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"Emergency department"

Hatim A AlSulaim, R Sterling Haring, Anthony O Asemota, Blair J Smart, Joseph K Canner, Aslam Ejaz, David T Efron, Catherine G Velopulos, Elliott R Haut, Eric B Schneider
OBJECTIVE: To assess the relationship between The International Classification of Diseases, Ninth Revision, Clinical Modification-derived conscious status and mortality rates in trauma centres (TC) vs. non-trauma centres (NTC). METHODS: Patients in the 2006-2011 Nationwide Emergency Department Sample meeting, The Centers for Disease Control and Prevention criteria for traumatic brain injury (TBI), with head/neck Abbreviated Injury Scale (AIS) scores ≥3 were included...
March 21, 2018: Brain Injury: [BI]
Karen-Leigh Edward, Jo-Ann Giandinoto, Tracey J Weiland, Jennie Hutton, Sarah Reel
This study aimed to systematically review evidence to assess the efficacy of non-pharmacological brief interventions in the emergency department to reduce the incidence, severity and impact of acute behavioural disturbances. The literature search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 18 articles were identified as meeting the inclusion criteria and read in full. Following a full read and a consensus discussion, it was subsequently considered the studies chosen had not met the inclusion criteria...
March 22, 2018: British Journal of Nursing: BJN
Daniele Dona, Maura Baraldi, Giulia Brigadoi, Rebecca Lundin, Giorgio Perilongo, Rana F Hamdy, Theoklis Zaoutis, Liviana Da Dalt, Carlo Giaquinto
BACKGROUND: Although Italian pediatric antimicrobial prescription rates are among the highest in Europe, little action has been taken to improve the appropriateness of antimicrobial prescriptions. The primary aim of this study was to assess changes in antibiotic prescription before and after acute otitis media (AOM) and group A streptococcus (GAS) pharyngitis Clinical Pathway (CP) implementation; secondary aims were to compare treatment failures and to assess change in the total antibiotics costs before and after CP implementation...
March 14, 2018: Pediatric Infectious Disease Journal
Mikkel S Andersen, Shulin Lu, Gregory J Lopez, Annmarie T Lassen, Nathan I Shapiro, Ionita C Ghiran
BACKGROUND: We have developed a novel, easily implementable methodology using magnetic levitation to quantify circulating leukocyte size, morphology, and magnetic properties, which may help in rapid, bed side screening for sepsis. OBJECTIVE: Our objectives were 1) to describe our methodological approach to leukocyte assessment; and 2) to perform a pilot investigation to test the ability of magnetic levitation to identify and quantify changes in leukocyte size, shape, density and/or paramagnetic properties in healthy controls and septic patients...
March 20, 2018: Shock
Roxanne C Oriel, Julie Wang
PURPOSE OF REVIEW: The aim of this review is to describe effective management strategies in nursery or school based upon research findings. RECENT FINDINGS: The prevalence of food allergy and number of emergency department visits for food-related anaphylaxis are increasing in children and adolescents. As there is currently no cure, the most effective strategy to decrease allergic reactions is food allergen avoidance. However, allergic reactions are inevitable in both food allergic children as well as in first-time reactors...
March 20, 2018: Current Opinion in Allergy and Clinical Immunology
Nikhil Jain, Frank M Phillips, Tristan Weaver, Safdar N Khan
STUDY DESIGN: Retrospective, economic analysis. OBJECTIVE: To study patient profile associated with preoperative chronic opioid therapy (COT), and study COT as a risk factor for 90-day complications, emergency department (ED) visits, and readmission after primary one- to two-level posterior lumbar fusion (PLF) for degenerative spine disease. We also evaluated associated costs, risk factors, and adverse events related to long-term postoperative opioid use. SUMMARY OF BACKGROUND DATA: Chronic opioid use is associated with poor outcomes and dependence after spine surgery...
March 20, 2018: Spine
Kate R Weinberger, Kipruto Kirwa, Melissa N Eliot, Julia Gold, Helen H Suh, Gregory A Wellenius
BACKGROUND: Climate change is expected to result in more heat-related, but potentially fewer cold-related, emergency department visits and deaths. The net effect of projected changes in temperature on morbidity and mortality remain incompletely understood. We estimated the change in temperature-related morbidity and mortality at two sites in southern New England, USA through the end of the 21st century. METHODS: We used distributed lag Poisson regression models to estimate the present-day associations between daily mean temperature and all-cause emergency department visits and deaths in Rhode Island and in Boston, Massachusetts...
March 16, 2018: Epidemiology
Matt Luther, Fergus Gardiner, Shane Lenson, David Caldicott, Ryan Harris, Ryan Sabet, Mark Malloy, Jo Perkins
Specific Event Identifiers a. Event type: Outdoor music festival. b. Event onset date: December 3, 2016. c. Location of event: Regatta Point, Commonwealth Park. d. Geographical coordinates: Canberra, Australian Capital Territory (ACT), Australia (-35.289002, 149.131957, 600m). e. Dates and times of observation in latitude, longitude, and elevation: December 3, 2016, 11:00-23:00. f. Response type: Event medical support. Abstract Introduction Young adult patrons are vulnerable to risk-taking behavior, including drug taking, at outdoor music festivals...
March 21, 2018: Prehospital and Disaster Medicine
Gino Vissers, Arno Talboom, Ben Gys, Damien Desbuquoit, Niels Komen, Guy Hubens
BACKGROUND: An internal abdominal hernia is defined as the protrusion of a viscus through a mesenteric or peritoneal aperture within the peritoneal cavity. A less common type of internal herniation is a small bowel herniation through a defect in the falciform ligament of the liver. This defect can be congenital or iatrogenic after penetration of the falciform ligament with a trocar during laparoscopic surgery. METHODS: We present a case report illustrating an internal herniation through an iatrogenic defect in the falciform ligament of the liver...
March 21, 2018: Acta Chirurgica Belgica
Majd Tarabichi, Abtin Alvand, Noam Shohat, Karan Goswami, Javad Parvizi
A 62-year-old man who had undergone a primary knee arthroplasty 3 years earlier, presented to the emergency department with an infected prosthesis. He underwent prosthesis resection. All cultures failed to identify the infecting organism. Analysis of the intraoperative samples by next-generation sequencing revealed Streptococcus canis (an organism that resides in the oral cavity of dogs). It was later discovered that the patient had sustained a dog scratch injury several days earlier. The patient reports that his dog had licked the scratch...
March 2018: Arthroplasty Today
Supriya Singh, Kamary Coriolano, Jacob Davidson, Megan Cashin, Timothy Carey, Debra Bartley
Trampolines are widely used by children, but trampoline injuries can be severe and may require hospital care or even surgery. This pilot study examined the effectiveness of an educational intervention on caregivers' perceptions of trampoline use and safety for their children. Primary caregivers were recruited from the orthopedic clinic at the Children's Hospital at our institution in 2015. Caregivers were asked to complete a survey at two time points, initially in clinic and one week post educational intervention...
June 2018: Preventive Medicine Reports
Parisa P Javedani, Gregory S Metzger, Jeremy R Oulton, Srikar Adhikari
Study objectives Although the focused assessment with sonography in trauma (FAST) examination was initially developed for rapid evaluation of trauma patients, the basic skillset required to perform a FAST examination provides valuable information that may alter a non-trauma patient's clinical course. The objective of this study was to determine the utility of the FAST examination in the emergency department management of non-trauma patients. Methods Cases in which the FAST examination was used to direct care in non-trauma patients were retrospectively reviewed...
January 16, 2018: Curēus
Chad M Myeroff, Jeffrey P Anderson, Daniel S Sveom, Julie A Switzer
Background: Known possible consequences of proximal humerus fractures include impaired shoulder function, decreased independence, and increased risk for mortality. The purpose of this report is to describe the survival and independence of elderly patients with fractures of the proximal humerus, treated in our institution, relative to patient characteristics and treatment method. Methods: Retrospective cohort study from 2006 to 2012. Setting: Community-based hospital with level 1 designation...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Maya S Iyer, Raymond D Pitetti, Melissa Vitale
Introduction: Procedural sedation and analgesia (PSA) is used by non-anesthesiologists (NAs) outside of the operating room for several types of procedures. Adverse events during pediatric PSA that pose the most risk to patient safety involve airway compromise. Higher Mallampati scores may indirectly indicate children at risk for airway compromise. Medical governing bodies have proposed guidelines for PSA performed by NAs, but these recommendations rarely suggest using Mallampati scores in pre-PSA evaluations...
March 2018: Western Journal of Emergency Medicine
Kimberly N Means, Amanda E Gentry, Tammy T Nguyen
Introduction: Atrial fibrillation (AF) is a common diagnosis of patients presenting to the emergency department (ED). Intravenous (IV) diltiazem bolus is often the initial drug of choice for acute management of AF with rapid ventricular response (RVR). The route of diltiazem after the initial IV loading dose may influence the disposition of the patient from the ED. However, no studies exist comparing oral (PO) immediate release and IV continuous infusion diltiazem in the emergency setting...
March 2018: Western Journal of Emergency Medicine
Michael Gottlieb, Damali Nakitende, Tina Sundaram, Anthony Serici, Shital Shah, John Bailitz
Introduction: In the emergency department setting, it is essential to rapidly and accurately confirm correct endotracheal tube (ETT) placement. Ultrasound is an increasingly studied modality for identifying ETT location. However, there has been significant variation in techniques between studies, with some using the dynamic technique, while others use a static approach. This study compared the static and dynamic techniques to determine which was more accurate for ETT identification. Methods: We performed this study in a cadaver lab using three different cadavers to represent variations in neck circumference...
March 2018: Western Journal of Emergency Medicine
Lauren R Klein, Marc L Martel, Brian E Driver, Mackenzie Reing, Jon B Cole
Introduction: A subset of frequent users of emergency services are those who use the emergency department (ED) for acute alcohol intoxication. This population and their ED encounters have not been previously described. Methods: This was a retrospective, observational, cohort study of patients presenting to the ED for acute alcohol intoxication between 2012 and 2016. We collected all data from the electronic medical record. Frequent users for alcohol intoxication were defined as those with greater than 20 visits for acute intoxication without additional medical chief complaints in the previous 12 months...
March 2018: Western Journal of Emergency Medicine
Jamie R Santistevan, Brian R Sharp, Azita G Hamedani, Scott Fruhan, Andrew W Lee, Brian W Patterson
Introduction: Opioid prescribing patterns have come under increasing scrutiny with the recent rise in opioid prescriptions, opioid misuse and abuse, and opioid-related adverse events. To date, there have been limited studies on the effect of default tablet quantities as part of emergency department (ED) electronic order entry. Our goal was to evaluate opioid prescribing patterns before and after the removal of a default quantity of 20 tablets from ED electronic order entry. Methods: We performed a retrospective observational study at a single academic, urban ED with 58,000 annual visits...
March 2018: Western Journal of Emergency Medicine
Joshua W Elder, Garrett DePalma, Jesse M Pines
The opioid epidemic is the most significant modern-day, public health crisis. Physicians and lawmakers have developed methods and practices to curb opioid use. This article describes one method, prescription drug monitoring programs (PDMP), through the lens of how to optimize use for emergency departments (ED). EDs have rapidly become a central location to combat opioid abuse and drug diversion. PDMPs can provide emergency physicians with comprehensive prescribing information to improve clinical decisions around opioids...
March 2018: Western Journal of Emergency Medicine
Jeff Lapoint, Seth Meyer, Charles K Yu, Kristi L Koenig, Roneet Lev, Sayone Thihalolipavan, Katherine Staats, Christopher A Kahn
Introduction: Cannabinoid hyperemesis syndrome (CHS) is an entity associated with cannabinoid overuse. CHS typically presents with cyclical vomiting, diffuse abdominal pain, and relief with hot showers. Patients often present to the emergency department (ED) repeatedly and undergo extensive evaluations including laboratory examination, advanced imaging, and in some cases unnecessary procedures. They are exposed to an array of pharmacologic interventions including opioids that not only lack evidence, but may also be harmful...
March 2018: Western Journal of Emergency Medicine
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