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https://www.readbyqxmd.com/read/29223132/homelessness-and-emergency-medicine-a-review-of-the-literature
#1
Bisan A Salhi, Melissa H White, Stephen R Pitts, David W Wright
OBJECTIVES: We aimed to synthesize the available evidence on the demographics, prevalence, and clinical characteristics, and evidence-based management of homeless persons in the Emergency Department (ED). Where appropriate, we highlight knowledge gaps and suggest directions for future research. METHODS: We conducted a systematic literature search following databases: PubMed, Ovid, and Google Scholar for articles published between January 1, 1990 and December 31, 2016...
December 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29222336/taking-control-of-alcohol-related-emergency-department-visits
#2
EDITORIAL
Fiona Wisniacki
No abstract text is available yet for this article.
December 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29222301/optimizing-the-care-model-for-an-uncomplicated-acute-pain-episode-in-sickle-cell-disease
#3
REVIEW
Paul Telfer, Banu Kaya
The pathophysiology, clinical presentation, and natural history of acute pain in sickle cell disease are unique and require a disease-centered approach that also applies general principles of acute and chronic pain management. The majority of acute pain episodes are managed at home without the need to access health care. The long-term consequences of poorly treated acute pain include chronic pain, adverse effects of chronic opioid usage, psychological maladjustment, poor quality of life, and excessive health care utilization...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222286/improving-emergency-department-based-care-of-sickle-cell-pain
#4
REVIEW
Jeffrey A Glassberg
Pain is the leading cause of emergency department (ED) visits for individuals living with sickle cell disease (SCD). The care that is delivered in the ED is often cited by patients with SCD as the area of health care in greatest need of improvement. In 2014, the National Heart, Lung, and Blood Institute released guidelines for the care of SCD, including recommendations for the management of acute sickle cell pain in the ED. These guidelines provide a framework to understand the elements of ideal emergency sickle cell pain care; however, they do not provide guidance on barriers and facilitators to achieving these ideals in the complex system of the ED...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222181/fifteen-minute-consultation-an-approach-to-a-child-presenting-to-the-emergency-department-with-acute-psychotic-symptoms
#5
Anil Vasudev Israni, Sumant Kumar, Nahin Hussain
Presentation of a child in the A&E with altered behaviour including psychotic features is not unusual. New-onset psychotic symptoms in children pose a significant diagnostic challenge due to several reasons. First, primary psychotic conditions are uncommon in pre-pubertal children. Second, differentiating between delirium and psychosis can be difficult in children, more so in infants, toddlers and young children. Third, intervening and managing a secondary cause of psychosis can significantly optimise outcome...
December 8, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29221691/characteristics-and-outcomes-of-pediatric-heart-failure-related-emergency-department-visits-in-the-united-states-a-population-based-study
#6
Erika J Mejia, Matthew J O'Connor, Kimberly Y Lin, Lihai Song, Heather Griffis, Christopher E Mascio, Pirouz Shamszad, Aaron Donoghue, Chitra Ravishankar, Robert E Shaddy, Joseph W Rossano
OBJECTIVES: To describe the frequency, characteristics, and outcomes of heart failure-related emergency department (ED) visits in pediatric patients. We aimed to test the hypothesis that these visits are associated with higher admission rates, mortality, and resource utilization. STUDY DESIGN: A retrospective analysis of the Nationwide Emergency Department Sample for 2010 of patients ≤18 years of age was performed to describe ED visits with and without heart failure...
December 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29221681/hypercalcemic-crisis-and-primary-hyperparathyroidism-cause-of-an-unusual-electrical-storm
#7
Tatiana Guimarães, Miguel Nobre Menezes, Diogo Cruz, Sónia do Vale, Armando Bordalo, Arminda Veiga, Fausto J Pinto, Dulce Brito
Hypercalcemia is a known cause of heart rhythm disorders, however its association with ventricular arrhythmias is rare. The authors present a case of a fifty-three years old male patient with a ischemic and ethanolic dilated cardiomyopathy, and severely reduced ejection fraction, carrier of cardiac resynchronization therapy (CRT) with cardioverter defibrillator (ICD), admitted in the emergency department with an electrical storm, with multiple appropriated ICD shocks, refractory to antiarrhythmic therapy. In the etiological investigation was documented severe hypercalcemia secondary to primary hyperparathyroidism undiagnosed until then...
December 5, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29220732/carbon-monoxide-poisoning-in-iran-during-1999-2016-a-systematic-review-and-meta-analysis
#8
REVIEW
Seyed Mohammad Hosseininejad, Hamed Aminiahidashti, Iraj Goli Khatir, Seyed Khosro Ghasempouri, Ali Jabbari, Mahmoud Khandashpour
BACKGROUND: Carbon monoxide (CO) poisoning is a common cause of emergency department (ED) visits worldwide with high levels of morbidity and mortality. No inclusive nationally statistics of CO poisoning in Iran is available. The present review aimed to describe and review the pattern of CO poisoning in Iran. METHODS: The search of Medline, SCOPUS, Cochrane library, Google Scholar, Magiran, IranDoc and SID (Scientific Information Database) yielded only 10 studies discussing the epidemiology of CO poisoning in Iran...
November 28, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29219904/incivility-in-the-emergency-department-implications-for-nurse-leaders
#9
Katy Garth, Dana Todd, Dina Byers, Betty Kuiper
Uncivil behavior leads to low self-esteem, anxiety, sleep disturbance, recurrent nightmares, and depression. This article looks at the perception of incivility among emergency department nurses and the leadership required to implement evidence-based strategies to address this growing problem.
January 2018: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29219885/displaced-clavicle-fractures-in-cyclists-return-to-athletic-activity-after-anteroinferior-plate-fixation
#10
Ven Denise J C van der, Tim K Timmers, Ivo A M J Broeders, Olden G D J van
BACKGROUND: One of the most commonly observed injuries in cycling is fracture of the clavicle. Nevertheless, there is limited literature available on clinical outcomes after plate fixation of clavicle fractures in cyclists, rehabilitation protocols, and the time to return to sports. PURPOSE: The aim of this study was to evaluate the functional outcome, complications, and return to athletic activity at short-term follow-up after surgical repair. STUDY DESIGN: Case series...
December 1, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29219828/improving-care-for-older-patients-in-the-acute-setting-a-qualitative-study-with-healthcare-providers
#11
C Brouwers, H Merten, M Willems, D J Habraken, F W Bloemers, T H Biesheuvel, L S van Galen, P W B Nanayakkara, C Wagner
BACKGROUND: The proportion of older people needing acute care is rapidly growing, thereby posing an increased burden on the acute care chain. The aim of this study is to gain more insight into the obstacles and potential improvement opportunities of the acute care process for older patients arriving at the hospital. METHODS: Semi-structured interviews were conducted to determine the experiences of 18 different primary (i.e. general practitioner, community nurse) and secondary healthcare professionals (i...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29219811/non-targeted-hiv-screening-in-emergency-departments-in-the-netherlands
#12
G P M Luiken, I K Joore, A Taselaar, S C E Schuit, S E Geerlings, A Govers, P P M Rood, J M Prins, B E Nichols, A Verbon, T E M S de Vries-Sluijs
BACKGROUND: In the Netherlands a substantial proportion of newly diagnosed human immunodeficiency virus (HIV) patients present late for care and an estimated 12-34% of people living with HIV are undiagnosed. Linkage to care of these patients is important to decrease HIV transmission and to improve individual patient outcomes. We investigated if non-targeted HIV testing in emergency departments is a useful and cost-effective way to identify these patients. METHODS: In a cross-sectional multicentre study, eligible adult patients who underwent phlebotomy were given an active choice to be additionally tested for HIV...
November 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29219796/-an-infant-with-moaning-breathing
#13
M S M Zijderveld, M Ruige
A girl of 3.5 months old was presented at the emergency department because of sudden onset of moaning breathing. Clinical examination and imaging showed a congenital diaphragmatic hernia.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29218817/impact-of-a-shared-decision-making-intervention-on-healthcare-utilization-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#14
Jason T Schaffer, Erik P Hess, Judd E Hollander, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Jonathan Inselman, Jeph Herrin, Victor M Montori, Nilay D Shah
BACKGROUND: Patients at low risk for acute coronary syndrome (ACS) are frequently admitted for observation and cardiac testing, resulting in substantial burden and cost to the patient and the healthcare system. OBJECTIVES: The purpose of this investigation was to measure the effect of the Chest Pain Choice decision aid (CPC) on overall healthcare utilization as well as utilization of specific services both during the index emergency department visit and in the subsequent 45 days...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29218798/high-risk-clinical-features-for-acute-aortic-dissection-a-case-control-study
#15
Robert Ohle, Justin Um, Omar Anjum, Helena Bleeker, Lindy Luo, George Wells, Jeffrey J Perry
BACKGROUND: Acute aortic dissection (AAD) is a rare condition with a high mortality that is often missed. The objective of our study was to assess the diagnostic accuracy of clinical and laboratory findings for AAD, in confirmed cases of AAD and a low risk control group. METHODS: Historical matched case-control study: participants were adults >18 years old presenting to two tertiary care emergency departments (ED) or one regional cardiac referral center. CASES: new ED or in-hospital diagnosis of non-traumatic AAD confirmed by computed tomography or echocardiography...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29218261/bilateral-occipital-lobe-hemorrhages-presenting-as-denial-of-blindness-in-posterior-reversible-encephalopathy-syndrome-a-rare-combination-of-anton-syndrome-and-encephalopathy
#16
Raja Godasi, Chintan Rupareliya, Pradeep C Bollu
Posterior reversible encephalopathy syndrome (PRES) or reversible posterior leukoencephalopathy (RPL) is an acute neurological syndrome characterized by the development of radiological abnormalities on brain imaging along with clinical manifestations, such as a headache, seizures, encephalopathy, etc. We report the case of a middle-aged male who presented to the emergency department after he woke up with complete blindness and was found to have hemorrhagic PRES. Intracranial hemorrhages were seen in around 15% of patients who presented with this condition...
October 4, 2017: Curēus
https://www.readbyqxmd.com/read/29218111/the-diagnostic-value-of-microrna-4787-5p-and-microrna-4306-in-patients-with-acute-aortic-dissection
#17
Lei Wang, Shijie Zhang, Zhigao Xu, Jingjing Zhang, Li Li, Guoqiang Zhao
Acute aortic dissection (AAD) is a life-threatening cardiovascular disease with the high morbidity and mortality. Imaging modalities are the gold standard for the diagnosis of AAD; however, they are not always available in emergency department. Biomarker-assisted diagnosis is important for the early treatment of AAD. The aim of the present study was to identify potential microRNA (miRNA) biomarkers for AAD. Differentially expressed plasma miRNAs between AAD patients and age-matched healthy volunteers were analyzed by miRNA microarray...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/29217721/insights-from-australians-with-respiratory-disease-living-in-the-community-with-experience-of-self-managing-through-an-emergency-department-near-miss-for-breathlessness-a-strengths-based-qualitative-study
#18
Tim Luckett, Jane Phillips, Miriam Johnson, Maja Garcia, Priyanka Bhattarai, Virginia Carrieri-Kohlman, Anne Hutchinson, Rebecca T Disler, David Currow, Meera Agar, Serra Ivynian, Richard Chye, Phillip J Newton, Patricia M Davidson
OBJECTIVES: Breathlessness 'crises' in people with chronic respiratory conditions are a common precipitant for emergency department (ED) presentations, many of which might be avoided through improved self-management and support. This study sought insights from people with experience of ED 'near misses' where they considered going to the ED but successfully self-managed instead. DESIGN AND METHODS: A qualitative approach was used with a phenomenological orientation...
December 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/29217389/competencies-for-engaging-high-needs-patients-in-primary-care
#19
Michael J Yedidia
BACKGROUND: Patients who heavily utilize hospitals and emergency departments frequently have complex needs requiring services spanning medical, behavioral, and social service sectors. This study identifies essential competencies for caring for high-needs patients and highlights their importance to primary care delivery. METHODS: Transcripts of in-depth interviews with 30 clinical and administrative staff at 23 complex care programs across the United States were analyzed using standard qualitative techniques...
December 4, 2017: Healthcare
https://www.readbyqxmd.com/read/29217362/rethinking-prehospital-stroke-notification-assessing-utility-of-emergency-medical-services-impression-and-cincinnati-prehospital-stroke-scale
#20
Stephen W English, Alejandro A Rabinstein, Jay Mandrekar, James P Klaas
BACKGROUND AND PURPOSE: Although prehospital stroke notification has improved stroke treatment, incorporation of these systems into existing infrastructure has resulted in new challenges. The goal of our study was to design an effective prehospital notification system that allows for early and accurate identification of patients presenting with acute stroke. METHODS: We conducted a retrospective single-center cohort study of patients presenting with suspicion of acute stroke from 2014 to 2015...
December 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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