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https://www.readbyqxmd.com/read/29120005/peripheral-neuropathy-due-to-recreational-use-of-nitrous-oxide-presenting-after-an-ankle-sprain-with-foot-drop
#1
Jackson A Middleton, John A Roffers
A 22-year-old man was referred for orthopedic follow-up after an ankle injury. Initial evaluation in urgent care included radiographs with negative findings. After a delayed presentation, a course of functional treatment was recommended. Subsequently, he developed a deep venous thrombosis and pulmonary emboli. He was found to be factor V Leiden deficient and was fully anticoagulated on warfarin. Later reevaluation revealed a steppage gait and foot drop. Electrodiagnostic studies (ie, electromyography and nerve conduction studies) revealed a severe peripheral polyneuropathy...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29102458/an-electronic-health-record-based-strategy-to-address-child-tobacco-smoke-exposure
#2
E Melinda Mahabee-Gittens, Judith W Dexheimer, Meredith Tabangin, Jane C Khoury, Ashley L Merianos, Lara Stone, Gabe T Meyers, Judith S Gordon
INTRODUCTION: A high proportion of children presenting to pediatric urgent cares are exposed to tobacco smoke. An electronic health record-based clinical decision support system for nurses to facilitate guideline-based tobacco smoke exposure screening and counseling for caregivers who smoke was designed and evaluated. DESIGN: A mixed-methods, 3-month, prospective study that began in November 2015, data were analyzed in June 2016. SETTING/PARTICIPANTS: Five urgent cares that were part of a large children's hospital in Cincinnati, OH...
November 1, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29100662/management-of-partial-fingertip-amputation-in-adults-operative-and-non-operative-treatment
#3
REVIEW
Kunal Sindhu, Steven F DeFroda, Andrew P Harris, Joseph A Gil
BACKGROUND: Hand and finger injuries account for approximately 4.8 million visits to emergency departments each year. These injuries can cause a great deal of distress for both patients and providers and are often initially encountered in urgent care clinics, community hospitals, and level one trauma centers. Tip amputation injuries vary widely in mechanism, ranging from sharp lacerations to crush injuries that present with varying degrees of contamination. The severity of damage to soft tissue, bone, arteries and nerves is dependent upon the mechanism and guides treatment decision-making...
October 31, 2017: Injury
https://www.readbyqxmd.com/read/29083219/smokers-who-are-unmotivated-to-quit-and-have-a-child-with-asthma-are-more-likely-to-quit-with-intensive-motivational-interviewing-and-repeated-biomarker-feedback
#4
Belinda Borrelli, Romano Endrighi, S Katharine Hammond, Shira Dunsiger
OBJECTIVE: Smokers who are not motivated to quit are an important group for intervention, particularly if they have children with asthma. Research indicates that unmotivated smokers are less responsive to intensive interventions, although motivation-by-treatment interactions have not been tested. This study examines whether motivation to quit moderates the effect of a cessation induction intervention. METHOD: Parents had an asthmatic child requiring urgent care, and did not have to want to quit smoking to be eligible for the study...
November 2017: Journal of Consulting and Clinical Psychology
https://www.readbyqxmd.com/read/29074067/a-tick-acquired-red-meat-allergy-a-case-series
#5
Joe Kevin Khoury, Neil Christian Khoury, Deborah Schaefer, Anup Chitnis, Getaw Worku Hassen
Allergic reaction is a common clinical picture in the Emergency Department (ED). Most allergic reactions are from food or drugs. A detailed history is an integral aspect of determining the causative agent of an allergy. Galactose-alpha-1,3-galactose (alpha-gal) allergy is a tick-acquired red meat allergy that causes delayed-onset allergic reaction or anaphylaxis due to molecular mimicry. Alpha-gal allergy may not be widely known as a cause of allergic reactions. Lack of universal awareness of this phenomenon in the ED and Urgent Care setting could lead to misdiagnosis, or delayed diagnosis...
October 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29071666/correction-to-expanding-antimicrobial-stewardship-to-urgent-care-centers-through-a-pharmacist-led-culture-follow-up-program
#6
Lisa E Dumkow, Thomas S Beuschel, Kasey L Brandt
In the original publication, the data labels have been inverted in Figure 1. The corrected figure is given here.
October 25, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29064895/nurse-telephonic-triage-service-for-after-hour-patient-calls-in-neurosurgery
#7
Eric Lee G Escobedo-Wu, Fouzel Dhebar, Griffith Harsh, Gary Steinberg, Alpa Vyas, Laurence Katznelson, Allen L Ho, Arjun V Pendharkar, Eric S Sussman, Nidhi Rohatgi
OBJECTIVE: The aim of this study was to report the utilization and experience of the nurse telephonic triage service for after-hour patient calls in Neurosurgery. BACKGROUND: It is challenging for patients to reach their clinicians after-hours in a timely manner. This may result in worse health outcomes for the patients, or inappropriate utilization of emergency rooms and urgent care facilities. Physicians continue to remain overwhelmed with frequent after-hours calls in addition to other clinical responsibilities while on-call...
October 23, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29061326/walk-in-model-for-ill-care-in-an-urban-academic-pediatric-clinic
#8
Stephen Warrick, John Morehous, Zeina M Samaan, Mona Mansour, Tracy Huentelman, Pamela J Schoettker, Srikant Iyer
OBJECTIVES: Since the Institute of Medicine's 2001 charge to reform healthcare, there has been a focus on the role of the medical home. Access to care in the proper setting and at the proper time is central to healthcare reform. We aimed to increase the volume of patients receiving care for acute illnesses within the medical home rather than the emergency department or urgent care center from 41% to 60%. METHODS: We used quality improvement methods to create a separate non-emergency care stream in a large academic primary care clinic serving 19,000 patients (> 90% Medicaid)...
October 20, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#9
Kira L Gossack-Keenan, April J Kam
BACKGROUND: Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease, characterized by fever, hypotension, and multiorgan system involvement. Toxic shock syndrome has made headlines because of its high associated morbidity and mortality rate in previously healthy young females. Incidence peaked in the early 1980s owing to increased usage of ultra-absorbent tampons. After improved patient education and tampon labeling, the incidence of menstrual TSS has declined. CASE: A previously healthy 14-year-old girl presented to an urgent care center with a 2-day history of fever, erythematous maculopapular rash, vomiting, diarrhea, and malaise...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29032926/message-from-an-urgent-care-prep-provider-for-health-care-professionals
#10
Yeow Chye Ng, Angela Caires, Jack Mayeux
No abstract text is available yet for this article.
September 28, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/28984018/the-impact-of-improving-access-to-primary-care
#11
David P Glass, Michael H Kanter, Steven J Jacobsen, Paul M Minardi
OBJECTIVES: To measure the size and timing of changes in utilization and costs for employees and dependents who had major access barriers to primary care removed, across an 8-year period (2007 to 2014). STUDY DESIGN AND METHODS: Retrospective observational study examining patterns of utilization and costs before and after the implementation of a worksite medical office in 2010. The worksite office offered convenient primary care services with no travel from work, essentially guaranteed same day access, and no co-pay...
October 6, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28976459/urgent-care-transfers-to-an-academic-pediatric-emergency-department
#12
Jennifer L McCarthy, Joel M Clingenpeel, Amy M Perkins, Margaret K Eason
OBJECTIVES: The aim of this study was to investigate the hypothesis that a significant percentage of urgent care center to pediatric ED transfers can be discharged home without emergency department (ED) resource utilization. METHODS: A retrospective chart review was completed for a 6-month period on all patients transferred from urgent care centers. A data collection tool focusing on demographics, diagnoses, reason for transfer, ED resource utilization, ED disposition, and 72-hour ED return was used...
October 2, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28964298/implementation-of-a-perioperative-surgical-home-protocol-for-pediatric-patients-presenting-for-adenoidectomy
#13
Vidya T Raman, Dmitry Tumin, Joshua Uffman, Arlyne K Thung, Candice Burrier, Kris R Jatana, Charles Elmaraghy, Joseph D Tobias
INTRODUCTION: The perioperative surgical home (PSH) is a patient-centered model designed to improve health, streamline the delivery of health care, and reduce the cost of care. Following the national introduction of PSH in 2014 by the ASA, adult hospitals have reported success with this model, with studies validating the benefits of PSH including reducing length of stay, lowering costs, and improving patient satisfaction. METHODS: Eligible patients, ranging in age from 16-35 months of age, were identified by the pre-admission testing (PAT) registered nurses (RNs) and faculty anesthesiologists upon review of the patient history...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28950856/new-zealand-s-emergency-department-target-did-it-reduce-ed-length-of-stay-and-if-so-how-and-when
#14
Tim Tenbensel, Linda Chalmers, Peter Jones, Sarah Appleton-Dyer, Lisa Walton, Shanthi Ameratunga
BACKGROUND: In 2009, the New Zealand government introduced a hospital emergency department (ED) target - 95% of patients seen, treated or discharged within 6 h - in order to alleviate crowding in public hospital EDs. While these targets were largely met by 2012, research suggests that such targets can be met without corresponding overall reductions in ED length-of-stay (LOS). Our research explores whether the NZ ED time target actually reduced ED LOS, and if so, how and when. METHODS: We adopted a mixed-methods approach with integration of data sources...
September 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28948122/a-case-of-persistent-low-back-pain-in-a-young-female-caused-by-a-trauma-induced-schmorl-s-node-in-the-lumbar-spine-five-vertebra
#15
Kurt M Mohty, Divneet Mandair, Brent Munroe, Deborah Baldemor
Physicians are often faced with managing difficult conditions such as chronic lower back pain. Intervertebral disk herniation typically occurs horizontally, leading to impingement of the spinal cord which can potentially cause radicular symptoms or other spinal cord pathologies; however, disk herniations can also occur vertically and extend through the endplate of an adjacent cranial or caudal vertebra: a phenomenon known as a Schmorl's node. Although Schmorl's nodes can be seen in many asymptomatic individuals, they can be a cause of degenerative disk disease and low back pain...
July 21, 2017: Curēus
https://www.readbyqxmd.com/read/28942398/disseminated-herpes-zoster-causing-acute-respiratory-distress-syndrome-in-an-immunocompetent-patient
#16
David M Rudinsky, Kim Jordan
Disseminated cutaneous varicella herpes zoster with visceral involvement is rare and seen almost exclusively in immunocompromised patients. We describe an unusual case of fulminant herpes zoster (HZ) in a healthy, immunocompetent 37-year-old woman. She initially presented to an urgent care centre with a classic HZ rash localised to her neck, and upper respiratory symptoms and was treated with prednisone and cephalexin. Within 1 week, the rash became diffuse and her clinical status rapidly deteriorated with development of severe acute respiratory distress syndrome...
September 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28935282/the-prudent-layperson-s-complicated-and-uncertain-road-to-urgent-care
#17
EDITORIAL
Michael L Callaham
No abstract text is available yet for this article.
September 18, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28935277/comparing-freestanding-emergency-departments-hospital-based-emergency-departments-and-urgent-care-in-texas-apples-oranges-or-lemons
#18
EDITORIAL
Jeremiah D Schuur, Donald M Yealy, Michael L Callaham
No abstract text is available yet for this article.
September 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28933675/using-the-concept-of-hubots-to-understand-the-work-entailed-in-using-digital-technologies-in-healthcare
#19
Catherine Pope, Joanne Turnbull
Purpose The purpose of this paper is to explore the human work entailed in the deployment of digital health care technology. It draws on imagined configurations of computers and machines in fiction and social science to think about the relationship between technology and people, and why this makes implementation of digital technology so difficult. The term hubots is employed as a metaphorical device to examine how machines and humans come together to do the work of healthcare. Design/methodology/approach This paper uses the fictional depiction of hubots to reconceptualise the deployment of a particular technology - a computer decision support system (CDSS) used in emergency and urgent care services...
August 21, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28921610/validation-and-adaptation-of-the-danger-assessment-5-da-5-a-brief-intimate-partner-violence-risk-assessment
#20
Jill Theresa Messing, Jacquelyn C Campbell, Carolyn Snider
AIMS: To assess the predictive validity of the DA-5 with the addition of a strangulation item in evaluating the risk of an intimate partner violence (IPV) victim being nearly killed by an intimate partner. BACKGROUND: The DA-5 was developed as a short form of the Danger Assessment for use in healthcare settings, including emergency and urgent care settings. Analyzing data from a sample of IPV survivors who had called the police for domestic violence, the DA-5 was tested with and without an item on strangulation, a potentially fatal and medically damaging IPV tactic used commonly by dangerous abusers...
September 16, 2017: Journal of Advanced Nursing
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