompting-with-electronic-checklist-improves-clinician-performance-in-medical-emergencies-a-high-fidelity-simulation-study
#8
Ronaldo Sevilla-Berrios, John C O'Horo, Christopher N Schmickl, Aysen Erdogan, Xiaomei Chen, Lisbeth Y Garcia Arguello, Yue Dong, Oguz Kilickaya, Brain Pickering, Rahul Kashyap, Ognjen Gajic
BACKGROUND: Inefficient processes of care delivery during acute resuscitation can compromise the "Golden Hour," the time when quick interventions can rapidly determine the course of the patient's outcome. Checklists have been shown to be an effective tool for standardizing care models. We developed a novel electronic tool, the Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN) to facilitate standardized evaluation and treatment approach for acutely decompensating patients...
April 27, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29675594/a-global-health-research-checklist-for-clinicians
#9
Rasha D Sawaya, Kristen A Breslin, Eiman Abdulrahman, Jennifer I Chapman, Dafina M Good, Lili Moran, Paul C Mullan, Oluwakemi Badaki-Makun
Global health research has become a priority in most international medical projects. However, it is a difficult endeavor, especially for a busy clinician. Navigating the ethics, methods, and local partnerships is essential yet daunting.To date, there are no guidelines published to help clinicians initiate and complete successful global health research projects. This Global Health Research Checklist was developed to be used by clinicians or other health professionals for developing, implementing, and completing a successful research project in an international and often low-resource setting...
April 19, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29651758/the-role-of-emergency-medicine-clerkship-e-portfolio-to-monitor-the-learning-experience-of-students-in-different-settings-a-prospective-cohort-study
#10
Arif Alper Cevik, Sami Shaban, Margret El Zubeir, Fikri M Abu-Zidan
BACKGROUND: Although emergency departments provide acute care learning opportunities for medical students, student exposure to recommended curriculum presentations and procedures are limited. In this perspective, clinical environments providing learning opportunities for students should be monitored as part of an ongoing quality improvement process. This study aims to analyze student exposures and their involvement levels in two different hospitals (Tawam and Al Ain) so as to improve the teaching and learning activities...
April 12, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29626314/necrotising-fasciitis-a-fatal-case-of-sepsis-and-a-diagnostic-challenge-case-report-and-review-of-literature
#11
Lekha Agarwal, Athar Yasin
BACKGROUND: Necrotising fasciitis (NF) is a severe, devastating soft tissue infection characterised by rapidly progressing tissue necrosis. This rare condition has a high mortality rate and poses diagnostic and management challenges to the clinician. There is usually a history of trauma, which maybe trivial. Some of the premorbid conditions associated with NF are diabetes and or immunocompromised state. It requires prompt recognition and early treatment with intravenous antibiotics and extensive surgical debridement...
April 6, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29626265/addressing-the-immediate-need-for-emergency-providers-in-resource-limited-settings-the-model-of-a-six-month-emergency-medicine-curriculum-in-haiti
#12
Shada A Rouhani, Kerling Israel, Fernet Leandre, Sosthène Pierre, Brennan Bollman, Regan H Marsh
BACKGROUND: In many resource-limited settings, emergency medicine (EM) is underdeveloped and formal EM training limited. Residencies and fellowships are an ideal long-term solution but cannot meet immediate needs for emergency providers, while short-term programs are often too limited in content. We describe a third method successfully implemented in Haiti: a medium-duration certificate program to meet the immediate need for emergency specialists. METHODS: In conjunction with the Haitian Ministry of Health and National Medical School, we developed and implemented a novel, 6-month EM certificate program to build human resources for health and emergency care capacity...
April 6, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29619581/approach-to-undifferentiated-dyspnea-in-emergency-department-aids-in-rapid-clinical-decision-making
#13
Siva Nageswara Rao Guttikonda, Kiran Vadapalli
BACKGROUND: Diagnosis and management of patients presenting with acute dyspnea is one of the major challenges for physicians in emergency department (ED). A correct diagnosis is frequently delayed and difficult to ascertain, and clinical uncertainty is common, explaining the need for rapid diagnosis and a management plan. The primary aim of our study is to assess a diagnostic strategy using multiorgan point of care ultrasonography (USG) to differentiate patients presenting with acute dyspnea to ED into different diagnostic categories for timely management in a resource-limited setting...
April 4, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29589196/debate-the-per-rectal-digital-rectal-examination-exam-in-the-emergency-department-still-best-practice
#14
REVIEW
John Quinn, Tomas Zeleny, Venu Rajaratnam, Dan-Lucian Ghiurluc, Vladimir Bencko
BACKGROUND: Emergency medicine practice in the UK and Ireland offers a junior and middle grade doctor great learning opportunities that force engagement with multiple specialties, life-saving procedures, exposure to a myriad of patient presentations, and opportunities for best practices in medicine. MAIN BODY: The emergency department (ED) can be a hectic and dynamic environment; communication from the ED to specialists is essential to ensure best clinical outcomes for patients...
March 27, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29549460/success-rates-of-pre-hospital-difficult-airway-management-a-quality-control-study-evaluating-an-in-hospital-training-program
#15
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported...
March 16, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29541949/the-radiation-footprint-on-the-pediatric-trauma-patient
#16
Raquel M Schears, Zainab Farzal, Zehra Farzal, Anne C Fischer
BACKGROUND: The actual baseline of radiation exposure used in evaluating pediatric trauma is not known and has relied on estimates in the literature that may not reflect clinical reality. Our objectives were to determine the baseline amount of radiation delivered in a pediatric trauma evaluation and correlate radiation exposure with trauma activation status to identify the cohort most at risk. METHODS: We retrospectively evaluated trauma patients (N = 1050) at an independent Level I children's hospital for each level of trauma activation (consults, alerts, stats) from June 2010 to January 2011...
March 14, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29536212/characteristics-and-outcomes-of-pediatric-patients-presenting-at-cambodian-referral-hospitals-without-appointments-an-observational-study
#17
Mackensie A Yore, Matthew C Strehlow, Lily D Yan, Elizabeth A Pirrotta, Joan L Woods, Koy Somontha, Yim Sovannra, Lauren Auerbach, Rebecca Backer, Christophe Grundmann, Swaminatha V Mahadevan
BACKGROUND: Emergency medicine is a young specialty in many low- and middle-income countries (LMICs). Although many patients seeking emergency or acute care are children, little information is available about the needs and current treatment of this group in LMICs. In this observational study, we sought to describe characteristics, chief complaints, management, and outcomes of children presenting for unscheduled visits to two Cambodian public hospitals. METHODS: Children enrolled in the study presented without appointment for treatment at one of two Cambodian public referral hospitals during a 4-week period in 2012...
March 13, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29532345/predictor-variables-of-abnormal-imaging-findings-of-syncope-in-the-emergency-department
#18
Kerem Ozturk, Esra Soylu, Cem Bilgin, Bahattin Hakyemez, Mufit Parlak
BACKGROUND: This study aimed to describe the pathological findings and to analyze clinical predictors of abnormal imaging findings in patients presenting to the emergency department (ED) with syncope. METHODS: The database was retrospectively reviewed for all patients who underwent cranial computed tomography (CT) or magnetic resonance imaging (MRI), having the symptom of syncope. Patients were included only if they were from the emergency department and excluded if were under 18 years of age, had known recent intracranial pathology, known brain tumor, or having a history of trauma...
March 12, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29532186/improving-performance-in-the-ed-through-laboratory-information-exchange-systems
#19
Louis Raymond, Guy Paré, Éric Maillet, Ana Ortiz de Guinea, Marie-Claude Trudel, Josianne Marsan
BACKGROUND: The accessibility of laboratory test results is crucial to the performance of emergency departments and to the safety of patients. This study aims to develop a better understanding of which laboratory information exchange (LIE) systems emergency care physicians (ECPs) are using to consult their patients' laboratory test results and which benefits they derive from such use. METHODS: A survey of 163 (36%) ECPs in Quebec was conducted in collaboration with the Quebec's Department of Health and Social Services...
March 12, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29527652/diagnostic-use-of-lung-ultrasound-compared-to-chest-radiograph-for-suspected-pneumonia-in-a-resource-limited-setting
#20
Yogendra Amatya, Jordan Rupp, Frances M Russell, Jason Saunders, Brian Bales, Darlene R House
BACKGROUND: Lung ultrasound is an effective tool for diagnosing pneumonia in developed countries. Diagnostic accuracy in resource-limited countries where pneumonia is the leading cause of death is unknown. The objective of this study was to evaluate the sensitivity of bedside lung ultrasound compared to chest X-ray for pneumonia in adults presenting for emergency care in a low-income country. METHODS: Patients presenting to the emergency department with suspected pneumonia were evaluated with bedside lung ultrasound, single posterioranterior chest radiograph, and computed tomography (CT)...
March 12, 2018: International Journal of Emergency Medicine
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