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Emergency department review

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https://www.readbyqxmd.com/read/28087889/national-audit-of-the-quality-of-pain-relief-provided-in-emergency-departments-in-aotearoa-new-zealand-the-prized-1-study
#1
(no author information available yet)
OBJECTIVE: Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs. METHODS: The present study is a secondary analysis of data initially collected for the Shorter Stays in Emergency Department Study, using a retrospective chart review of 1685 randomly selected ED presentations (2006-2012) from 26 New Zealand public hospital EDs...
January 13, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28086819/efficacy-safety-and-effectiveness-of-licensed-rotavirus-vaccines-a-systematic-review-and-meta-analysis-for-latin-america-and-the-caribbean
#2
Raúl F Velázquez, Alexandre C Linhares, Sergio Muñoz, Pamela Seron, Pedro Lorca, Rodrigo DeAntonio, Eduardo Ortega-Barria
BACKGROUND: RotaTeq™ (RV5; Merck & Co. Inc., USA) and Rotarix™ (RV1, GlaxoSmithKline, Belgium) vaccines, developed to prevent rotavirus diarrhea in children under five years old, were both introduced into national immunization programs in 2006. As many countries in Latin America and the Caribbean have included either RV5 or RV1 in their routine childhood vaccination programs, we conducted a systematic review and meta-analysis to analyze efficacy, safety and effectiveness data from the region...
January 13, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28081211/development-and-validation-of-a-clinical-prediction-rule-for-bacteremia-among-maintenance-hemodialysis-patients-in-outpatient-settings
#3
Sho Sasaki, Takeshi Hasegawa, Hiroo Kawarazaki, Atsushi Nomura, Daisuke Uchida, Takahiro Imaizumi, Masahide Furusho, Hiroki Nishiwaki, Shingo Fukuma, Yugo Shibagaki, Shunichi Fukuhara
BACKGROUND: To our knowledge, no reliable clinical prediction rule (CPR) for identifying bacteremia in hemodialysis (HD) patients has been established. The aim of this study was to develop a CPR for bacteremia in maintenance HD patients visiting the outpatient department. METHODS: This multicenter cohort study involved consecutive maintenance HD patients who visited the outpatient clinic or emergency room of seven Japanese institutions between August 2011 and July 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28079562/can-an-age-adjusted-d-dimer-level-be-adopted-in-managing-venous-thromboembolism-in-the-emergency-department-a-retrospective-cohort-study
#4
Tom Jaconelli, Mazin Eragat, Steven Crane
INTRODUCTION: Patients suspected of having venous thromboembolism (VTE), with a low pretest probability, undergo D-dimer testing. A negative D-dimer, in a low-risk patient rules out VTE with a high degree of certainty because of its high sensitivity. It is, however, a poorly specific test, and the absolute value increases with age. The aim of this study was to establish whether an age-adjusted D-dimer could be safely used instead of a standard cut-off level in low-risk patients over the age of 50 years...
January 10, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28078763/development-and-feasibility-testing-of-the-pediatric-emergency-discharge-interaction-coding-scheme
#5
Janet A Curran, Alexandra Taylor, Jill Chorney, Stephen Porter, Andrea Murphy, Shannon MacPhee, Andrea Bishop, Rebecca Haworth
BACKGROUND: Discharge communication is an important aspect of high-quality emergency care. This study addresses the gap in knowledge on how to describe discharge communication in a paediatric emergency department (ED). OBJECTIVE: The objective of this feasibility study was to develop and test a coding scheme to characterize discharge communication between health-care providers (HCPs) and caregivers who visit the ED with their children. DESIGN: The Pediatric Emergency Discharge Interaction Coding Scheme (PEDICS) and coding manual were developed following a review of the literature and an iterative refinement process involving HCP observations, inter-rater assessments and team consensus...
January 12, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28078188/new-innovations-for-deep-partial-thickness-burn-treatment-with-acell-matristem-matrix
#6
Justine S Kim, Alexander J Kaminsky, J Blair Summitt, Wesley P Thayer
Objective: Burn injuries remain a large financial burden on the healthcare system. According to CDC statistics (2010), nonfatal and hospitalized burns in the U.S. cost $1.8 billion for an annual incidence of ∼486,000 cases. To date, no technique proves to be the ideal therapy of deep partial-thickness burns. In this study, we review a trial usage of ACell (ACell, Inc.) wound matrix on deep partial-thickness burns. Approach: Burn patients were admitted through the Vanderbilt Emergency Department. Three were consented to receive ACell therapy...
December 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/28076656/combined-inhaled-beta-agonist-and-anticholinergic-agents-for-emergency-management-in-adults-with-asthma
#7
REVIEW
Scott W Kirkland, Christine Vandenberghe, Britt Voaklander, Taylor Nikel, Sandra Campbell, Brian H Rowe
BACKGROUND: Inhaled short-acting anticholinergics (SAAC) and short-acting beta₂-agonists (SABA) are effective therapies for adult patients with acute asthma who present to the emergency department (ED). It is unclear, however, whether the combination of SAAC and SABA treatment is more effective in reducing hospitalisations compared to treatment with SABA alone. OBJECTIVES: To conduct an up-to-date systematic search and meta-analysis on the effectiveness of combined inhaled therapy (SAAC + SABA agents) vs...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28074563/a-time-and-motion-study-of-screening-brief-intervention-and-referral-to-treatment-implementation-in-health-care-settings
#8
Alexander J Cowell, William N Dowd, Justin Landwehr, Carolina Barbosa, Jeremy W Bray
AIMS: Screening and brief intervention for harmful substance use in medical settings is being promoted heavily in the United States. To justify service provision fiscally, the field needs accurate estimates of the number and type of staff required to provide services, and thus the time taken to perform activities used to deliver services. This study analyzed the time spent in activities for the component services of the substance misuse Screening, Brief Intervention and Referral to Treatment (SBIRT) program implemented in emergency departments, in-patient units and ambulatory clinics...
February 2017: Addiction
https://www.readbyqxmd.com/read/28074458/endovascular-treatment-of-peripheral-and-visceral-arterial-injuries-in-patients-with-acute-trauma
#9
Aysun Erbahçeci Salık, Filiz Saçan İslim, Barbaros Erhan Çil
BACKGROUND: The present study is an evaluation of the efficacy of endovascular treatment in emergency setting for patients with acute peripheral and visceral arterial injury secondary to penetrating or blunt trauma. METHODS: Twelve patients (11 men) aged 35.8±11.3 years (range: 18-56 years) with penetrating or blunt trauma who underwent endovascular treatment in our department between March 2010 and June 2014 for peripheral and visceral arterial injury were retrospectively reviewed...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28073795/in-patients-presenting-to-the-emergency-department-with-skin-and-soft-tissue-infections-what-is-the-diagnostic-accuracy-of-point-of-care-ultrasonography-for-the-diagnosis-of-abscess-compared-to-the-current-standard-of-care-a-systematic-review-and-meta-analysis
#10
David Barbic, Jordan Chenkin, Dennis D Cho, Tomislav Jelic, Frank X Scheuermeyer
OBJECTIVES: The primary objective of this systematic review was to determine the accuracy of point-of-care ultrasonography (POCUS) in diagnosing abscess in emergency department (ED) patients with skin and soft tissue infections (SSTI). The secondary objective was the accuracy of POCUS in the paediatric population subgroup. SETTING: Prospective studies set in emergency departments. PARTICIPANTS: Emergency department patients (adult and paediatric) presenting with SSTI and suspected abscess...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28073653/rare-lateral-dislocation-of-the-first-metatarsophalangeal-joint-a-case-report-and-review-of-the-literature
#11
Amir Reza Vosoughi, Pascal F Rippstein
Traumatic lateral dislocations of the first metatarsophalangeal (MTP) joint are very rare. A 44-year-old male was referred after a motorcycle to car accident because of an exposed head of the left first metatarsal through a laceration on the medial aspect of the first MTP joint. Radiographs showed a lateral dislocation of the first MTP joint, with concomitant fractures of the neck of the second metatarsal and the base of the third and fourth metatarsal bones. The dislocation was reduced in the emergency department with the patient under conscious sedation after thorough irrigation...
January 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28072893/a-pediatric-application-of-the-strac-regional-hospital-trauma-registry-database-pediatric-trauma-deaths-in-south-central-texas-during-2004-2013
#12
Michelle Buehner, Jay Aden, Mathew Borgman, Preston Love, Brandi Wright, Mary Edwards
The purpose of this study was to define the demographics of pediatric traumatic injuries and to understand the predictive value of injury type, prehospital, and emergency department (ED) data regarding the mortality of pediatric trauma patients (<14 years of age) in South Central Texas. We report a retrospective review of pediatric trauma patients presenting to Trauma Service Area P in South Central Texas during 2004-2013. The primary outcome was mortality; secondary outcomes were ventilator days, hospital days, and intensive care unit stay...
January 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28072670/instruments-to-identify-commercially-sexually-exploited-children-feasibility-of-use-in-an-emergency-department-setting
#13
Stephanie Armstrong
OBJECTIVE: This review examines the screening instruments that are in existence today to identify commercially sexually exploited children. The instruments are compared and evaluated for their feasibility of use in an emergency department setting. METHODS: Four electronic databases were searched to identify screening instruments that assessed solely for commercial sexual exploitation. Search terms included "commercially sexually exploited children," "CSEC," "domestic minor sex trafficking," "DMST," "juvenile sex trafficking," and "JST...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072669/swimming-pool-electrical-injuries-steps-toward-prevention
#14
Jun Tashiro, Cathy A Burnweit
OBJECTIVE: Electrical injuries in swimming pools are an important pediatric public health concern. We sought to (1) improve our understanding of the clinical presentation and outcomes following and (2) describe the epidemiology of swimming pool electrical injuries in the United States. METHODS: We reviewed 4 cases of pediatric (<18 y old) electrical injury from a single, urban level 1 pediatric trauma center. We also queried the National Electronic Injury Surveillance System (NEISS) for emergency department visits due to electrical injury associated with swimming pools, occurring between 1991 and 2013...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072668/genital-and-extragenital-gonorrhea-and-chlamydia-in-children-and-adolescents-evaluated-for-sexual-abuse
#15
Nancy D Kellogg, John D Melville, James L Lukefahr, Shalon M Nienow, Edward L Russell
OBJECTIVE: The aim of this study was to describe the use of a nucleic acid amplification test in detecting genital and extragenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in children and adolescents assessed for sexual abuse/assault. METHODS: The charts of children aged 0 to 17 years, consecutively evaluated for sexual victimization, in emergency department and outpatient settings were reviewed. Data extracted included age, sex, type of sexual contact, anogenital findings, previous sexual contact, toxicology results, and sites tested for NG and CT...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072666/outcomes-from-referrals-and-unscheduled-visits-from-community-emergency-departments-to-a-regional-pediatric-emergency-department-in-canada
#16
Ethan Reiner, Ardalan Ahmadi, Eric Grafstein, Quynh Doan
OBJECTIVES: Existing pediatric literature describing repeat visits to the emergency department (ED) for the same medical complaint has yet to report on patient flow patterns from general EDs (GEDs) to a pediatric ED (PED). We sought to characterize the population of patients who are treated in a GED and subsequently present to a PED for further care. METHODS: We conducted a retrospective cohort study reviewing all pediatric visits (age < 17 y) at 5 GEDs in Vancouver...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28069882/linea-arcuate-hernia-disguised-as-pfannenstiel-incision-s-hernia-a-case-report-and-a-systemic-literature-review
#17
Veronica Vincelli, Cesare Marazzi, Alberto Posabella, Aurore Steiger
We report a rare case of a 46-year-old woman 2 weeks after a cesarean section with Pfannenstiel incision, who presented at the Emergency Department with a significant abdominal pain accompanied by two episodes of vomiting. After that a clinical examination and an abdominal computed tomography scan were completed, a visceral herniation through Pfannenstiel incision was suspected. The indication of surgical exploration was clear. Finally, the laparotomy revealed a linea arcuata hernia with a hernia of the small intestine...
January 8, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28067687/a-case-of-toxic-breast-feeding
#18
Megan L Schultz, Mark Kostic, Sigmund Kharasch
Opiates are frequently prescribed postpartum for pain relief after cesarean delivery, episiotomies, and headaches. It is estimated that greater than 30% of breast-feeding mothers in the United States are prescribed opiates for pain relief associated with childbirth. Many opiates are readily transferred to human milk, although life-threatening events are rare. We report a 6-day-old breast-feeding infant whose mother was taking hydromorphone for pain relief from a cesarean delivery and whose clinical course was suggestive of opiate toxicity...
January 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28063864/the-end-of-life-experience-of-pediatric-heart-transplant-recipients
#19
Seth A Hollander, John Dykes, Sharon Chen, Lynsey Barkoff, Barbara Sourkes, Harvey Cohen, David N Rosenthal, Daniel Bernstein, Beth D Kaufman
CONTEXT: Despite advances in therapies, many pediatric heart transplant (Htx) recipients will die prematurely. We characterized the circumstances surrounding death in this cohort, including location of death and interventions performed in the final 24 hours. METHODS: We reviewed all patients who underwent Htx at Lucile Packard Children's Hospital, Stanford, survived hospital discharge, and subsequently died between 7/19/2007-9/13/2015. The primary outcome studied was location of death, characterized as inpatient, outpatient, or emergency department (ED)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28063084/methodological-issues-surrounding-the-use-of-baseline-health-related-quality-of-life-data-to-inform-trial-based-economic-evaluations-of-interventions-within-emergency-and-critical-care-settings-a-systematic-literature-review
#20
REVIEW
Melina Dritsaki, Felix Achana, James Mason, Stavros Petrou
BACKGROUND: Trial-based cost-utility analyses require health-related quality of life data that generate utility values in order to express health outcomes in terms of quality-adjusted life years (QALYs). Assessments of baseline health-related quality of life are problematic where trial participants are incapacitated or critically ill at the time of randomisation. This review aims to identify and critique methods for handling non-availability of baseline health-related quality of life data in trial-based cost-utility analyses within emergency and critical illness settings...
January 6, 2017: PharmacoEconomics
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