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https://www.readbyqxmd.com/read/29779180/the-impact-of-an-adolescent-depressive-disorders-clinical-pathway-on-healthcare-utilization
#1
Brooke Lifland, Davene R Wright, Rita Mangione-Smith, Arti D Desai
Clinical pathways are known to improve the value of health care in medical and surgical settings but have been rarely studied in the psychiatric setting. This study examined the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway and length of stay (LOS), cost, and readmissions. Patients in the high adherence category had significantly longer LOS and higher costs compared to the low adherence category. There was no difference in the odds of 30-day emergency department return visits or readmissions...
May 19, 2018: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/29778609/emergency-department-utilization-after-lower-extremity-bypass-for-critical-limb-ischemia
#2
Vangelina Osteguin, Thomas W Cheng, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Stephen J Raulli, Jeffrey J Siracuse
OBJECTIVES: Patients with critical limb ischemia (CLI) utilize hospital resources at high rates. One major driver for resource utilization are Emergency Department (ED) visits. Our goal was to assess perioperative ED visits after lower extremity bypass (LEB) for CLI. METHODS: All patients undergoing LEB for CLI from 2008 to 2017 at our institution were analyzed. Emergency department visits and details of the visit within 30 and 90 days of discharge from index admission were recorded...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29778398/antipsychotic-induced-disorders-reported-cases-and-prospective-study-on-muscle-biomarkers-after-high-exposure-to-haloperidol
#3
Abderrezak Khelfi, Mohammed Azzouz, Rania Abtroun, Mohammed Reggabi, Berkahoum Alamir
Antipsychotic drugs are known to induce neuromuscular effects. In this study, we review 13 years (2002-2014) of antipsychotic intoxications reported by the anti-poisoning center of Algiers (APCA). The most recorded symptoms were neuromuscular/muscular disorders, of which haloperidol was the most inducer among all antipsychotics. A prospective study was conducted between December 2012 and January 2017 to evaluate muscle effects generated after intentional or accidental ingestion of haloperidol. Fifty-one patients admitted in different emergency departments in Algiers were included in this study...
May 17, 2018: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/29778034/early-discharge-of-patients-with-pulmonary-embolism-in-daily-clinical-practice-a-prospective-observational-study-comparing-clinical-gestalt-and-clinical-rules
#4
Simone Vanni, Cecilia Becattini, Peiman Nazerian, Carlo Bova, Valerio Teodoro Stefanone, Ludovica Anna Cimini, Gabriele Viviani, Cosimo Caviglioli, Michela Sanna, Giuseppe Pepe, Stefano Grifoni
OBJECTIVES: To estimate the efficiency and safety of clinicians' gestalt in the identification of patients with pulmonary embolism (PE) candidates for early discharge and to compare the efficiency and safety of clinical gestalt with that of the Pulmonary Embolism Severity Index (PESI), the simplified PESI (sPESI) and the Hestia criteria (HC). METHODS: Consecutive adult patients presenting to the emergency department of four Italian hospitals with confirmed diagnosis of PE were included...
May 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29777436/fatigue-related-risk-management-in-the-emergency-department-a-focus-group-study
#5
Pierre Bérastégui, Mathieu Jaspar, Alexandre Ghuysen, Anne-Sophie Nyssen
Fatigue has major implications on both patient safety and healthcare practitioner's well-being. Traditionally, two approaches can be used to reduce fatigue-related risk: reducing the likelihood of a fatigued operator working (i.e. fatigue reduction), or reducing the likelihood that a fatigued operator will make an error (i.e. fatigue proofing). Recent progress mainly focussed on fatigue reduction strategies such as reducing work hours. Yet it has to be recognized that such approach has not wholly overcome the experience of fatigue...
May 18, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29777243/comparison-of-formulae-for-orotracheal-intubation-depth-in-the-paediatric-population
#6
Jen Heng Pek, Elizabeth Mj Tan, Ying Hao, Gene Yk Ong
INTRODUCTION: Multiple formulae have been proposed for calculating orotracheal depth for paediatric intubation. However, literature on the validation of these formulae in the emergency department setting is limited. Three methods described in the local Advanced Paediatric Life Support curriculum include the Broselow tape, endotracheal tube (ETT) size x 3, and the age-based formula of age divided by 2, add 12. We aimed to determine their accuracy. MATERIALS AND METHODS: Patients with intubation performed in the Children's Emergency from 1 January 2009 to 31 December 2013 were included in this retrospective observational study...
April 2018: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/29777042/rates-of-infection-after-colonoscopy-and-osophagogastroduodenoscopy-in-ambulatory-surgery-centres-in-the-usa
#7
Peiqi Wang, Tim Xu, Saowanee Ngamruengphong, Martin A Makary, Anthony Kalloo, Susan Hutfless
OBJECTIVE: Over 15 million colonoscopies and 7 million osophagogastroduodenoscopies (OGDs) are performed annually in the USA. We aimed to estimate the rates of infections after colonoscopy and OGD performed in ambulatory surgery centres (ASCs). DESIGN: We identified colonoscopy and OGD procedures performed at ASCs in 2014 all-payer claims data from six states in the USA. Screening mammography, prostate cancer screening, bronchoscopy and cystoscopy procedures were comparators...
May 18, 2018: Gut
https://www.readbyqxmd.com/read/29776828/septic-acute-kidney-injury-patients-in-emergency-department-the-risk-factors-and-its-correlation-to-serum-lactate
#8
Yin-Chou Hsu, Chih-Wei Hsu
BACKGROUND: Acute kidney injury (AKI) is a common complication in septic patients, imposing a heavy burden of illness in terms of morbidity and mortality. Serum lactate is a widely used marker predicting the severity of sepsis. A paucity of research has investigated septic AKI in emergency departments (EDs) and its correlation with initial serum lactate level. This study aimed at identifying risk factors for septic AKI and clarifying the link between initial serum lactate level and septic AKI in ED patients...
May 15, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776823/acute-stent-thrombosis-should-preventative-measures-start-in-the-emergency-department-a-case-report-with-review-of-literature
#9
Getaw Worku Hassen, Soheila Talebi, Basel Alhadad, Alaleh Azhir, Catherine Ann Jennings, Doris Zavaro, Hossein Kalantari
Stent thrombosis is a potentially life threatening condition caused by several factors or a combination factors, such as resistance to platelet agents and type of anticoagulation used as well as stent types. We report a case of acute thrombosis and discuss potential areas of intervention with literature review.
May 7, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776702/naloxone-use-among-emergency-department-patients-with-opioid-overdose
#10
Catherine A Marco, William Trautman, Alexander Cook, Dennis Mann, Jordan Rasp, Oswald Perkins, Michael Ballester
BACKGROUND: Emergency department (ED) visits for unintentional opioid overdoses have increased dramatically. Naloxone hydrochloride (Narcan®) is an opioid antagonist commonly used to treat these overdoses. OBJECTIVE: This study was undertaken to identify experiences regarding naloxone use among ED patients with opioid overdose. METHODS: This prospective survey study was conducted at an urban level I trauma center. A survey was administered to eligible ED patients after unintentional opioid overdose...
May 16, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776701/nonstandard-advance-directives-in-emergency-medicine-what-should-we-do
#11
Kenneth V Iserson
BACKGROUND: Critically ill or injured emergency department or prehospital patients who lack decision-making capacity sometimes present with a non-standard advance directive, such as a "Do Not Resuscitate" tattoo or medallion. Emergency clinicians must immediately address the question of whether to withhold treatment based on what may or may not be a valid patient directive. DISCUSSION: Advance directives have been standardized for a good reason. Emergency department or prehospital healthcare providers must be able to immediately interpret and act on them without needing a legal interpretation...
May 16, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776700/assessment-of-the-utility-of-ordering-a-troponin-in-low-and-intermediate-risk-patients-presenting-to-the-emergency-department-with-supraventricular-tachycardia-a-retrospective-chart-review
#12
David Noorvash, Rosemarie Ramos, Linda Hatch, Andrew Muck, Adriana Segura Olson
BACKGROUND: A troponin assay is commonly sent for patients presenting to emergency departments (EDs) with supraventricular tachycardia (SVT). Multiple studies suggest that elevated troponin levels do not predict coronary artery disease in these patients. Patients with elevated troponins are more likely to have additional cardiac testing, which can lead to increased health care costs and unnecessary invasive procedures. OBJECTIVE: Our objective was to evaluate low- to intermediate-risk patients (HEART [history, electrocardiography, age, risk factors and troponin] Score 1-6) presenting to the ED with SVT...
May 15, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776511/ensuring-emergency-department-patient-access-to-appropriate-pain-treatment
#13
EDITORIAL
(no author information available yet)
No abstract text is available yet for this article.
June 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#14
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29776360/the-impact-of-telephone-follow-up-on-adverse-events-for-aboriginal-people-with-chronic-disease-in-new-south-wales-australia-a-retrospective-cohort-study
#15
Amanda Jayakody, Erin Passmore, Christopher Oldmeadow, Jamie Bryant, Mariko Carey, Eunice Simons, Aaron Cashmore, Louise Maher, Kiel Hennessey, Jacinta Bunfield, Maurice Terare, Andrew Milat, Rob Sanson-Fisher
BACKGROUND: Chronic diseases are more prevalent and occur at a much younger age in Aboriginal people in Australia compared with non-Aboriginal people. Aboriginal people also have higher rates of unplanned hospital readmissions and emergency department presentations. There is a paucity of research on the effectiveness of follow up programs after discharge from hospital in Aboriginal populations. This study aimed to assess the impact of a telephone follow up program, 48 Hour Follow Up, on rates of unplanned hospital readmissions, unplanned emergency department presentations and mortality within 28 days of discharge among Aboriginal people with chronic disease...
May 18, 2018: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29775642/national-early-warning-score-news-in-a-finnish-multidisciplinary-emergency-department-and-direct-vs-late-admission-to-intensive-care
#16
Mikko Kivipuro, Joonas Tirkkonen, Timo Kontula, Juuso Solin, Jari Kalliomäki, Satu-Liisa Pauniaho, Heini Huhtala, Arvi Yli-Hankala, Sanna Hoppu
OBJECTIVES: We investigated the national early warning scores (NEWSs) and related outcomes of patients in a tertiary referral center's multidisciplinary emergency department (ED). Patients were further categorized into three groups: triaged directly to intensive care unit (EDICU), triaged to general ward with later ICU admission (EDwardICU) and triaged to general ward (EDward). NEWSs and subsequent outcomes among these sub groups were compared. METHODS: We conducted a prospective one-month cohort study in Tampere University Hospital's ED, Finland...
May 15, 2018: Resuscitation
https://www.readbyqxmd.com/read/29775132/evaluation-of-lateral-atlantodental-interval-asymmetry-in-the-pediatric-age-group-normative-values
#17
Stephen K Mendenhall, Andrew Huh, Janit Pandya, Vincent Alentado, Karl Balsara, Chang Ho, Andrew Jea
OBJECTIVE The revelation of normative radiographic measurements for the developing pediatric spine is incomplete. The purpose of this analysis was to determine the normal range of asymmetry of the lateral atlantodental interval (LADI) and define age- and sex-related differences. METHODS A total of 3072 children aged 0-18 years who underwent CT scanning of the cervical spine were identified at Riley Hospital for Children between 2005 and 2017. Patients were stratified by sex and age (in years) into 36 cohorts...
May 18, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29775117/intravenous-low-dose-ketamine-provides-greater-pain-control-compared-to-fentanyl-in-a-civilian-prehospital-trauma-system-a-propensity-matched-analysis
#18
E Stein Bronsky, Catherine Koola, Alessandro Orlando, Diane Redmond, Cecile D'Huyvetter, Heather Sieracki, Allen Tanner, Ray Fowler, Charles Mains, David Bar-Or
OBJECTIVE: A few studies report comparable analgesic efficacy between low-dose ketamine and opioids such as morphine or fentanyl; however, limited research has explored the safety and effectiveness of intravenous low-dose ketamine as a primary analgesic in a civilian prehospital setting. The objective of this study is to compare pain control between low-dose ketamine and fentanyl when administered intravenously (IV) for the indication of severe pain. METHODS: This was a retrospective, observational review of prehospital adult patients (≥18 years) who presented with severe pain (numeric rating scale, 7-10) and were treated solely with either low-dose ketamine IV or fentanyl IV between January 1, 2014 and December 31, 2016...
May 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29775090/evaluation-of-management-and-guideline-adherence-in-children-with-mild-traumatic-brain-injury
#19
Merel C Broers, Jikke-Mien F Niermeijer, Irene A W Kotsopoulos, Hester F Lingsma, Jos F M Bruinenberg, Coriene E Catsman-Berrevoets
AIM: To evaluate the management and guideline adherence in children with mild traumatic brain injury (MTBI) in emergency departments (ED) in the Netherlands. METHODS: A multicentre cohort study was conducted, including children younger than 18 years with MTBI who presented within 24 hours after trauma in the ED of hospitals in the southwest region of the Netherlands, in 2014. Primary outcome measures for management were percentages of performed computed tomography (CT) scans and hospital admissions...
May 18, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29774966/test-characteristics-of-point-of-care-ultrasound-for-the-diagnosis-of-retinal-detachment-in-the-emergency-department
#20
Daniel J Kim, Mario Francispragasam, Gavin Docherty, Byron Silver, Ross Prager, Donna Lee, David Maberley
Previous studies of point of care ultrasound (POCUS) have reported high sensitivities and specificities for retinal detachment (RD). Our primary objective was to assess the test characteristics of POCUS performed by a large heterogeneous group of emergency physicians (EPs) for the diagnosis of RD. METHODS: This was a prospective diagnostic test assessment of POCUS performed by EPs with varying ultrasound experience on a convenience sample of emergency department (ED) patients presenting with flashes or floaters in one or both eyes...
May 18, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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