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Emergency department review

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https://www.readbyqxmd.com/read/28926507/point-of-care-ultrasound-could-streamline-the-emergency-department-workflow-of-clinically-nonspecific-intussusception
#1
Jung Heon Kim, Jeong-Yong Lee, Jae Hyun Kwon, Hyung-Rae Cho, Jong Seung Lee, Jeong-Min Ryu
OBJECTIVES: The aim of this study was to evaluate whether point-of-care ultrasound (POCUS) for intussusception screening streamlines the workflow of clinically nonspecific intussusception (CNI), an intussusception presenting with only 1 manifestation of the classic triad, and/or vomiting. METHODS: We reviewed 274 consecutive children with intussusception, aged 6 years or younger, who visited a tertiary care hospital emergency department between May 2012 and April 2016...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28924747/effectiveness-of-intensive-primary-care-interventions-a-systematic-review
#2
Samuel T Edwards, Kim Peterson, Brian Chan, Johanna Anderson, Mark Helfand
BACKGROUND: Multicomponent, interdisciplinary intensive primary care programs target complex patients with the goal of preventing hospitalizations, but programs vary, and their effectiveness is not clear. In this study, we systematically reviewed the impact of intensive primary care programs on all-cause mortality, hospitalization, and emergency department use. METHODS: We searched PubMed, CINAHL, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Reviews of Effects from inception to March 2017...
September 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28924623/the-effectiveness-of-pharmacist-provided-telephonic-medication-therapy-management-on-emergency-department-utilization-in-home-health-patients
#3
Stephanie A Gernant, Margie E Snyder, Heather Jaynes, Jason M Sutherland, Alan J Zillich
BACKGROUND: Preventable emergency department (ED) use may be targeted with interventions for improving the medication use process, as medication misadventures and non-adherence frequently cause preventable ED utilization. One intervention that could prevent ED visits is Medication Therapy Management (MTM). OBJECTIVE: To evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing emergency department utilization within a Medicare insured home health population...
October 1, 2016: Journal of Pharmacy Technology: JPT: Official Publication of the Association of Pharmacy Technicians
https://www.readbyqxmd.com/read/28924000/nerf-gun-eye-injuries-traumatic-hyphema
#4
Mukhtar Bizrah, Seema Verma
Three unrelated patients attended the accident and emergency department with pain and blurred vision after ocular injury with a Nerf gun. Two were adults and one was a child, all of which presented within a 3 months' period. All three cases were found to have ≥1 mm of traumatic hyphema (pooling of blood in anterior chamber of the eye), indicating significant ocular trauma. The two adult patients had formed hyphema and uveitis. The 11-year-old child had formed hyphema, corneal oedema, anterior uveitis, localised angle recession and commotio retinae, which further highlight the severity of the ocular trauma...
September 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28923560/computed-tomography-findings-in-young-children-with-minor-head-injury-presenting-to-the-emergency-department-greater-than-24h-post-injury
#5
Renana Gelernter, Giora Weiser, Eran Kozer
BACKGROUND: Large studies which developed decision rules for the use of Computed tomography (CT) in children with minor head trauma excluded children with late presentation (more than 24h). OBJECTIVE: To assess the prevalence of significant traumatic brain injury (TBI) on CT in infants with head trauma presenting to the emergency department (ED) more than 24h from the injury. METHODS: A retrospective chart review of infants less than 24 months old referred for head CT because of traumatic brain injury from January 2004 to December 2014 in Assaf-Harofeh medical center was conducted...
September 11, 2017: Injury
https://www.readbyqxmd.com/read/28922339/incidence-and-risk-factors-of-anaesthesia-related-perioperative-cardiac-arrest-a-6-year-observational-study-from-a-tertiary-care-university-hospital
#6
Andreas Hohn, Jan-Nicolas Machatschek, Jeremy Franklin, Stephan A Padosch
BACKGROUND: In recent decades, the incidences of anaesthesia-related perioperative mortality and adverse outcomes have decreased drastically. However, to date, data on perioperative cardiac arrest and risk factors of perioperative cardiac arrest from European countries are scarce. OBJECTIVES: To determine the incidences of perioperative cardiac arrest and rates of anaesthesia-related and anaesthesia-contributory cardiac arrest. Identification of pre-existing risk factors leading to perioperative cardiac arrest...
September 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28918297/a-rare-case-of-spontaneous-rupture-of-an-aneurysm-of-the-right-gastric-artery
#7
Yu-Ki Takemoto, Nobuaki Fujikuni, Kazuaki Tanabe, Hironobu Amano, Toshio Noriyuki, Masahiro Nakahara
BACKGROUND: Visceral artery aneurysms at the origin of the gastric and gastroepiploic artery are uncommon. Raptured visceral aneurysms cause high mortality and require urgent and adequate intervention and treatment. PRESENTATION OF CASE: A 65-year-old woman was transferred to the emergency department with sudden abdominal and back pain. Radiographically, we diagnosed intra-abdominal bleeding due to a ruptured aneurysm of the right gastric artery. Although her vital signs were relatively stable, transcatheter arterial embolization (TAE) could not be performed due to thrombotic occlusion of her abdominal aorta, and bilateral axillary arteries...
September 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28917436/comparison-of-the-loop-technique-with-incision-and-drainage-for-soft-tissue-abscesses-a-systematic-review-and-meta-analysis
#8
REVIEW
Michael Gottlieb, Gary D Peksa
INTRODUCTION: Skin and soft tissue infections are a common presentation to the emergency department. Traditional management of abscesses involves a linear incision through the center of the abscess with packing placed. The loop drainage technique (LDT) is an alternate approach that may reduce pain and scarring, as well as decrease the number of follow up visits needed. This systematic review and meta-analysis aimed to compare the efficacy of the LDT with conventional incision and drainage (CID) in the treatment of soft tissue abscesses...
September 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28917255/stereotactic-body-radiotherapy-for-primary-renal-cell-carcinoma-and-adrenal-metastases
#9
Gargi Kothari, Alexander V Louie, David Pryor, Ian Vela, Simon S Lo, Bin S Teh, Shankar Siva
The incidence of renal cell carcinoma (RCC) and metastatic adrenal lesions continues to rise and present evolving complexities in terms of management. Technical challenges in treatment delivery are compounded by the setting of an ageing patient population with multiple medical co-morbidities. While the standard of care treatment for both primary RCC and oligometastatic adrenal lesions has typically been surgery, a number of patients may be medically or surgically inoperable, and for whom alternative options require consideration...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28916143/violent-behavior-by-emergency-department-patients-with-an-involuntary-hold-status
#10
Nancy L Dawson, Christian Lachner, Tyler F Vadeboncoeur, Michael J Maniaci, Veronica Bosworth, Teresa A Rummans, Archana Roy, M Caroline Burton
BACKGROUND: Violence against health care workers has been increasing. Health care workers in emergency departments (EDs) are highly vulnerable because they provide care for patients who may have mental illness, behavioral problems, or substance use disorders (alone or in combination) and who are often evaluated during an involuntary hold. Our objective was to identify factors that may be associated with violent behavior in ED patients during involuntary holds. METHODS: Retrospective review of patients evaluated during an involuntary hold at a suburban acute care hospital ED from January 2014 through November 2015...
August 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28916122/myasthenia-gravis-and-crisis-evaluation-and-management-in-the-emergency-department
#11
Jamie Roper, M Emily Fleming, Brit Long, Alex Koyfman
BACKGROUND: Myasthenia gravis (MG) is an uncommon autoimmune disorder affecting the neuromuscular junction and manifesting as muscle weakness. A multitude of stressors can exacerbate MG. When symptoms are exacerbated, muscle weakness can be severe enough to result in respiratory failure, a condition known as myasthenic crisis (MC). OBJECTIVE: This review discusses risk factors, diagnosis, management, and iatrogenic avoidance of MC. DISCUSSION: MC can affect any age, ethnicity, or sex and can be precipitated with any stressor, infection being the most common...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28916120/does-early-and-appropriate-antibiotic-administration-improve-mortality-in-emergency-department-patients-with-severe-sepsis-or-septic-shock
#12
Robert Sherwin, Michael E Winters, Gary M Vilke, Gabriel Wardi
BACKGROUND: Severe sepsis and septic shock remain significant public health concerns. Appropriate emergency department management includes early recognition, hemodynamic resuscitation, source control, and prompt antibiotic administration. Current international guidelines strongly recommend administration of early and appropriate antibiotics for patients with severe sepsis and septic shock. Interestingly, a recent Cochrane Review found insufficient evidence to provide a similar recommendation on antibiotic administration...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28916013/the-emergency-department-challenges-and-opportunities-for-suicide-prevention
#13
REVIEW
Joan Rosenbaum Asarnow, Kalina Babeva, Elizabeth Horstmann
Emergency departments (EDs) can offer life-saving suicide prevention care. This article focuses on the ED and emergency services as service delivery sites for suicide prevention. Characteristics of EDs, models of emergency care, ED screening and brief intervention models, and practice guidelines and parameters are reviewed. A care process model for youths at risk for suicide and self-harm is presented, with guidance for clinicians based on the scientific evidence. Strengthening emergency infrastructure and integrating effective suicide prevention strategies derived from scientific research are critical for advancing suicide prevention objectives...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28915161/unenhanced-dual-energy-computed-tomography-visualization-of-brain-edema
#14
Mohammed F Mohammed, Olivia Marais, Adam Min, David Ferguson, Sabeena Jalakhan, Faisal Khosa, Michael OʼKeeffe, Tim OʼConnell, Heiko Schmiedeskamp, Bernhard Krauss, Axel Rohr, Savvas Nicolaou
PURPOSE: The aim of this study was to determine whether dual-energy computed tomography (DECT) imaging is superior to conventional noncontrast computed tomography (CT) imaging for the detection of acute ischemic stroke. MATERIALS AND METHODS: This was a retrospective, single-center study of 40 patients who presented to the emergency department (ED) of a major, acute care, teaching center with signs and symptoms of acute stroke. Only those patients who presented to the ED within 4 hours of symptom onset were included in this study...
September 14, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28914227/a-system-analysis-of-delay-in-outpatient-respiratory-equipment-delivery
#15
Sheila Kun, Gregory Placencia, Sally Davidson Ward, Thomas Keens
OBJECTIVES: To systematically assess barriers delaying home respiratory equipment requisition and to evaluate for temporal correlation between delays and emergency room or hospitalization episodes. BACKGROUND: Initiation of home respiratory treatments is delayed because of delays in delivery of durable medical equipment (DME). This study assesses root causes of such delays from a system perspective. We also describe clinical consequences by measuring emergency room visits and hospitalization days for temporal correlations...
December 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
https://www.readbyqxmd.com/read/28913694/emergency-neurological-life-support-traumatic-spine-injury
#16
Deborah M Stein, William A Knight
Traumatic spine injuries (TSIs) carry significantly high risks of morbidity, mortality, and exorbitant health care costs from associated medical needs following injury. For these reasons, TSI was chosen as an ENLS protocol. This article offers a comprehensive review on the management of spinal column injuries using the best available evidence. Though the review focuses primarily on cervical spinal column injuries, thoracolumbar injuries are briefly discussed as well. The initial emergency department (ED) clinical evaluation of possible spinal fractures and cord injuries, along with the definitive early management of confirmed injuries, are also covered...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913001/methamphetamine-use-and-emergency-department-utilization-20-years-later
#17
John R Richards, Sheiva Hamidi, Connor D Grant, Colin G Wang, Nabil Tabish, Samuel D Turnipseed, Robert W Derlet
BACKGROUND: Methamphetamine (MAP) users present to the emergency department (ED) for myriad reasons, including trauma, chest pain, and psychosis. The purpose of this study is to determine how their prevalence, demographics, and resource utilization have changed. METHODS: Retrospective review of MAP patients over 3 months in 2016. Demographics, mode of arrival, presenting complaints, disposition, and concomitant cocaine/ethanol use were compared to a 1996 study at the same ED...
2017: Journal of Addiction
https://www.readbyqxmd.com/read/28911830/norovirus-infection-in-older-adults-epidemiology-risk-factors-and-opportunities-for-prevention-and-control
#18
REVIEW
Cristina V Cardemil, Umesh D Parashar, Aron J Hall
Norovirus is the leading cause of acute gastroenteritis. In older adults, it is responsible for an estimated 3.7 million illnesses; 320,000 outpatient visits; 69,000 emergency department visits; 39,000 hospitalizations; and 960 deaths annually in the United States. Older adults are particularly at risk for severe outcomes, including prolonged symptoms and death. Long-term care facilities and hospitals are the most common settings for norovirus outbreaks in developed countries. Diagnostic platforms are expanding...
September 12, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28905531/elucidation-of-bacterial-pneumonia-causing-pathogens-in-patients-with-respiratory-viral-infection
#19
Hwa Sik Jung, Byung Ju Kang, Seung Won Ra, Kwang Won Seo, Yangjin Jegal, Jae Bum Jun, Jiwon Jung, Joseph Jeong, Hee Jeong Jeon, Jae Sung Ahn, Taehoon Lee, Jong Joon Ahn
BACKGROUND: Bacterial pneumonia occurring after respiratory viral infection is common. However, the predominant bacterial species causing pneumonia secondary to respiratory viral infections other than influenza remain unknown. The purpose of this study was to know whether the pathogens causing post-viral bacterial pneumonia vary according to the type of respiratory virus. METHODS: Study subjects were 5,298 patients, who underwent multiplex real-time polymerase chain reaction for simultaneous detection of respiratory viruses, among who visited the emergency department or outpatient clinic with respiratory symptoms at Ulsan University Hospital between April 2013 and March 2016...
September 1, 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28903578/mental-health-services-use-trends-in-canadian-veterans-a-population-based-retrospective-cohort-study-in-ontario
#20
Alyson L Mahar, Alice B Aiken, Heidi Cramm, Marlo Whitehead, Patti Groome, Paul Kurdyak
OBJECTIVE: A substantial evidence base in the peer-reviewed literature exists investigating mental illness in the military, but relatively less is documented about mental illness in veterans. This study uses provincial, administrative data to study the use of mental health services by Canadian veterans in Ontario. METHOD: This was a retrospective cohort study of Canadian Armed Forces and Royal Canadian Mounted Police veterans who were released between 1990 and 2013 and resided in Ontario...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
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