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Emergency department review

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https://www.readbyqxmd.com/read/29791930/the-pediatric-emergency-care-applied-research-network-registry-a-multicenter-electronic-health-record-registry-of-pediatric-emergency-care
#1
Sara J Deakyne Davies, Robert W Grundmeier, Diego A Campos, Katie L Hayes, Jamie Bell, Evaline A Alessandrini, Lalit Bajaj, James M Chamberlain, Marc H Gorelick, Rene Enriquez, T Charles Casper, Beth Scheid, Marlena Kittick, J Michael Dean, Elizabeth R Alpern
BACKGROUND:  Electronic health record (EHR)-based registries allow for robust data to be derived directly from the patient clinical record and can provide important information about processes of care delivery and patient health outcomes. METHODS:  A data dictionary, and subsequent data model, were developed describing EHR data sources to include all processes of care within the emergency department (ED). ED visit data were deidentified and XML files were created and submitted to a central data coordinating center for inclusion in the registry...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29791300/which-chart-elements-accurately-identify-emergency-department-visits-for-suicidal-ideation-or-behavior
#2
Sarah A Arias, Edwin D Boudreaux, Elizabeth Chen, Ivan Miller, Carlos A Camargo, Richard N Jones, Lisa Uebelacker
OBJECTIVE: In an emergency department (ED) sample, we investigated the concordance between identification of suicide-related visits through standardized comprehensive chart review versus a subset of three specific chart elements: ICD-9-CM codes, free-text presenting complaints, and free-text physician discharge diagnoses. METHODS: Review of medical records for adults (≥18 years) at eight EDs across the United States. RESULTS: A total of 3,776 charts were reviewed...
May 23, 2018: Archives of Suicide Research: Official Journal of the International Academy for Suicide Research
https://www.readbyqxmd.com/read/29791084/the-hospital-readmissions-reduction-program-learning-from-failure-of-a-healthcare-policy
#3
REVIEW
Ankur Gupta, Gregg C Fonarow
Heart failure is the leading cause of readmissions in patients aged ≥65 years with high associated societal and economic costs. The utilization metric of 30-day risk standardized readmission rates (RSRRs) has therefore become a target to reduce healthcare costs. In this review, we discuss in detail the implementation, effectiveness, and unintended consequences of the Hospital Readmissions Reduction Program (HRRP)-the major healthcare policy approach in the U.S. to reduce readmissions by financially penalizing hospitals with higher than average 30-day RSRRs...
May 23, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29789175/macrolide-resistance-in-cases-of-community-acquired-bacterial-pneumonia-in-the-emergency-department
#4
John P Haran, Gregory A Volturo
BACKGROUND: Emergency physicians are under pressure to prescribe an antibiotic early in the treatment course of a patient with community-acquired pneumonia (CAP). Macrolides are recommended first-line empirical therapy for the outpatient treatment of CAP in patients without associated comorbidities; however, resistance rates to macrolides in the United States are on the rise. OBJECTIVE: This review considers macrolide use for CAP in the emergency department by reviewing the microbiologic environment in the United States and whether macrolides can overcome in vitro resistance during actual clinical use...
May 19, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29784512/epidemiology-and-etiology-of-invasive-bacterial-infection-in-infants-%C3%A2-60-days-old-treated-in-emergency-departments
#5
Christopher Woll, Mark I Neuman, Christopher M Pruitt, Marie E Wang, Eugene D Shapiro, Samir S Shah, Russell J McCulloh, Lise E Nigrovic, Sanyukta Desai, Adrienne G DePorre, Rianna C Leazer, Richard D Marble, Fran Balamuth, Elana A Feldman, Laura F Sartori, Whitney L Browning, Paul L Aronson
OBJECTIVES: To help guide empiric treatment of infants ≤60 days old with suspected invasive bacterial infection by describing pathogens and their antimicrobial susceptibilities. STUDY DESIGN: Cross-sectional study of infants ≤60 days old with invasive bacterial infection (bacteremia and/or bacterial meningitis) evaluated in the emergency departments of 11 children's hospitals between July 1, 2011 and June 30, 2016. Each site's microbiology laboratory database or electronic medical record system was queried to identify infants from whom a bacterial pathogen was isolated from either blood or cerebrospinal fluid...
May 18, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29782635/effect-of-home-based-rehabilitation-for-hip-fracture-a-meta-analysis-of-randomized-controlled-trials
#6
Desheng Wu, Xiulan Zhu, Shaowei Zhang
BACKGROUND: Home-based rehabilitation following hip fracture may be beneficial; however, the evidence is controversial. The aim of this systematic review and meta-analysis was to evaluate the effectiveness of home-based rehabilitation in patients with hip fracture. METHODS: PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases were searched systematically. Randomized controlled trials (RCTs) assessing the effect of home-based rehabilitation for patients with hip fracture were included...
May 21, 2018: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29781681/the-management-of-diabetic-ketoacidosis-at-a-rural-regional-hospital-in-kwazulu-natal
#7
Nontobeko F M Ndebele, Mergan Naidoo
BACKGROUND:  Diabetic ketoacidosis (DKA) is a biochemical triad of hyperglycaemia, ketoacidosis and ketonaemia and one of the potentially life-threatening acute metabolic complications of diabetes mellitus. This study aimed at describing the clinical profile of patients presenting with DKA to a busy rural regional hospital in KwaZulu-Natal. METHODS:  A retrospective review of clinical notes of patients presenting with DKA to the Emergency Department was performed over a 10-month period...
March 22, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29779678/spontaneous-perirenal-hemorrhage-wunderlich-syndrome-an-analysis-of-28-cases
#8
Jong Wook Kim, Jung Youn Kim, Sun Tae Ahn, Tae Yong Park, Mi Mi Oh, Du Geon Moon, Hong Seok Park
INTRODUCTION: This study aimed to analyze the characteristics, etiology, and treatment of a series of patients with spontaneous perirenal hemorrhage (Wunderlich syndrome [WS]). METHODS: We retrospectively reviewed the records of 26 patients hospitalized for WS in a tertiary urological center between 2011 and 2018. All patients were evaluated for perirenal hemorrhage observed on computed tomography (CT) in the emergency department. Clinical variables (age, underlying diseases, symptoms, shock, and hospitalization period), laboratory test results, and radiological and pathological results were reviewed...
April 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29779551/emerging-roles-for-peer-providers-in-mental-health-and-substance-use-disorders
#9
Susan A Chapman, Lisel K Blash, Kimberly Mayer, Joanne Spetz
INTRODUCTION: The purpose of this study was to identify and assess states with best practices in peer provider workforce development and employment. A growing body of research demonstrates that peer providers with lived experience contribute positively to the treatment and recovery of individuals with behavioral health needs. Increased employment opportunities have led to policy concerns about training, certification, roles, and reimbursement for peer provider services. METHODS: A case study approach included a national panel of subject matter experts who suggested best practice states...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29778398/antipsychotic-induced-disorders-reported-cases-and-prospective-study-on-muscle-biomarkers-after-high-exposure-to-haloperidol
#10
Abderrezak Khelfi, Mohammed Azzouz, Rania Abtroun, Mohammed Reggabi, Berkahoum Alamir
Antipsychotic drugs are known to induce neuromuscular effects. In this study, we review 13 years (2002-2014) of antipsychotic intoxications reported by the anti-poisoning center of Algiers (APCA). The most recorded symptoms were neuromuscular/muscular disorders, of which haloperidol was the most inducer among all antipsychotics. A prospective study was conducted between December 2012 and January 2017 to evaluate muscle effects generated after intentional or accidental ingestion of haloperidol. Fifty-one patients admitted in different emergency departments in Algiers were included in this study...
May 17, 2018: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/29776828/septic-acute-kidney-injury-patients-in-emergency-department-the-risk-factors-and-its-correlation-to-serum-lactate
#11
Yin-Chou Hsu, Chih-Wei Hsu
BACKGROUND: Acute kidney injury (AKI) is a common complication in septic patients, imposing a heavy burden of illness in terms of morbidity and mortality. Serum lactate is a widely used marker predicting the severity of sepsis. A paucity of research has investigated septic AKI in emergency departments (EDs) and its correlation with initial serum lactate level. This study aimed at identifying risk factors for septic AKI and clarifying the link between initial serum lactate level and septic AKI in ED patients...
May 15, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776823/acute-stent-thrombosis-should-preventative-measures-start-in-the-emergency-department-a-case-report-with-review-of-literature
#12
Getaw Worku Hassen, Soheila Talebi, Basel Alhadad, Alaleh Azhir, Catherine Ann Jennings, Doris Zavaro, Hossein Kalantari
Stent thrombosis is a potentially life threatening condition caused by several factors or a combination factors, such as resistance to platelet agents and type of anticoagulation used as well as stent types. We report a case of acute thrombosis and discuss potential areas of intervention with literature review.
May 7, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776700/assessment-of-the-utility-of-ordering-a-troponin-in-low-and-intermediate-risk-patients-presenting-to-the-emergency-department-with-supraventricular-tachycardia-a-retrospective-chart-review
#13
David Noorvash, Rosemarie Ramos, Linda Hatch, Andrew Muck, Adriana Segura Olson
BACKGROUND: A troponin assay is commonly sent for patients presenting to emergency departments (EDs) with supraventricular tachycardia (SVT). Multiple studies suggest that elevated troponin levels do not predict coronary artery disease in these patients. Patients with elevated troponins are more likely to have additional cardiac testing, which can lead to increased health care costs and unnecessary invasive procedures. OBJECTIVE: Our objective was to evaluate low- to intermediate-risk patients (HEART [history, electrocardiography, age, risk factors and troponin] Score 1-6) presenting to the ED with SVT...
May 15, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#14
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29775117/intravenous-low-dose-ketamine-provides-greater-pain-control-compared-to-fentanyl-in-a-civilian-prehospital-trauma-system-a-propensity-matched-analysis
#15
E Stein Bronsky, Catherine Koola, Alessandro Orlando, Diane Redmond, Cecile D'Huyvetter, Heather Sieracki, Allen Tanner, Ray Fowler, Charles Mains, David Bar-Or
OBJECTIVE: A few studies report comparable analgesic efficacy between low-dose ketamine and opioids such as morphine or fentanyl; however, limited research has explored the safety and effectiveness of intravenous low-dose ketamine as a primary analgesic in a civilian prehospital setting. The objective of this study is to compare pain control between low-dose ketamine and fentanyl when administered intravenously (IV) for the indication of severe pain. METHODS: This was a retrospective, observational review of prehospital adult patients (≥18 years) who presented with severe pain (numeric rating scale, 7-10) and were treated solely with either low-dose ketamine IV or fentanyl IV between January 1, 2014 and December 31, 2016...
May 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29774760/safety-of-nonsteroidal-anti-inflammatory-drugs-in-copperhead-snakebite-patients
#16
Hoang X Pham, Michael E Mullins
INTRODUCTION: Current management guidelines for pit viper envenomations recommend against the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control due to concern for platelet dysfunction and resulting coagulopathy. However, prior research suggests that copperhead snakes generally do not cause coagulopathy and they are responsible for most of the venomous snakebites in the USA. Thus, we compared the occurrences of clinically apparent bleeding and most abnormal laboratory values of coagulation between copperhead envenomation patients who received NSAIDs and those who did not...
May 18, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29774222/asymmetrical-traumatic-bilateral-hip-dislocations-with-hemodynamic-instability-and-an-unstable-pelvic-ring-case-report-and-review-of-literature
#17
Kai Huang, Grey Giddins, Jian-Fang Zhang, Jian-Wei Lu, Jun-Ming Wan, Peng-Li Zhang, Shao-Yu Zhu
Simultaneous anterior and posterior traumatic dislocations of both hips are very rare. Only 33 cases have been previously reported in the English language literature. Although they were all due to high-energy injuries, they were hemodynamically stable and had a stable pelvic ring. We report a unique case of asymmetrical hip dislocations with an unstable pelvic ring and hemodynamic instability. A 40-year-old man was injured in a high-energy motor vehicle accident. He was hemodynamically unstable when he presented in the emergency department...
May 16, 2018: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/29774199/malignant-metastasis-misdiagnosed-as-osteoporotic-compression-fracture-a-case-report
#18
Seul Gi Kim, Chang Il Ju, Hui Sun Wang, Seok Won Kim
In cases of vertebral collapse after a trivial injury in elderly patients with severe osteoporosis, it can be a diagnostic challenge to determine whether the cause is a benign compression fracture or malignant metastasis. A 78-year-old male patient was referred to the emergency department for the evaluation of weakness of the left lower limb. He had undergone percutaneous vertebroplasty four months earlier after being diagnosed with L3 osteoporotic compression fracture. He was treated with foraminotomy at the L3-4 level after being diagnosed with foraminal stenosis two months earlier at a spine clinic...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29773453/a-structured-bowel-management-program-for-patients-with-severe-functional-constipation-can-help-decrease-emergency-department-visits-hospital-admissions-and-healthcare-costs
#19
Carlos A Reck-Burneo, Alejandra Vilanova-Sanchez, Alessandra C Gasior, Alexander J M Dingemans, Victoria A Lane, Robert Dyckes, Onnalisa Nash, Laura Weaver, Tassiana Maloof, Richard J Wood, Sarah Zobell, Michael D Rollins, Marc A Levitt
BACKGROUND: Published health-care costs related to constipation in children in the USA are estimated at $3.9 billion/year. We sought to assess the effect of a bowel management program (BMP) on health-care utilization and costs. METHODS: At two collaborating centers, BMP involves an outpatient week during which a treatment plan is implemented and objective assessment of stool burden is performed with daily radiography. We reviewed all patients with severe functional constipation who participated in the program from March 2011 to June 2015 in center 1 and from April 2014 to April 2016 in center 2...
March 24, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29773309/posttraumatic-stress-disorder-in-patients-who-rule-out-versus-rule-in-for-acute-coronary-syndrome
#20
Ian M Kronish, Donald Edmondson, Nathalie Moise, Bernard P Chang, Ying Wei, David Lopez Veneros, William Whang
OBJECTIVE: Many patients who present to the emergency department (ED) with acute coronary syndromes (ACS) develop posttraumatic stress disorder (PTSD) due to the experience. Less is known about risk for PTSD in patients who rule out for ACS. Our objective was to compare the risk of developing PTSD among patients who rule out versus rule in for ACS. METHODS: We enrolled a consecutive sample of 1000 patients presenting to an emergency department (ED) with symptoms of a probable ACS...
May 14, 2018: General Hospital Psychiatry
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