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safety procedures in emergency care

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https://www.readbyqxmd.com/read/29438575/primary-care-professionals-providing-non-urgent-care-in-hospital-emergency-departments
#1
REVIEW
Daniela Gonçalves-Bradley, Jaspreet K Khangura, Gerd Flodgren, Rafael Perera, Brian H Rowe, Sasha Shepperd
BACKGROUND: In many countries emergency departments (EDs) are facing an increase in demand for services, long waits, and severe crowding. One response to mitigate overcrowding has been to provide primary care services alongside or within hospital EDs for patients with non-urgent problems. However, it is unknown how this impacts the quality of patient care and the utilisation of hospital resources, or if it is cost-effective. This is the first update of the original Cochrane Review published in 2012...
February 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29432404/duration-to-establish-an-emergency-vascular-access-and-how-to-accelerate-it-a-simulation-based-study-performed-in-real-life-neonatal-resuscitation-rooms
#2
Eva M Schwindt, Florian Hoffmann, Philipp Deindl, Thomas J Waldhoer, Jens C Schwindt
OBJECTIVES: To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. DESIGN: Retrospective analysis of audio-video recorded neonatal simulation training. SETTINGS: Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany)...
February 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29423259/comprehensive-geriatric-assessment-pilot-of-a-randomized-control-study-in-a-swedish-acute-hospital-a-feasibility-study
#3
Theresa Westgård, Isabelle Ottenvall Hammar, Eva Holmgren, Anna Ehrenberg, Aase Wisten, Anne W Ekdahl, Synneve Dahlin-Ivanoff, Katarina Wilhelmson
Background: Comprehensive geriatric assessment (CGA) represent an important component of geriatric acute hospital care for frail older people, secured by a multidisciplinary team who addresses the multiple needs of physical health, functional ability, psychological state, cognition and social status. The primary objective of the pilot study was to determine feasibility for recruitment and retention rates. Secondary objectives were to establish proof of principle that CGA has the potential to increase patient safety...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29397806/something-in-the-water-hospital-responds-to-water-crisis
#4
Roberta Redfern, Jennifer Micham, Rebecca Daniels, Sue Childers
Early on August 2, 2014, in the city of Toledo, Ohio, a media alert informed the public that traces of microcystin, a hazardous toxin, had been detected in the drinking water. The warning stated that residents should not drink, boil, or even touch the contaminated water. A water crisis of this magnitude was recognized to pose a potentially serious and significant impact on patient care and safety in health care environments. ProMedica Toledo Hospital's Emergency Operation Plan addressed 3 critical issues: safe water availability, alternate cleaning solutions, and preparations for a prolonged crisis...
February 5, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29386154/assesment-of-predictor-variables-and-clinical-consequences-associated-with-surgical-site-infection-in-tertiary-care-setting-karachi-pakistan
#5
Anum Tariq, Huma Ali, Farya Zafar, Ali Akbar Sial, Kamran Hameed, Mehwish Rizvi, Rabia Bushra, Saima Salim, Zeb-Un Nisa, Ghazala R Naqvi, Saba Zubair
Among the well-known Health care-associated infections (HAIs), surgical site infections (SSIs) contribute to considerable high mortality and morbidity rate, substantial prolongation in hospitalization period and extra expenses in terms of treatment cost. This study was aimed to evaluate the predictive variables associated with surgical site infections, and their clinical consequences. This was a prospective, cross sectional study conducted in the surgical department of tertiary care setting in Karachi, Pakistan...
January 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29384586/emergency-patient-handoffs-identifying-essential-elements-and-developing-an-evidence-based-training-tool
#6
Andrew P Reimer, Celeste M Alfes, Amanda S Rowe, Bianca M Rodriguez-Fox
BACKGROUND: Patient handoffs between care teams have been recognized as a major patient safety risk due to inadequate exchange or loss of critical information, especially during emergent patient transfers. The purpose of this literature review was to identify the essential elements of effective patient handoffs in emergency situations to develop a standardized tool to support a structured patient handoff procedure capable of guiding education and training. METHOD: A literature search of handoff procedures and patient transfers was conducted using the Cumulative Index to Nursing and Allied Health Literature and PubMed between 2008 and 2015...
January 1, 2018: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/29376560/inotropic-agents-and-vasodilator-strategies-for-the-treatment-of-cardiogenic-shock-or-low-cardiac-output-syndrome
#7
REVIEW
Julia Schumann, Eva C Henrich, Hellen Strobl, Roland Prondzinsky, Sophie Weiche, Holger Thiele, Karl Werdan, Stefan Frantz, Susanne Unverzagt
BACKGROUND: Cardiogenic shock (CS) and low cardiac output syndrome (LCOS) as complications of acute myocardial infarction (AMI), heart failure (HF) or cardiac surgery are life-threatening conditions. While there is a broad body of evidence for the treatment of people with acute coronary syndrome under stable haemodynamic conditions, the treatment strategies for people who become haemodynamically unstable or develop CS remain less clear. We have therefore summarised here the evidence on the treatment of people with CS or LCOS with different inotropic agents and vasodilative drugs...
January 29, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29358491/ketamine-procedural-sedation-in-the-emergency-department-of-an-urban-tertiary-hospital-in-dar-es-salaam-tanzania
#8
Zlatan Coralic, Hendry R Sawe, Juma A Mfinanga, Alfredo Cortez, Jennifer Koehl, Hannah Siroker, Teri A Reynolds
STUDY OBJECTIVE: We describe ketamine procedural sedations and associated adverse events in low-acuity and high-acuity patients in a resource-limited ED. METHODS: This was a prospective observational study of ketamine procedural sedations at the Emergency Medical Department at the Muhimbili National Hospital in Dar es Salaam, Tanzania. We observed consecutive procedural sedations and recorded patient demographics, medications, vital signs, pulse oximetry, capnography and a priori defined adverse events (using standard definitions in emergency medicine sedation guidelines)...
January 22, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#9
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29342059/patients-living-alone-can-be-safely-discharged-directly-home-after-total-joint-arthroplasty-a-prospective-cohort-study
#10
Andrew N Fleischman, Matthew S Austin, James J Purtill, Javad Parvizi, William J Hozack
BACKGROUND: Despite the expense and potential hazards of inpatient rehabilitation, there is a prevailing belief that patients living alone cannot be safely discharged directly home after total joint arthroplasty. The purpose of this study was to assess the safety and efficacy of direct home discharge for patients living alone during convalescence after primary total joint arthroplasty. METHODS: We prospectively studied 910 consecutive patients undergoing primary, unilateral total hip arthroplasty or total knee arthroplasty over an 8-month period...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29332776/compliance-with-a-national-standard-by-norwegian-helicopter-emergency-physicians
#11
Lars Petter Bjørnsen, Andrea Marie Solheim, Oddvar Uleberg, Eirik Skogvoll
OBJECTIVE: The "National Standard Requirements for Helicopter Emergency Medicine Services Physicians" gives recommendations on medical requirements for flight physicians. This study describes the level of formal competence, experience, and guideline compliance of Norwegian helicopter emergency medical service (HEMS) physicians. METHODS: In May 2013, all HEMS physicians with full-time engagement at Norwegian HEMS bases were invited to participate in a cross-sectional survey using a structured, Web-based questionnaire...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29325162/an-analysis-of-adverse-events-in-the-rehabilitation-department-using-the-veterans-affairs-root-cause-analysis-system
#12
Gregory W Hagley, Peter D Mills, Brian Shiner, Robin R Hemphill
Background: Root cause analyses (RCA) are often completed in health care settings to determine causes of adverse events (AEs). RCAs result in action plans designed to mitigate future patient harm. National reviews of RCA reports have assessed the safety of numerous health care settings and suggested opportunities for improvement. However, few studies have assessed the safety of receiving care from physical therapists, occupational therapists, or speech and language pathology pathologists...
January 9, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29314751/emergency-airway-and-ventilator-procedures-for-community-based-home-care-staff-validation-of-an-educational-program
#13
Ann Marie Ramsey, Sarah Brennan, Adam Stricker, Kurt Riek, Dana Brown, Rachel Gurtowsky, Julie Sturza, Amy Goldstein Filbrun
BACKGROUND: Children discharged home with tracheostomy and chronic mechanical ventilator support are at high risk for complications and adverse events. Private duty nursing and home respiratory care services are a critical support necessary for successful discharge. The literature suggests that there are opportunities for home care staff (HCS) to improve upon the skills necessary to assess and intervene in an emergency thereby increasing the likelihood of improving long-term outcomes...
January 4, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29304787/factors-associated-with-prolonged-length-of-stay-for-elective-hepatobiliary-and-neurosurgery-patients-a-retrospective-medical-record-review
#14
Siu Yin Lee, Soo-Hoon Lee, Jenny H H Tan, Howard S L Foo, Phillip H Phan, Alfred W C Kow, Sein Lwin, Penelope M Y Seah, Siti Zubaidah Mordiffi
BACKGROUND: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries...
January 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29283967/pediatric-appendicitis-is-referral-to-a-regional-pediatric-center-necessary
#15
Maggie M Hodges, Clay Cothren Burlew, Shannon N Acker, Ernest E Moore, Genie E Roosevelt, Anna Schubert, Lauren R S Hill, David A Partrick, Denis Bensard
BACKGROUND: Acute appendicitis is the most common emergent surgical procedure performed among children in the US, with an incidence exceeding 80,000 cases per year. Appendectomies are often performed by both pediatric surgeons and adult general/trauma acute care surgeons (TACS surgeons). We hypothesized that children undergoing appendectomy for acute appendicitis have equivalent outcomes whether a pediatric surgeon or a TACS surgeon performs the operation. METHODS: A retrospective chart review was performed for patients 6-18 years of age, who underwent appendectomy at either a regional children's hospital (CHCO, n=241) or an urban safety net hospital (n=347) between July 2010 and June 2015...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283917/anesthetic-management-and-procedural-outcomes-of-patients-undergoing-off-pump-transapical-implantation-of-artificial-chordae-to-correct-mitral-regurgitation-case-series-of-76-patients
#16
Robertas Stasys Samalavicius, Ieva Norkiene, Agne Drasutiene, Arturas Lipnevicius, Vilius Janusauskas, Karolis Urbonas, Diana Zakarkaite, Audrius Aidietis, Kestutis Rucinskas
BACKGROUND: Transapical implantation of artificial chordae using the NeoChord system (NeoChord Inc, Minneapolis, MN) is an emerging beating-heart technique for correction of mitral regurgitation (MR) through a minimally invasive left minithoracotomy. The purpose of the study was to describe the anesthetic management and procedural success of patients undergoing this procedure. METHODS: All patients (n = 76) who underwent mitral valve repair with the NeoChord system in our institution from December 2011 to December 2016 were included in this observational prospective study...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29241477/insights-from-the-front-lines-a-collection-of-stories-of-hta-impact-from-inahta-member-agencies
#17
Tara Schuller, Sophie Söderholm Werkö
This mini-theme contains six stories of health technology assessment (HTA) impact from member agencies of The International Network of Agencies for Health Technology Assessment (INAHTA), which were originally shared at the 2015 and 2016 INAHTA Congresses. The INAHTA impact story sharing is an innovative network activity where member agency representatives share experiences of HTA impact in a loosely structured story format. Through this process, members gain insights from other agencies on new ways of thinking about and approaching HTA impact assessment...
January 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29239751/feasibility-of-single-vs-two-physician-procedural-sedation-in-a-small-community-emergency-department
#18
Clayton P Josephy, David R Vinson
OBJECTIVE: Sedation is commonly required for painful procedures in the emergency department (ED). Some facilities mandate two physicians be present for deep sedation cases. Evidence is lacking, however, that a two-physician approach improves safety outcomes. We report our experience on the feasibility of replacing a two-physician ED procedural sedation policy with a single-physician policy in a small, single-coverage community ED. METHODS: This is a retrospective, before/after, single-center observational study of prospectively collected data from January 2013 through December 2016...
November 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29224990/the-shift-to-same-day-outpatient-joint-arthroplasty-a-systematic-review
#19
REVIEW
Jeffrey D Hoffmann, Nicholas A Kusnezov, John C Dunn, Nicholas J Zarkadis, Gens P Goodman, Richard A Berger
BACKGROUND: Hip and knee arthroplasties length of stay continues to shorten after advances in perioperative and intraoperative management, as well as financial incentives. Some authors have demonstrated good results with outpatient arthroplasty, but safety and general feasibility of such procedures remain unclear. Our hypothesis is that outpatient arthroplasty would demonstrate higher readmission and complication rates than inpatient arthroplasty. METHODS: We performed a systematic review of all publications on outpatient arthroplasty between January 1, 2000 and June 1, 2016...
November 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29214070/percutaneous-tracheostomy-a-comprehensive-review
#20
REVIEW
Ashraf O Rashid, Shaheen Islam
Tracheostomy is a common procedure. It can be done surgically or percutaneously by dilating the stoma using Seldinger technique. Percutaneous tracheostomy (PT) is now routinely performed by surgeons and non-surgeons such as intensivists and anesthesiologists in the intensive care units (ICU) all over the world. Although obesity, emergent tracheostomy, coagulopathy, inability to extend the neck and high ventilator demand (HVD) were initially thought to be a relative contraindication, recent data suggest safety of PT in these patient population...
September 2017: Journal of Thoracic Disease
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