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"Emergency department" review

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28210363/using-the-electronic-medical-record-to-reduce-unnecessary-ordering-of-coagulation-studies-for-patients-with-chest-pain
#8
Jeremiah S Hinson, Binoy Mistry, Yu-Hsiang Hsieh, Nicholas Risko, David Scordino, Karolina Paziana, Susan Peterson, Rodney Omron
INTRODUCTION: Our goal was to reduce ordering of coagulation studies in the emergency department (ED) that have no added value for patients presenting with chest pain. We hypothesized this could be achieved via implementation of a stopgap measure in the electronic medical record (EMR). METHODS: We used a pre and post quasi-experimental study design to evaluate the impact of an EMR-based intervention on coagulation study ordering for patients with chest pain. A simple interactive prompt was incorporated into the EMR of our ED that required clinicians to indicate whether patients were on anticoagulation therapy prior to completion of orders for coagulation studies...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28210358/american-association-for-emergency-psychiatry-task-force-on-medical-clearance-of-adults-part-i-introduction-review-and-evidence-based-guidelines
#9
REVIEW
Eric L Anderson, Kimberly Nordstrom, Michael P Wilson, Jennifer M Peltzer-Jones, Leslie Zun, Anthony Ng, Michael H Allen
INTRODUCTION: In the United States, the number of patients presenting to the emergency department (ED) for a mental health concern is significant and expected to grow. The breadth of the medical evaluation of these patients is controversial. Attempts have been made to establish a standard evaluation for these patients, but to date no nationally accepted standards exist. A task force of the American Association of Emergency Psychiatry, consisting of physicians from emergency medicine and psychiatry, and a psychologist was convened to form consensus recommendations on the medical evaluation of psychiatric patients presenting to EDs...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209392/transfer-of-do-not-resuscitate-orders-to-the-emergency-department-from-extended-care-facilities
#10
Colleen M McQuown, Jennifer A Frey, Ahmad Amireh, Ali Chaudhary
PURPOSE/OBJECTIVE: With an elderly and chronically ill patient population visiting the emergency department, it is important to know patients' wishes regarding care preferences and advanced directives. Ohio law states DNR orders must be transported with the patient when they leave an extended care facility (ECF). We reviewed the charts of ECF patients to evaluate which patients presenting to the ED had their DNR status recognized by the physician and DNR orders that were made during their hospital stay...
February 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28207971/emergency-department-initiated-home-oxygen-for-bronchiolitis-a-prospective-study-of-community-follow-up-caregiver-satisfaction-and-outcomes
#11
Julia Fuzak Freeman, Sara Deakyne, Lalit Bajaj
OBJECTIVE: Retrospective studies performed have shown home oxygen to be a safe alternative to hospitalization for some patients with bronchiolitis living at high altitudes. We aimed to prospectively describe adverse events, follow-up, duration of home oxygen, factors associated with failure, and caregiver preferences. METHODS: This was a prospective observational study of hypoxemic bronchiolitis patients ages 3-18months who were discharged from a tertiary care pediatric emergency department on home oxygen over 3 winters (2011-2014)...
February 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28205446/intramuscular-ziprasidone-dosing-for-acute-agitation-in-the-pediatric-emergency-department
#12
Tammy Nguyen, Jillian Stanton, Robin Foster
BACKGROUND: Intramuscular (IM) ziprasidone is often used to manage acute agitation. Limited data exist on the pediatric dosing of ziprasidone in the emergency department (ED). OBJECTIVE: To characterize the mg/kg dosing differences between pediatric ED patients who respond to an initial dose of ziprasidone versus patients who do not. METHODS: This was a retrospective, observational study of 5- to 18-year-old patients who were treated with IM ziprasidone in the pediatric ED from 2007 to 2015...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28205213/haemodynamic-changes-to-a-midazolam-fentanyl-rocuronium-protocol-for-pre-hospital-anaesthesia-following-return-of-spontaneous-circulation-after-cardiac-arrest
#13
M Miller, C Groombridge, R Lyon
Following the return of spontaneous circulation after out-of-hospital cardiac arrest, neurological dysfunction, airway or ventilatory compromise can impede transport to early percutaneous coronary intervention, necessitating pre-hospital or emergency department anaesthesia to facilitate this procedure. There are no published reports of the ideal induction agents in these patients. We sought to describe haemodynamic changes associated with induction of anaesthesia using a midazolam (0.1 mg.kg(-1) ), fentanyl (2 μg...
February 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28202206/retrospective-chart-analysis-of-concussion-discharge-instructions-in-the-emergency-department
#14
Allison D Lane, Matthew R Berkman, David Verbunker, Taylor Shekell, Michael Bouska, Lauren Barnett, Allie Keogh, Tomas Nuno, Uwe Stolz, Anna L Waterbrook
BACKGROUND: Recognition and diagnosis of concussion is increasing, but current research shows these patients are discharged from the emergency department (ED) with a wide variability of recommendations and instructions. OBJECTIVE: To assess the adequacy of documentation of discharge instructions given to patients discharged from the ED with concussions. METHODS: This was a quality-improvement study conducted at a University-based Level I trauma center...
February 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28200012/frailty-identification-in-the-emergency-department-a-systematic-review-focussing-on-feasibility
#15
Amy Elliott, Louise Hull, Simon Paul Conroy
No abstract text is available yet for this article.
February 14, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28196949/referral-pathways-for-patients-with-tia-avoiding-hospital-admission-a-scoping-review
#16
Bridie Angela Evans, Khalid Ali, Jenna Bulger, Gary A Ford, Matthew Jones, Chris Moore, Alison Porter, Alan David Pryce, Tom Quinn, Anne C Seagrove, Helen Snooks, Shirley Whitman, Nigel Rees
OBJECTIVE: To identify the features and effects of a pathway for emergency assessment and referral of patients with suspected transient ischaemic attack (TIA) in order to avoid admission to hospital. DESIGN: Scoping review. DATA SOURCES: PubMed, CINAHL Web of Science, Scopus. STUDY SELECTION: Reports of primary research on referral of patients with suspected TIA directly to specialist outpatient services. DATA EXTRACTION: We screened studies for eligibility and extracted data from relevant studies...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#17
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28196831/child-and-adolescent-mental-health-repeat-visits-to-the-emergency-department-a-systematic-review
#18
REVIEW
Stephanie L Leon, Paula Cloutier, Christine Polihronis, Roger Zemek, Amanda S Newton, Clare Gray, Mario Cappelli
OBJECTIVES: Repeat visits represent up to 45% of mental health (MH) presentations to emergency departments (EDs) and are associated with higher health care costs. We aimed to synthesize available literature on predictors of pediatric MH repeat ED visits and differences between repeat visitors and nonrepeat visitors. METHODS: A systematic review was performed using PsycINFO, PubMed, and CINAHL databases. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement checklist...
February 14, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28196622/non-cardiac-chest-pain-a-review-for-the-consultation-liaison-psychiatrist
#19
Kirsti A Campbell, Elizabeth N Madva, Ana C Villegas, Eleanor E Beale, Scott R Beach, Jason H Wasfy, Ariana M Albanese, Jeff C Huffman
BACKGROUND: Patients presenting with chest pain to general practice or emergency providers represent a unique challenge, as the differential is broad and varies widely in acuity. Importantly, most cases of chest pain in both acute and general practice settings are ultimately found to be non-cardiac in origin, and a substantial proportion of patients experiencing non-cardiac chest pain (NCCP) suffer significant disability. In light of emerging evidence that mental health providers can serve a key role in the care of patients with NCCP, knowledge of the differential diagnosis, psychiatric co-morbidities, and therapeutic techniques for NCCP would be of great use to both consultation-liaison (C-L) psychiatrists and other mental health providers...
December 9, 2016: Psychosomatics
https://www.readbyqxmd.com/read/28196608/management-of-major-bleeding-events-in-patients-treated-with-dabigatran-for-nonvalvular-atrial-fibrillation-a-retrospective-multicenter-review
#20
Truman J Milling, Christian Fromm, Michael Ganetsky, Daniel J Pallin, Julie Cong, Adam J Singer
STUDY OBJECTIVE: There are limited data on the clinical presentations and management of dabigatran-associated major bleeding outside the clinical trial setting. The aim of this study is to describe clinical characteristics, interventions, and outcomes in patients with dabigatran-associated major bleeding who present to the emergency department (ED). METHODS: We performed a retrospective observational chart review study of dabigatran-treated patients with nonvalvular atrial fibrillation who presented with acute major bleeding to the ED...
February 3, 2017: Annals of Emergency Medicine
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