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International Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/29455310/germans-learn-how-to-save-lives-a-nationwide-cpr-education-initiative
#1
Manuela Malsy, Richard Leberle, Bernhard Graf
BACKGROUND: Sudden cardiac death is one of the most frequent causes of death in Germany and the third leading cause of death in the industrialized world. Yet, the percentage of people providing first aid in the case of sudden cardiac arrest in Germany is alarmingly low by international comparison. Training Germans or reminding them of the simple but effective steps of resuscitation, so that everybody can save a live in an emergency. METHODS: For the campaign 'Resuscitation Week', physicians and paramedics trained passers-by in cardiovascular resuscitation free of charge...
February 17, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29445882/procedure-rates-performed-by-emergency-medicine-residents-a-retrospective-review
#2
Joshua T Bucher, Christopher Bryczkowski, Grant Wei, Renee L Riggs, Anoop Kotwal, Brian Sumner, Jonathan V McCoy
BACKGROUND: The purpose of our study is to investigate rates of individual procedures performed by residents in our emergency medicine (EM) residency program. Different programs expose residents to different training environments. Our hypothesis is that ultrasound examinations are the most commonly performed procedure in our residency. METHODS: The study took place in an academic level I trauma center with multiple residency and fellowship programs including surgery, surgical critical care, trauma, medicine, pulmonary/critical care, anesthesiology and others...
February 14, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29423875/emergency-medicine-in-the-kingdom-of-bahrain
#3
Feras Abuzeyad, Leena Alqusem, Mudhaffar I Al Farras, Shaikha S Al Jawder, Ghada Al Qasim, Salah Alghanem
It has been more than a decade since emergency medicine became recognized as a specialty in the Kingdom of Bahrain. In the last fifteen years emergency medicine has widely established itself and developed rapidly in the Kingdom. The three main emergency departments are: Salmanyia Medical Complex (SMC), Royal Medical Services of Bahrain Defence Force (RMS-BDF) and King Hamad University Hospital (KHUH) are now fully equipped and operated by a majority of board certified emergency physicians.Standardized protocols, and the Central National Ambulance will be established in the near future, and the ambulances will offer both basic and advanced life support by trained nurses and paramedics...
February 8, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29423767/patient-understanding-of-discharge-instructions-in-the-emergency-department-do-different-patients-need-different-approaches
#4
Hasan Sheikh, Aleksandar Brezar, Agata Dzwonek, Lawrence Yau, Lisa A Calder
BACKGROUND: Previous studies have demonstrated that patients have poor understanding of the discharge instructions provided from the emergency department (ED). The aims of this study are to determine if patient factors, such as income and level of education, correlate with patient understanding of discharge instructions and to explore if different patient populations prefer different resources for receiving discharge instructions. METHODS: We conducted live observations of physicians providing discharge instructions in the ED to 100 patients followed by a patient survey to determine their understanding in four domains (diagnosis, treatment plan, follow-up instructions, and return to ED (RTED) instructions) and collect patient demographics...
February 8, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29423602/clinical-care-review-systems-in-healthcare-a-systematic-review
#5
Laura E Walker, David M Nestler, Torrey A Laack, Casey M Clements, Patricia J Erwin, Lori Scanlan-Hanson, M Fernanda Bellolio
BACKGROUND: Clinical care review is the process of retrospectively examining potential errors or gaps in medical care, aiming for future practice improvement. The objective of our systematic review is to identify the current state of care review reported in peer-reviewed publications and to identify domains that contribute to successful systems of care review. METHODS: A librarian designed and conducted a comprehensive literature search of eight electronic databases...
February 8, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29335793/accuracy-of-emergency-department-triage-using-the-emergency-severity-index-and-independent-predictors-of-under-triage-and-over-triage-in-brazil-a-retrospective-cohort-analysis
#6
Jeremiah S Hinson, Diego A Martinez, Paulo S K Schmitz, Matthew Toerper, Danieli Radu, James Scheulen, Sarah A Stewart de Ramirez, Scott Levin
BACKGROUND: Emergency department (ED) triage is performed to prioritize care for patients with critical and time-sensitive illness. Triage errors create opportunity for increased morbidity and mortality. Here, we sought to measure the frequency of under- and over-triage of patients by nurses using the Emergency Severity Index (ESI) in Brazil and to identify factors independently associated with each. METHODS: This was a single-center retrospective cohort study. The accuracy of initial ESI score assignment was determined by comparison with a score entered at the close of each ED encounter by treating physicians with full knowledge of actual resource utilization, disposition, and acute outcomes...
January 15, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29299773/a-comparative-epidemiological-study-of-acute-renal-colic-presentations-to-emergency-departments-in-doha-qatar-and-melbourne-australia
#7
Sameer A Pathan, Biswadev Mitra, Zain A Bhutta, Isma Qureshi, Elle Spencer, Asmaa A Hameed, Sana Nadeem, Ramsha Tahir, Shahzad Anjum, Peter A Cameron
BACKGROUND: This study aimed to compare the epidemiology, clinical presentations, management, and outcomes of renal colic presentations in two major academic centers from geographically diverse populations: Qatar (a country in the Afro-Asian stone belt) and South-Eastern Australia (not within a stone belt). METHODS: We undertook a retrospective cohort study of patients with renal colic who presented to the Hamad General Hospital Emergency Department (HGH-ED), Qatar, and The Alfred ED, Melbourne, Australia, during a period of 1 year from August 1, 2012, to July 31, 2013...
January 3, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29299704/older-adults-and-technology-in-telehealth-they-may-not-be-who-you-think-they-are
#8
LETTER
Peter Greenwald, Michael Ethan Stern, Sunday Clark, Rahul Sharma
When we established an emergency department-based telemedicine program, we assumed that many older patients would be skeptical of the new technology and choose not to participate. Our assumption was incorrect. Of the 1052 patients we evaluated in the first several months, 355 (33%) were 60, 2 were 99. Satisfaction and quality assessment scores among older patients were similar to those for younger patients. Many of these older patients demonstrated flexibility and interest in the novel use of technology. Our emergency department-based telemedicine program resulted in safe and satisfactory care and was readily accepted by our older patients...
January 3, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29247274/procedural-sedation-and-analgesia-practices-by-emergency-physicians-in-the-netherlands-a-nationwide-survey
#9
Maybritt I Kuypers, Gaël J P Smits, Suzanne C Valkenet, Wendy A M H Thijssen, Frans B Plötz
BACKGROUND: Several efforts have been made to assure and to improve the quality of procedural sedation and analgesia (PSA) performed by emergency physicians (EPs) in The Netherlands. This study investigated the current PSA practice and competences of EPs in both adult and paediatric patients. In particular, if residency and current training, awareness of guidelines is sufficient for registered EPs to adequately perform PSA and if the availability of both adult and paediatric PSA in the ED is adequate...
December 15, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29209849/comments-on-blood-product-transfusion-in-emergency-department-patients-a-case-control-study-of-practice-patterns-and-impact-on-outcome
#10
LETTER
Manoochehr Karami, Salman Khazaei
Clinical decision makings according studies result require the valid and correct data collection, andanalysis. However, there are some common methodological and statistical issues which may ignore by authors. In individual matched case- control design bias arising from the unconditional analysis instead of conditional analysis. Using an unconditional logistic for matched data causes the imposition of a large number of nuisance parameters which may result in seriously biased estimates.
December 6, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29204728/variation-in-outpatient-emergency-department-utilization-in-texas-medicaid-a-state-level-framework-for-finding-superutilizers
#11
Chris Delcher, Chengliang Yang, Sanjay Ranka, Joseph Adrian Tyndall, Bruce Vogel, Elizabeth Shenkman
BACKGROUND: Very frequent outpatient emergency department (ED) use-so called "superutilization"-at the state level is not well-studied. To address this gap, we examined frequent ED utilization in the largest state Medicaid population to date. METHODS: Using Texas Medicaid (the third largest in the USA) claims data, we examined the variability in expenditures, sociodemographics, comorbidities, and persistence across seven levels of ED utilization/year (i.e., 1, 2, 3-4, 5-6, 7-9, 10-14, and ≥ 15 visits)...
December 4, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28752502/attitude-of-patients-healthcare-professionals-and-noninjured-lay-persons-towards-online-video-instructions-on-mild-traumatic-brain-injury-a-cross-sectional-study
#12
Amber E Hoek, Maaike van den Hamer, Carianne K Deelstra, Ed F van Beeck, Diederik W J Dippel, Juanita A Haagsma, Pleunie P M Rood
BACKGROUND: The objective of this study was to determine the attitude of patients, healthcare professionals, and noninjured lay persons towards adding a video with discharge instructions to patient care for patients with mild traumatic brain injury (MTBI). A survey was conducted at the emergency department (ED). Participants consisted of MTBI patients (n = 50), healthcare professionals (n = 50), and noninjured lay persons (n = 50). The participants viewed a video with discharge instructions on MTBI and filled out a questionnaire that measured their attitude towards the use of a video as part of discharge instructions...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28707273/team-communication-patterns-in-emergency-resuscitation-a-mixed-methods-qualitative-analysis
#13
Lisa Anne Calder, George Mastoras, Mitra Rahimpour, Benjamin Sohmer, Brian Weitzman, A Adam Cwinn, Tara Hobin, Avi Parush
BACKGROUND: In order to enhance patient safety during resuscitation of critically ill patients, we need to optimize team communication and enhance team situational awareness but little is known about resuscitation team communication patterns. The objective of this study is to understand how teams communicate during resuscitation; specifically to assess for a shared mental model (organized understanding of a team's relationships) and information needs. METHODS: We triangulated 3 methods to evaluate resuscitation team communication at a tertiary care academic trauma center: (1) interviews; (2) simulated resuscitation observations; (3) live resuscitation observations...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28702883/risk-factors-for-recurrent-emergency-department-visits-for-hyperglycemia-in-patients-with-diabetes-mellitus
#14
Justin W Yan, Katherine M Gushulak, Melanie P Columbus, Kristine van Aarsen, Alexandra L Hamelin, George A Wells, Ian G Stiell
BACKGROUND: Patients with poorly controlled diabetes mellitus may present repeatedly to the emergency department (ED) for management and treatment of hyperglycemic episodes, including diabetic ketoacidosis and hyperosmolar hyperglycemic state. The objective of this study was to identify risk factors that predict unplanned recurrent ED visits for hyperglycemia in patients with diabetes within 30 days of initial presentation. METHODS: We conducted a 1-year health records review of patients ≥18 years presenting to one of four tertiary care EDs with a discharge diagnosis of hyperglycemia, diabetic ketoacidosis, or hyperosmolar hyperglycemic state...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28695492/patterns-of-acute-poisoning-with-pesticides-in-the-paediatric-age-group
#15
Kavinda Chandimal Dayasiri, Shaluka F Jayamanne, Chamilka Y Jayasinghe
BACKGROUND: Pesticides are identified as one of the dangerous poisons globally in children and are associated with increased short- and long-term morbidity. Pesticide poisoning is the most common method of self-poisoning among adults in rural Sri Lanka, and the clinical management is associated with significant healthcare costs to the country. There is however little data published on acute pesticide poisoning among children in rural Sri Lanka. The current study aimed to comprehensively evaluate clinical profiles, harmful first aid measures, emergency clinical management, complications and outcomes related to acute pesticide poisoning among children in the rural community of Sri Lanka...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28685213/telemedicine-and-its-transformation-of-emergency-care-a-case-study-of-one-of-the-largest-us-integrated-healthcare-delivery-systems
#16
Rahul Sharma, Peter Fleischut, Daniel Barchi
Innovative methods for delivering healthcare via the use of technology are rapidly growing. Despite the passage of the Affordable Care Act, emergency department visits have continued to rise nationally. Healthcare systems must devise solutions to face these increasing volumes and also deliver high quality care. In response to the changing healthcare landscape, New York Presbyterian Hospital has implemented a comprehensive enterprise wide digital health portfolio which includes the first mobile stroke treatment unit on the east coast and the first emergency department-based digital emergency care program in New York City...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28647922/comparison-of-quality-of-chest-compressions-during-training-of-laypersons-using-push-heart-and-little-anne-manikins-using-blinded-cprcards
#17
Shota Tanaka, Alexander E White, Ryo Sagisaka, Guanseng Chong, Eileen Ng, Jinny Seow, Nurul Asyikin Mj, Hideharu Tanaka, Marcus Eng Hock Ong
BACKGROUND: Mass Cardio-Pulmonary Resuscitation (CPR) training using less expensive and easily portable manikins is one way to increase the number of trained laypeople in a short time. The easy-to-carry, low-cost CPR training model called Push Heart (PH) is widely used in Japan. The aim of this study was to examine if PH can achieve chest compression quality that is similar to that using more conventional Little Anne (LA) manikins for training laypersons. METHODS: This prospective randomized crossover study was done during routine community CPR training of laypersons in Singapore...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28589462/discharge-or-admit-emergency-department-management-of-incidental-pulmonary-embolism-in-patients-with-cancer-a-retrospective-study
#18
Srinivas R Banala, Sai-Ching Jim Yeung, Terry W Rice, Cielito C Reyes-Gibby, Carol C Wu, Knox H Todd, W Frank Peacock, Kumar Alagappan
BACKGROUND: Hospitalization and early anticoagulation therapy remain standard care for patients who present to the emergency department (ED) with pulmonary embolism (PE). For PEs discovered incidentally, however, optimal therapeutic strategies are less clear-and all the more so when the patient has cancer, which is associated with a hypercoagulable state that exacerbates the threat of PE. METHODS: We conducted a retrospective review of a historical cohort of patients with cancer and incidental PE who were referred for assessment to the ED in an institution whose standard of care is outpatient treatment of selected patients and use of low-molecular-weight heparin for anticoagulation...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28585119/the-effectiveness-of-hybrid-treatment-for-sever-multiple-trauma-a-case-of-multiple-trauma-for-damage-control-laparotomy-and-thoracic-endovascular-repair
#19
Naofumi Bunya, Keisuke Harada, Yosuke Kuroda, Tsubasa Toyohara, Takashi Toyohara, Narumi Kubota, Ryuichiro Kakizaki, Hideto Irifune, Shuji Uemura, Eichi Narimatsu
BACKGROUND: Time is a crucial factor for the successful early management of the multi-trauma patient. Hybrid operating theaters, which support the integration of surgical treatment and interventional radiology, provide opportunities to reduce the time-to-surgery for life threatening conditions. CASE PRESENTATION: We describe the early successful treatment of a 54-year-old male who sustained multiple injuries when he was hit by a 1000 kg bale of wheat that fell from a height...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28484958/markers-of-diuretic-resistance-in-emergency-department-patients-with-acute-heart-failure
#20
Andrew Doering, Cathy A Jenkins, Alan B Storrow, JoAnn Lindenfeld, Gregory J Fermann, Karen F Miller, Matthew Sperling, Sean P Collins
BACKGROUND: Loop diuretics are common therapy for emergency department (ED) patients with acute heart failure (AHF). Diuretic resistance (DR) is a term used to describe blunted natriuretic response to loop diuretics. It would be important to detect DR prior to it becoming clinically apparent, so early interventions can be initiated. However, several definitions have been proposed, and it is not clear if they identify similar patients. We compared these definitions and described the clinical characteristics of patients who fulfilled them...
December 2017: International Journal of Emergency Medicine
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