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Emergency department review

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https://www.readbyqxmd.com/read/28230446/economic-impact-of-treatment-duration-and-persistence-with-basal-insulin-in-previously-insulin-naive-users
#1
Samaneh Kalirai, Ran Duan, Dongju Liu, Beverly L Reed
BACKGROUND: Although insulin is a well-established therapy that is associated with improved clinical outcomes, adherence and persistence with insulin regimens are poor in patients with type 2 diabetes mellitus (T2DM). Diabetes-related health care costs and the impact of insulin persistence patterns on these health care costs have been previously studied; however, these aspects of insulin therapy have limited data beyond the first year of use and have not been characterized among patients previously naive to basal insulin...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28228342/evaluation-of-the-implementation-of-the-south-african-triage-system-at-an-academic-hospital-in-central-haiti
#2
Shada A Rouhani, Emily Aaronson, Angella Jacques, Sandy Brice, Regan H Marsh
BACKGROUND: Effective triage is an important part of high quality emergency care, yet is frequently lacking in resource-limited settings. The South African Triage Scale (SATS) is designed for these settings and consists of a numeric score (triage early warning score, TEWS) and a list of clinical signs (known as discriminators). Our objective was to evaluate the implementation of SATS at a new teaching hospital in Haiti. METHODS: A random sample of emergency department charts from October 2013 were retrospectively reviewed for the completeness and accuracy of the triage form, correct calculation of the triage score, and final patient disposition...
February 19, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28226416/the-contribution-of-the-emergency-department-to-opioid-pain-reliever-misuse-and-diversion-a-critical-review
#3
REVIEW
Tatyana Lyapustina, Renan Castillo, Elise Omaki, Wendy Shields, Eileen McDonald, Richard Rothman, Andrea Gielen
Prescription opioid pain reliever (OPR) misuse and diversion is an important and growing public health problem in the United States that is responsible for significant morbidity and mortality. Emergency physicians are among the top prescribers of OPRs, yet the relative contribution of emergency department (ED) OPR prescriptions to the overall opioid abuse epidemic remains unclear. This study critically reviews seven peer-reviewed studies that specifically identified the ED as a source of OPRs. Of the OPRs prescribed in the ED, approximately 10% are associated with indicators of inappropriate prescribing, and approximately 42% may ultimately be misused; of the OPRs that are diverted, approximately 10% originate from an ED prescription...
February 22, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28225742/review-of-military-and-civilian-trauma-registries-does-consensus-matter
#4
Thijs T C F van Dongen, Johan de Graaf, Eelco P Huizinga, Howard R Champion, Rigo Hoencamp, Luke P H Leenen
BACKGROUND: Structural collection of data from combat injuries is important to improve provided care and the outcome of (combat) casualties. Trauma registries are used in civilian and military health care systems for systematic administration of injury data. However, these registries often use different methods of data management, compromising international comparison of trauma systems. The aim of this review is to aid in reaching international (coalition-wide) consensus for compatible data collection methods with uniform definitions, which is needed for transnational research and subsequent improvement of medical support organizations...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28224082/clinical-characteristics-of-adult-patients-with-inborn-errors-of-metabolism-in-spain-a-review-of-500-cases-from-university-hospitals
#5
J Pérez-López, L Ceberio-Hualde, J S García-Morillo, J M Grau-Junyent, A Hermida Ameijeiras, M López-Rodríguez, J C Milisenda, M Moltó Abad, M Morales-Conejo, J J Nava Mateos
Patients with inborn errors of metabolism (IEMs) have become an emerging and challenging group in the adult healthcare system whose needs should be known in order to implement appropriate policies and to adapt adult clinical departments. We aimed to analyze the clinical characteristics of adult patients with IEMs who attend the most important Spanish hospitals caring for these conditions. A cohort study was conducted in 500 patients, categorized by metabolic subtype according to pathophysiological classification...
March 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/28223831/cost-analysis-of-facial-injury-treatment-in-two-university-hospitals-in-malaysia-a-prospective-study
#6
Bin Sulong Saperi, Roszalina Ramli, Zafar Ahmed, Amrizal Muhd Nur, Mohd Ismail Ibrahim, Muhd Fazlynizam Rashdi, Rifqah Nordin, Normastura Abd Rahman, Azizah Yusoff, Abd Jabar Nazimi, Roselinda Abdul Rahman, Noorhayati Abdul Razak, Norlen Mohamed
OBJECTIVE: Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. MATERIALS AND METHODS: A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28222988/thirty-day-and-90-day-hospital-readmission-after-outpatient-upper-extremity-hemodialysis-access-creation
#7
Jeffrey J Siracuse, Nishant K Shah, Matthew R Peacock, Georges Tahhan, Jeffrey A Kalish, Denis Rybin, Mohammad H Eslami, Alik Farber
OBJECTIVE: Patients with end-stage renal disease have multiple comorbidities and are at increased risk for postoperative complications and resource utilization. Our goal was to determine the rate and causes of 30-day and 90-day hospital readmissions after the creation of outpatient hemodialysis access. METHODS: We retrospectively reviewed all outpatient upper extremity hemodialysis access creations performed at our medical center from 2008 to 2015. Readmission was defined as any inpatient status admission ≤30 and 90 days...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28221280/the-elusive-diagnosis-of-adolescent-systemic-lupus-erythematosus
#8
Michelino Mancini
Systemic lupus erythematosus (SLE) is an autoimmune disease affecting multiple systems, and its various symptoms are often mistaken for other diseases. This case report describes a 15-year-old girl who presented to the emergency department with complaints of diffuse abdominal pain, facial swelling, joint pain, low-grade fever, and rash. An initial autoimmune process was suspected, and, with prompt referral, a diagnosis of SLE was confirmed. This case report and discussion review the difficulty of diagnosing SLE and the importance of maintaining autoimmune diseases, such as SLE, on an emergency physician's differential...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221279/risk-factors-for-recurrent-intussusception-after-fluoroscopy-guided-air-enema
#9
Jung Heon Kim, Jong Seung Lee, Jeong Min Ryu, Kyoung Soo Lim, Won Young Kim
OBJECTIVES: The aim of this study was to identify risk factors for recurrent intussusception after a successful reduction by fluoroscopy-guided air enema, the time required for recurrence, and the association between delayed reduction and the recurrence. METHODS: Medical records of 479 consecutive children with intussusception who underwent fluoroscopy-guided air enema between January 2004 and September 2014 were reviewed. Recurrent intussusception was defined as a recurrence within 48 hours of a reduction...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28220246/treatment-of-open-fractures-of-the-hand-in-the-emergency-department
#10
Nofar Ben Basat, Raviv Allon, Ahmad Nagmi, Ronit Wollstein
Current guidelines suggest early surgical treatment of open fractures. This rule in open hand fractures is not well supported and may be unpractical. Furthermore, desirable debridement and washout can be obtained in the emergency department (ED). The purpose of this study was to evaluate the relationship between the level of contamination, quality of washout in the emergency room, and the development of infection. Sixty-one patients with open fractures of the hand were retrospectively reviewed for demographic and fracture characteristics, and other complications...
February 20, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28219383/the-alice-springs-hospital-readmission-prevention-project-ashrapp-a-randomised-control-trial
#11
Gabrielle Diplock, James Ward, Simon Stewart, Paul Scuffham, Penny Stewart, Carole Reeve, Lea Davidson, Graeme Maguire
BACKGROUND: Hospitals are frequently faced with high levels of emergency department presentations and demand for inpatient care. An important contributing factor is the subset of patients with complex chronic diseases who have frequent and preventable exacerbations of their chronic diseases. Evidence suggests that some of these hospital readmissions can be prevented with appropriate transitional care. Whilst there is a growing body of evidence for transitional care processes in urban, non-indigenous settings, there is a paucity of information regarding rural and remote settings and, specifically, the indigenous context...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28215446/a-predictive-model-for-diagnosis-of-lower-extremity-cellulitis-a-cross-sectional-study
#12
Adam B Raff, Qing Yu Weng, Jeffrey M Cohen, Nicole Gunasekera, Jean-Phillip Okhovat, Priyanka Vedak, Cara Joyce, Daniela Kroshinsky, Arash Mostaghimi
BACKGROUND: Cellulitis has many clinical mimickers (pseudocellulitis), which leads to frequent misdiagnosis. OBJECTIVE: To create a model for predicting the likelihood of lower extremity cellulitis. METHODS: A cross-sectional review was performed of all patients admitted with a diagnosis of lower extremity cellulitis through the emergency department at a large hospital between 2010 and 2012. Patients discharged with diagnosis of cellulitis were categorized as having cellulitis, while those given an alternative diagnosis were considered to have pseudocellulitis...
February 16, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28215397/clinical-mimics-an-emergency-medicine-focused-review-of%C3%A2-influenza-mimics
#13
Erica Simon, Brit Long, Alex Koyfman
BACKGROUND: Influenza viruses are a significant cause of morbidity and mortality in the United States. Given the wide range of symptoms, emergency physicians must maintain a broad differential diagnosis in the evaluation and treatment of patients presenting with influenza-like illnesses. OBJECTIVE: This review addresses objective and subjective symptoms commonly associated with influenza and discusses important mimics of influenza viruses, while offering a practical approach to their clinical evaluation and treatment...
February 15, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#14
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28214106/multicenter-study-of-cigarette-smoking-among-adults-with-asthma-exacerbations-in-the-emergency-department-2011-2012
#15
Robert A Silverman, Kohei Hasegawa, Daniel J Egan, Kirk A Stiffler, Ashley F Sullivan, Carlos A Camargo
INTRODUCTION: Previous studies demonstrated a high prevalence of cigarette smoking in patients presenting to the emergency department (ED) with acute asthma. Despite the clinical and public health importance, there have been no recent multicenter efforts to characterize this patient population. We aimed to update the prevalence of cigarette smoking among ED patients with asthma exacerbations. METHODS: Multicenter chart review study of 48 EDs across 23 US states...
February 7, 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28214061/open-physeal-fracture-of-the-distal-phalanx-of-the-hallux-case-study-diagnosis-and-management
#16
Brandon Morris, Scott Mullen, Paul Schroeppel, Bryan Vopat
Open physeal fractures of the distal phalanx of the hallux are the lesser described counterpart to the same fracture of the finger, known by its eponym as a "Seymour fracture". Displaced Salter-Harris phalangeal fractures present with a concomitant nailbed or soft tissue injury. Often these fractures occur in the summer months when open-toe footwear can be worn, however, they may occur indoors as well. Frequently, the injury results from direct axial load of the toe, or "stubbing", which causes the fracture and associated soft tissue injury...
February 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28213317/developing-and-assessing-the-acceptability-of-an-epilepsy-first-aid-training-intervention-for-patients-who-visit-uk-emergency-departments-a-multi-method-study-of-patients-and-professionals
#17
Darlene A Snape, Myfanwy Morgan, Leone Ridsdale, Steve Goodacre, Anthony G Marson, Adam J Noble
Epilepsy affects around 1% of the UK population; 40% of whom experience two or more seizures annually. However, most Emergency Department (ED) visits by people with epilepsy (PWE) are clinically unnecessary. Evidence highlights that with correct training, seizures can be safely managed by patients and their families within the community. Arguably therefore, PWE who frequently visit the ED might benefit from a self-management intervention that improves their own and their families' confidence and ability in managing seizures...
February 14, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28212836/point-of-care-ultrasonography-for-evaluation-of-acute-dyspnea-in-the-emergency-department
#18
Maurizio Zanobetti, Margherita Scorpiniti, Chiara Gigli, Peiman Nazerian, Simone Vanni, Francesca Innocenti, Valerio T Stefanone, Caterina Savinelli, Alessandro Coppa, Sofia Bigiarini, Francesca Caldi, Irene Tassinari, Alberto Conti, Stefano Grifoni, Riccardo Pini
BACKGROUND: Acute dyspnea is a common symptom in the emergency department (ED). Standard approach to dyspnea often relies on radiologic and laboratoristic results, causing excessive delay before adequate therapy is started; an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis maintaining an acceptable safety profile. METHODS: Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled...
February 14, 2017: Chest
https://www.readbyqxmd.com/read/28212197/screening-children-for-abuse-and-neglect-a-review-of-the-literature
#19
Mary Hoft, Lisa Haddad
Child abuse and neglect occur in epidemic numbers in the United States and around the world, resulting in major physical and mental health consequences for abused children in the present and future. A vast amount of information is available on the signs and symptoms and short- and long-term consequences of abuse. A limited number of instruments have been empirically developed to screen for child abuse, with most focused on physical abuse in the context of the emergency department, which have been found to be minimally effective and lacking rigor...
January 2017: Journal of Forensic Nursing
https://www.readbyqxmd.com/read/28210835/a-10-year-review-of-cannabis-exposure-in-children-under-3-years-of-age-do-we-need-a-more-global-approach
#20
Isabelle Claudet, Mathilde Le Breton, Camille Bréhin, Nicolas Franchitto
: Pediatricians working in an emergency environment are confronted with children admitted to emergency departments for intoxication on a daily basis. We carried out a retrospective cohort study of children admitted to a pediatric emergency department due to unintentional cannabis exposure over a 10-year period from 2004 to 2014. Twenty-nine children under the age of 3 were admitted with a positive cannabis urine test. Eighty-seven percent of intoxications occurred at the family home. Resin was the main form of ingested cannabis (69%)...
February 16, 2017: European Journal of Pediatrics
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