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"Emergency department"

Sathyaseelan Subramaniam, Jennifer H Chao
Sickle cell disease is a chronic hematologic disease with a variety of acute, and often recurring, complications. Vaso-occlusive crisis, a unique but common presentation in sickle cell disease, can be challenging to manage. Acute chest syndrome is the leading cause of death in patients with sickle cell disease, occurring in more than half of patients who are hospitalized with a vaso-occlusive crisis. Uncommon diagnoses in children, such as stroke, priapism, and transient red cell aplasia, occur more frequently in patients with sickle cell disease and necessitate a degree of familiarity with the disease process and its management...
November 2016: Pediatric Emergency Medicine Practice
Zuzana Novak, Mary Aglipay, Nick Barrowman, Keith O Yeates, Miriam H Beauchamp, Jocelyn Gravel, Stephen B Freedman, Isabelle Gagnon, Gerard Gioia, Kathy Boutis, Emma Burns, Andrée-Anne Ledoux, Martin H Osmond, Roger L Zemek
Importance: Persistent postconcussion symptoms (PPCS) pose long-term challenges and can negatively affect patients' health-related quality of life (HRQoL). To date, no large comprehensive study has addressed the association between PPCS and HRQoL. Objectives: To determine the association between HRQoL and PPCS at 4 weeks after concussion and assess the degree of impairment of HRQoL in the subsequent 12 weeks. Design, Setting, and Participants: In a prospective, multicenter cohort study (Predicting Persistent Postconcussive Problems in Pediatrics [5P]) from August 14, 2013, to September 30, 2014, children aged 5 to 18 years who presented to the emergency department within 48 hours after head injury and were considered to have an acute concussion were enrolled across 9 pediatric emergency departments within the Pediatric Emergency Research Canada Network...
October 24, 2016: JAMA Pediatrics
John Ashurst, Shane R Sergent, Benjamin R Sergent
Hypokalemia and hyperkalemia are the most common electrolyte disorders managed in the emergency department. The diagnosis of these potentially life-threatening disorders is challenging due to the often vague symptomatology a patient may express, and treatment options may be based upon very little data due to the time it may take for laboratory values to return. This review examines the most current evidence with regard to the pathophysiology, diagnosis, and management of potassium disorders. In this review, classic paradigms, such as the use of sodium polystyrene and the routine measurement of serum magnesium, are tested, and an algorithm for the treatment of potassium disorders is discussed...
November 2016: Emergency Medicine Practice
Tonya Deen, Theresa Terna, Elizabeth Kim, Brian Leahy, Wende Fedder
PURPOSE: The purpose of this study was to describe the impact a Stroke Nurse Navigation Program has on concurrent chart reviews and patient compliance post discharge. DESIGN: Phase I: Concurrent chart review of The Joint Commission Primary Stroke Center core measures for ischemic stroke patients. Phase II: Longitudinal study of 100 ischemic stroke patients discharged to home. METHODS: Telephone surveys were conducted at prescribed intervals posthospital discharge (Phase II)...
October 24, 2016: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
E M M Hoytema van Konijnenburg, J H van der Lee, A H Teeuw, R Lindeboom, S N Brilleslijper-Kater, T Sieswerda-Hoogendoorn, J B van Goudoever, R J L Lindauer
BACKGROUND: High levels of maltreatment are found in children who are identified because their parents visit the emergency department due to partner violence, substance abuse or suicide attempt. However, it is unknown if these children experience psychosocial problems. This study aims to assess their levels of post-traumatic stress, anxiety, depression, behavioural problems and health-related quality of life. METHODS: A cross-sectional study was conducted in six hospitals...
October 23, 2016: Child: Care, Health and Development
Nancy M Dunbar, Nicholas J Olson, Zbigniew M Szczepiorkowski, Eric D Martin, Ryan M Tysarcyk, Darrell J Triulzi, Louis H Alarcon, Mark H Yazer
BACKGROUND: The purpose of massive transfusion protocols (MTPs) is to provide large quantities of blood products rapidly to exsanguinating patients. The expected rates of blood product transfusion and wastage in this setting have not been defined. This study was undertaken to assess the transfusion and wastage rates for bleeding patients requiring emergency issue of blood components at three American Level I trauma centers. STUDY DESIGN AND METHODS: Three hospitals participated, all of which are Level I trauma centers that have MTPs in place where uncrossmatched red blood cells (RBCs) can be ordered with or without platelets (PLTs), plasma, and cryoprecipitate...
October 23, 2016: Transfusion
Robert Jong, Eugene Krustev, Aron Heroux, Adam Dubrowski
Smoke inhalation-associated lung injuries (SI-ALI) present multiple challenges to the rural emergency department, and they require timely and appropriate management to prevent significant mortality and morbidity. In this report, we outline an adaptable simulation of an SI-ALI patient that is designed for use in a rural emergency department. The aim of this simulation is to better equip clinicians and emergency department staff who may encounter SI-ALI in rural settings. The case is suitable for resident doctors and emergency department staff...
September 15, 2016: Curēus
Ann E Vandenberg, Melissa Stevens, Katharina V Echt, S Nicole Hastings, James Powers, Alayne Markland, Ula Hwang, William Hung, Stephanie Belbis, Camille P Vaughan
The Enhancing Quality of Prescribing Practices for Older Veterans Discharged From the Emergency Department (EQUiPPED) program aimed to reduce potentially inappropriate medication prescribing to older adults at 5 VAMCs.
April 2016: Federal Practitioner: for the Health Care Professionals of the VA, DoD, and PHS
Ian S Metzler, Rebecca Smith-Bindman, Michelle Moghadassi, Ralph C Wang, Marshall L Stoller, Thomas Chi
PURPOSE: In the emergency department (ED), ultrasonography (US) is emerging as an alternative to computed tomography (CT) for diagnosing patients with nephrolithiasis. In this multi-center randomized clinical trial, we examined rates of urologic referral and intervention to elucidate if initial diagnostic imaging modality affected management of nephrolithiasis. MATERIALS AND METHODS: Patients ages 18-76 years who presented to the ED with renal colic across 15 diverse treatment centers were randomized to receive either an abdominal US by an ED physician, a radiologist or an abdominal CT...
October 20, 2016: Journal of Urology
Kimberly A Kilfoyle, Roxanne Vrees, Christina A Raker, Kristen A Matteson
BACKGROUND: Emergency department use is common among pregnant women. Non-urgent emergency department use may represent care that would be better provided by an established obstetric provider in an ambulatory setting. OBJECTIVE: To identify socio-demographic factors associated with non-urgent emergency department use in pregnancy. STUDY DESIGN: This is a cross-sectional study of women recruited during their postpartum hospitalization. Data regarding prenatal care and emergency department visits was collected from medical records; participants completed a survey with questions regarding demographics and emergency department use...
October 20, 2016: American Journal of Obstetrics and Gynecology
Melissa K James, Sebastian D Schubl, Michael P Francois, Geoffrey K Doughlin, Shi-Wen Lee
STUDY OBJECTIVE: The aim of this study is to determine if the introduction of a pan-scan protocol during the initial assessment for blunt trauma activations would affect missed injuries, incidental findings, treatment times, radiation exposure, and cost. METHODS: A 6-month prospective study was performed on patients with blunt trauma at a level 1 trauma center. During the last 3 months of the study, a pan-scan protocol was introduced to the trauma assessment. Categorical data were analyzed by Fisher exact test and continuous data were analyzed by Mann-Whitney nonparametric test...
September 22, 2016: American Journal of Emergency Medicine
Ranee Solomon, Karen Jurica
: Patients and practitioners rate the insertion of a nasogastric tube as one of the most painful and distressing procedures performed. Research supports using lidocaine and a nasal vasoconstrictor to significantly decrease patient discomfort. The recommended medications were not being used routinely in a large urban emergency department. METHODS: We identified departmental barriers using a nurse survey and physician interviews. We educated the nursing and physician staff about the comfort medications for nasogastric tube insertion recommended in the literature...
October 20, 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Judith Shindul-Rothschild, Catherine Y Read, Kelly D Stamp, Jane Flanagan
: In the 2014 Emergency Department Benchmarking Alliance Summit, for the first time, participants recommended tracking nursing and advanced practice nurse hours. Performance data from the Centers for Medicare and Medicaid Services provides an opportunity to analyze factors associated with delays in emergency care. The purpose of this study was to investigate hospital characteristics associated with time to a diagnostic evaluation in 67 Massachusetts emergency departments from 2013 to 2014...
October 20, 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Victoria A Morgan, Joanna Jhant, Justin Ellison, Armando Varela, Will Carpenter
No abstract text is available yet for this article.
October 20, 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Martin J Churcher, Chris Florkowski, Sarah Carr, Lesney Stuart, Peter M George
No abstract text is available yet for this article.
February 2016: Pathology
C Lincoln, J Crilly, P Scuffham, J Timms, K Becker, N van Buuren, A Fisher, D Murphy, D Green
No abstract text is available yet for this article.
February 2016: Pathology
Rita Vale Rodrigues, Filipa Santos, João Pereira da Silva, Inês Francisco, Isabel Claro, Cristina Albuquerque, Maria Manuel Lemos, Manuel Limbert, António Dias Pereira
Multiple gastrointestinal stromal tumors (GISTs) caused by germline KIT gene mutations are an extremely rare autosomal dominant disorder. We report a case of a 21-year-old woman who presented to the emergency department with a 2-week history of asthenia, palpitations and upper gastrointestinal bleeding. After further clinical evaluation one gastric and two small bowel GISTs were diagnosed, which were surgically resected after neoadjuvant therapy with Imatinib. Diffuse hyperplasia of the interstitial cells of Cajal was also seen in the background gastric and small intestinal walls...
October 22, 2016: Familial Cancer
Sharukh Lokhandwala, Lars W Andersen, Sunil Nair, Parth Patel, Michael N Cocchi, Michael W Donnino
PURPOSE: Lactate reduction, a common method of risk stratification, has been variably defined. Among patients with an initial lactate >4mmol/L, we compared mortality prediction between a subsequent lactate ≥4mmol/L to a <10% and <20% decrease between initial and subsequent lactate values. MATERIALS AND METHODS: We performed a single-center retrospective study of patients presenting to the emergency department with an initial lactate ≥4mmol/L and suspected infection...
October 6, 2016: Journal of Critical Care
Mutimbwa Anaene, Kenneth Soyemi, Rachel Caskey
OBJECTIVES: The purpose of this study was to measure the prevalence of Chlamydia Trachomatis (CT) and Neisserria Gonorrhea (GC) and the rates and factors associated with their over-treatment (OT) and under-treatment (UT). METHODS: A retrospective chart review was performed on patients aged 13-to-24 years who were screened for GC/CT in the ED of a public hospital and were screened for GC/CT. Descriptive statistics were obtained for all variables and a multivariate log binomial regression was performed to ascertain the factors associated with OT and UT...
October 19, 2016: International Journal of Infectious Diseases: IJID
Ram A Pathak, Gregory A Broderick, Todd C Igel, Steven P Petrou, Paul R Young, Michael J Wehle, Michael G Heckman, Nancy N Diehl, Emily R Vargas, Kandarp Shah, David D Thiel
OBJECTIVE: To compare the frequency of postoperative encounters in the 30-day and 90-day postoperative periods for various bladder outlet obstruction surgical therapies. METHODS: All patients who underwent transurethral resection of the prostate (TURP), GreenLight laser photovaporization of the prostate (GL-PVP) (American Medical Systems Inc.), and holmium laser enucleation of the prostate (HoLEP) from January 1(st), 2012 through December 31(st), 2014 were followed for 6 months postoperatively...
October 19, 2016: Urology
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