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emergency department, emergency medicine

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https://www.readbyqxmd.com/read/27905006/guidelines-on-the-management-of-atrial-fibrillation-in-the-emergency-department-a-critical-appraisal
#1
Giorgio Costantino, Gian Marco Podda, Lorenzo Falsetti, Primiano Iannone, Ana Lages, Alberto M Marra, Maristella Masala, Olaug Marie Reiakvam, Florentia Savva, Jan Schovanek, Sjoerd van Bree, Inês João da Silva Chora, Graziella Privitera, Silvio Ragozzino, Matthias von Rotz, Lycke Woittiez, Christopher Davidson, Nicola Montano
Several guidelines often exist on the same topic, sometimes offering divergent recommendations. For the clinician, it can be difficult to understand the reasons for this divergence and how to select the right recommendations. The aim of this study is to compare different guidelines on the management of atrial fibrillation (AF), and provide practical and affordable advice on its management in the acute setting. A PubMed search was performed in May 2014 to identify the three most recent and cited published guidelines on AF...
November 30, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#2
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27904259/profile-and-outcome-of-sudden-cardiac-arrests-in-the-emergency-department-of-a-tertiary-care-hospital-in-south-india
#3
Gautham Raja Pandian, Suma Mary Thampi, Nilanchal Chakraborty, Deepthi Kattula, Paul Prabhakar Abhilash Kundavaram
BACKGROUND: Sudden cardiac arrest (SCA) requiring cardiopulmonary resuscitation (CPR) is one of the common emergencies encountered in the emergency department (ED) of any hospital. Although several studies have reported the predictors of CPR outcome in general, there are limited data from the EDs in India. MATERIALS AND METHODS: This retrospective study included all patients above 18 years with SCA who were resuscitated in the ED of a tertiary care hospital with an annual census of 60,000 patients between August 2014 and July 2015...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27900531/accidental-cannabis-poisoning-in-the-elderly
#4
Anja Zupan Mežnar, Miran Brvar, Gregor Kralj, Dragan Kovačič
There are two main varieties of Cannabis sativa plant, namely, hemp which is cultivated for fiber and seeds and contains low amounts of psychoactive cannabinoids and the other which is cultivated for the drug cannabis or marijuana. Increasing popularity of hemp food products and alleged beneficial effects of cannabinoids in the drug variety of cannabis might lead to confusion in the lay population and unintentional ingestion of marijuana, as described in this case report. During a workshop on the use of hemp for medicinal purposes, there was a degustation of various hemp food products including also cookies that were brought by one of the attendees...
November 29, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27894630/finding-factors-associated-with-post-emergency-department-morbidity-and-mortality-in-elderly-patients-analyzing-a-case-control-study-answers-to-the-july-2016-annals-of-emergency-medicine-journal-club
#5
Nupur Garg, Tyler W Barrett, David L Schriger
No abstract text is available yet for this article.
December 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27893295/medical-directors-of-breastfeeding-programs-at-academic-medical-centers-duties-and-challenges
#6
Casey B Rosen-Carole
INTRODUCTION: An emerging trend in Academic Medical Centers (AMCs) is to coordinate breastfeeding care, research, and trainee education through "medical director" positions. Little is known about their duties, supports, and challenges. OBJECTIVE: To determine the duties and challenges of directors of breastfeeding medicine in AMCs. METHODS: A survey was distributed four times over a 3-month period to three listservs with a total of 860 members...
November 28, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/27890780/a-clinical-score-to-predict-appendicitis-in-older-male-children
#7
Anupam B Kharbanda, Michael C Monuteaux, Richard G Bachur, Nanette C Dudley, Lalit Bajaj, Michelle D Stevenson, Charles G Macias, Manoj K Mittal, Jonathan E Bennett, Kelly Sinclair, Peter S Dayan
OBJECTIVE: To develop a clinical score to predict appendicitis among older, male children who present to the emergency department (ED) with suspected appendicitis. METHODS: Patients with suspected appendicitis were prospectively recruited at 9 pediatric EDs. A total 2,625 patients enrolled; a subset of 961 males, age 8-18 were analyzed in this secondary analysis. Outcomes determined by pathology, operative reports and follow-up calls. Clinical and laboratory predictors with < 10% missing data and Kappa > 0...
November 24, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27890300/evaluating-clinical-care-in-the-prehospital-setting-is-rapid-emergency-medicine-score-the-missing-metric-of-ems
#8
Scott M Alter, Allison Infinger, Doug Swanson, Jonathan R Studnek
INTRODUCTION: The Rapid Emergency Medicine Score (REMS) was developed to predict emergency department patient mortality. Our objective was to utilize REMS to assess initial patient acuity and evaluate clinical change during prehospital care. METHODS: All non-cardiac arrest emergency transports from April 1, 2013 to March 31, 2014 were analyzed from a single EMS agency. Using age, pulse rate, mean arterial pressure, respiratory rate, oxygen saturation, and Glasgow Coma Scale, initial and final REMS were calculated...
October 25, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27889359/elevated-liver-enzymes-emergency-department-focused-management
#9
Eric Sulava, Samuel Bergin, Brit Long, Alex Koyfman
BACKGROUND: Liver function test (LFT) abnormalities are a common problem faced by emergency physicians. This has become more common with the introduction of laboratory panels and automated routine laboratory testing. Fortunately, not all patients with irregularities in liver enzymes possess underlying pathology. This emergency medicine focused review provides a discussion of the various biochemical tests, their underlying biological basis, and an algorithmic approach to the interpretation of abnormalities...
November 23, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27888601/key-issues-in-the-infected-patient-care-in-the-emergency-department
#10
F Chiarella, J González-Del Castillo, F J Candel, E J García-Lamberechts, M J Núñez-Orantos, F J Martín-Sánchez
OBJECTIVE: To develop a set of recommendations, by consensus of Emergency Medicine experts, on key aspects related to the care of adult patients with acute infection attended in Spanish emergency departments (ED). METHODS: The study was divided into three phases: 1) To design a questionnaire by a coordinating group; 2) To conduct a survey in ED physicians in order to know their opinion on the issues raised by the coordinating group; 3) To develop a number of recommendations based on the responses to the questionnaire and their subsequent discussion...
December 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27887758/blind-nasal-intubation-revisited-no-longer-a-blind-technique
#11
Prakash K Dubey, Preksha Dubey, Niranjan Kumar, Gautam Bhardwaj, Neeraj Kumar
BACKGROUND: Advancements in airway management have made the practice of blind nasal intubation obsolete. We report on successful blind nasal intubation performed with the help of capnography and real-time ultrasonography in two patients with tempormandibular joint ankylosis. CASE REPORT: Blind nasal intubation was performed in a 12-year-old patient and a 17-year old patient under general anesthesia with spontaneous respiration. Capnography was used as an aid during insertion and dynamic ultrasonography was performed to guide and confirm proper tracheal tube placement...
November 22, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27886161/cardiac-ct-in-the-emergency-department-in-the-era-of-highly-sensitive-troponins-is-there-still-a-role
#12
Admir Dedic, Koen Nieman, Udo Hoffmann, Maros Ferencik
INTRODUCTION: Physicians practicing cardiovascular medicine are every day confronted with patients presenting with symptoms suggestive of an acute coronary syndrome (ACS). Over the years, there have been substantial technical advances, such as the introduction of new non-invasive imaging techniques and the introduction of new highly sensitive cardiac biomarkers. EVIDENCE ACQUISITION AND SYNTHESIS: Physicians have adopted these new assets and have become more experienced with them thus improving medical care...
November 25, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27884844/medication-reconciliation-as-a-medication-safety-initiative-in-ethiopia-a-study-protocol
#13
Alemayehu B Mekonnen, Andrew J McLachlan, Jo-Anne E Brien, Desalew Mekonnen, Zenahebezu Abay
INTRODUCTION: Medication related adverse events are common, particularly during transitions of care, and have a significant impact on patient outcomes and healthcare costs. Medication reconciliation (MedRec) is an important initiative to achieve the Quality Use of Medicines, and has been adopted as a standard practice in many developed countries. However, the impact of this strategy is rarely described in Ethiopia. The aims of this study are to explore patient safety culture, and to develop, implement and evaluate a theory informed MedRec intervention, with the aim of minimising the incidence of medication errors during hospital admission...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27884585/the-successful-treatment-of-5-fluorouracil-5-fu-overdose-in-a-patient-with-malignancy-and-hiv-aids-with-uridine-triacetate
#14
Cynthia Santos, Brent W Morgan, Robert J Geller
According to the NIH, about 275000 patients receive treatment with 5-Fluorouracil (5-FU) and more than 1300 die from 5-FU toxicity every year from life-threatening myelosuppression, gastrointestinal complications, and neurotoxicity. Immunocompromised persons are at higher risk of developing toxicity. Recently uridine triacetate (Vistagard®) has been approved by the Food and Drug Administration (FDA) as the only specific antidote available for 5-FU poisoning. In a clinical trial (n=135), 96% of patients with 5-FU toxicity recovered after treatment, where as in a historical control group only 10% survived...
November 15, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27881091/conducting-a-large-multi-site-survey-about-patients-views-on-broad-consent-challenges-and-solutions
#15
Maureen E Smith, Saskia C Sanderson, Kyle B Brothers, Melanie F Myers, Jennifer McCormick, Sharon Aufox, Martha J Shrubsole, Nanibaá A Garrison, Nathaniel D Mercaldo, Jonathan S Schildcrout, Ellen Wright Clayton, Armand H Matheny Antommaria, Melissa Basford, Murray Brilliant, John J Connolly, Stephanie M Fullerton, Carol R Horowitz, Gail P Jarvik, Dave Kaufman, Terri Kitchner, Rongling Li, Evette J Ludman, Catherine McCarty, Valerie McManus, Sarah Stallings, Janet L Williams, Ingrid A Holm
BACKGROUND: As biobanks play an increasing role in the genomic research that will lead to precision medicine, input from diverse and large populations of patients in a variety of health care settings will be important in order to successfully carry out such studies. One important topic is participants' views towards consent and data sharing, especially since the 2011 Advanced Notice of Proposed Rulemaking (ANPRM), and subsequently the 2015 Notice of Proposed Rulemaking (NPRM) were issued by the Department of Health and Human Services (HHS) and Office of Science and Technology Policy (OSTP)...
November 24, 2016: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/27879182/-acute-respiratory-failure-caused-by-minocycline
#16
B Kok, M J T van de Ven, H J van Leeuwen
BACKGROUND: In the case of pneumonia an infectious cause is always considered first. However, toxic agents and medicines can also be the cause of pneumonia. CASE DESCRIPTION: A 54-year-old woman was referred to the emergency department because of progressive dyspnoea, a non-productive cough, headache, and fever. She was admitted with the diagnosis community acquired pneumonia. Despite treatment with antibiotics and oxygen she developed hypoxic respiratory failure, which necessitated invasive mechanical ventilation...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27878444/is-a-mobile-emergency-severity-index-esi-triage-better-than-the-paper-esi
#17
Sorravit Savatmongkorngul, Chaiyaporn Yuksen, Chanakarn Suwattanasilp, Kittisak Sawanyawisuth, Yuwares Sittichanbuncha
This study aims to evaluate the mobile emergency severity index (ESI) tool in terms of validity compared with the original ESI triage. The original ESI and mobile ESI were used with patients at the Department of Emergency Medicine, Ramathibodi Hospital, Thailand. Eligible patients were evaluated by sixth-year medical students/emergency physicians using either the original or mobile ESI. The ESI results for each patient were compared with the standard ESI. Concordance and kappa statistics were calculated for pairs of the evaluators...
November 22, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27878404/inter-rater-agreement-between-trained-emergency-medicine-residents-and-radiologists-in-the-examination-of-gallbladder-and-common-bile-duct-by-ultrasonography
#18
Javad Seyedhosseini, Azade Nasrelari, Narges Mohammadrezaei, Ehsan Karimialavijeh
STUDY OBJECTIVES: Bedside emergency ultrasonograAmerican Society of Emergency Radiologyphy is a rapid diagnostic tool in the emergency department (ED). Nevertheless, the learning curve for ultrasound (US) training in various indications has to date not been clearly defined. The aim of the present study was to assess how much a short specialized training program in hepatobiliary US might impact the skills of novice emergency medicine residents. METHODS: This was a prospective observational study conducted at a university-affiliated ED from May 2014 to January 2015...
November 22, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27873322/non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care
#19
REVIEW
Greg Weeks, Johnson George, Katie Maclure, Derek Stewart
BACKGROUND: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants substituting for doctors in a prescribing role, and this is one approach to improve access to medicines. OBJECTIVES: To assess clinical, patient-reported, and resource use outcomes of non-medical prescribing for managing acute and chronic health conditions in primary and secondary care settings compared with medical prescribing (usual care)...
November 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27871580/c1-esterase-inhibitor-for-short-term-prophylaxis-in-a-patient-with-hereditary-angioedema-with-normal-c1-inhibitor-function
#20
Savio K H Yu, Jeannie Callum, Asim Alam
Hereditary angioedema with normal C1-esterase inhibitor (HAE-nC1INH) perioperative is a rare condition which could have potential disastrous ramifications for the anesthesiologist in the perioperative period. However, there is limited evidence and/or guidelines on the optimal way to manage these patients. We present the case of a patient with HAE-nC1INH who was successfully managed in the perioperative period with plasma derived C1-esterase inhibitor (pdC1INH). A 29-year-old woman with a diagnosis of HAE-nC1INH presented to the preoperative consultation in preparation for an upcoming total thyroidectomy...
December 2016: Journal of Clinical Anesthesia
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