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https://www.readbyqxmd.com/read/28444153/computed-tomography-derived-fractional-flow-reserve-testing-in-stable-patients-with-typical-angina-pectoris-influence-on-downstream-rate-of-invasive-coronary-angiography
#1
Jesper Møller Jensen, Hans Erik Bøtker, Ole Norling Mathiassen, Erik Lerkevang Grove, Kristian Altern Øvrehus, Kamilla Bech Pedersen, Christian Juhl Terkelsen, Evald Høj Christiansen, Michael Maeng, Jonathon Leipsic, Anne Kaltoft, Lars Jakobsen, Jacob Thorsted Sørensen, Troels Thim, Steen Dalby Kristensen, Lars Romer Krusell, Bjarne Linde Nørgaard
Aims: To assess the use of downstream coronary angiography (ICA) and short-term safety of frontline coronary CT angiography (CTA) with selective CT-derived fractional flow reserve (FFRCT) testing in stable patients with typical angina pectoris. Methods and results: Between 1 January 2016 and 30 June 2016 all patients (N = 774) referred to non-emergent ICA or coronary CTA at Aarhus University Hospital on a suspicion of CAD had frontline CTA performed. Downstream testing and treatment within 3 months and adverse events ≥90 days were registered...
April 20, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28443354/optimization-of-intelligent-infusion-pump-technology-to-minimize-vasopressor-pump-programming-errors
#2
Nina Vadiei, Carrie A Shuman, Manasa S Murthy, Mitchell J Daley
STUDY OBJECTIVE: To determine if incorporation of vasopressor upper hard limits (UHL) into intelligent infusion pump technology (IIPT) increases efficacy of alerts by preventing pump programming errors. DESIGN & METHODS: Retrospective review from five hospitals within a single healthcare network between April 1, 2013 and May 31, 2014. A total of 65,680 vasopressor data entries were evaluated; 19,377 prior to hard limit implementation and 46,303 after hard limit implementation...
April 26, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28441963/in-hospital-airway-management-training-for-non-anesthesiologist-ems-physicians-a-descriptive-quality-control-study
#3
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Pre-hospital airway management is a major challenge for emergency medical service (EMS) personnel. Despite convincing evidence that the rescuer's qualifications determine efficacy of tracheal intubation, in-hospital airway management training is not mandatory in Austria, and often neglected. Thus we sought to prove that airway management competence of EMS physicians can be established and maintained by a tailored training program. METHODS: In this descriptive quality control study we retrospectively evaluated all in- and pre-hospital airway cases managed by EMS physicians who underwent a structured in-hospital training program in anesthesia at General Hospital Wiener Neustadt...
April 26, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28441939/estimation-of-the-severity-of-breathlessness-in-the-emergency-department-a-dyspnea-score
#4
Tibor Gondos, Viktor Szabó, Ágnes Sárkány, Adrienn Sárkány, Gábor Halász
BACKGROUND: Dyspnea is a frequent complaint in emergency departments (ED). It has a significant amount of subjective and affective components, therefore the dyspnea scores, based on the patients' rating, can be ambiguous. Our purpose was to develop and validate a simple scoring system to evaluate the severity of dyspnea in emergency care, based on objectively measured parameters. METHODS: We performed a double center, prospective, observational study including 350 patients who were admitted in EDs with dyspnea...
April 26, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28441632/emergency-computed-tomography-in-patients-with-first-seizure
#5
Kaisa Kotisaari, Pekka Virtanen, Nina Forss, Daniel Strbian, Filip Scheperjans
PURPOSE: To determine the frequency of emergent imaging findings on head computed tomography (CT) in an adult population of first seizure (FS) patients presenting to an emergency department (ED); and to search for associations between clinical features and emergent imaging findings among these patients. METHODS: For this retrospective registry-based study, adult FS patients presenting to Helsinki University Hospital ED in 2006 were identified based on ICD-10 diagnosis...
April 17, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28438104/impact-of-a-scribe-program-on-patient-throughput-physician-productivity-and-patient-satisfaction-in-a-community-based-emergency-department
#6
Waqas Shuaib, John Hilmi, Joshua Caballero, Ijaz Rashid, Hashim Stanazai, Kerolos Tawfeek, Ahmed Amari, Alan Ajanovic, Alex Moshtaghi, Anjit Khurana, Hesham Hasabo, Abdulrehman Baqais, Arthur J Szczerba, Theodore J Gaeta
Previous literature on the impact of scribe programs varies and has mostly been reported from academic institutions or other clinics. We report the implementation of the scribe program in the emergency room of a community hospital and its impact on patient throughput, physician productivity, and patient satisfaction. We performed a quasi-experimental, before-and-after study measuring patient throughput metrics, physician productivity, and patient satisfaction. The intervention measuring the scribe implementation was divided into pre- and post-implementation periods...
April 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/28436175/chronic-hypertension-and-adverse-pregnancy-outcomes-a-cohort-study
#7
Anca M Panaitescu, Argyro Syngelaki, Natalia Prodan, Ranjit Akolekar, Kypros H Nicolaides
OBJECTIVE: To examine the association between chronic hypertension (CH) and a wide range of adverse pregnancy outcomes after adjustment for confounding factors in obstetric history and maternal characteristics. METHODS: This was a prospective screening study for adverse pregnancy outcomes in women with singleton pregnancies attending the first routine hospital visit at 11(+0) -13(+6) weeks' gestation. Data on maternal characteristics, medical and obstetric history and pregnancy outcomes were collected...
April 23, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#8
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434269/electronic-adherence-monitoring-device-performance-and-patient-acceptability-a-randomized-control-trial
#9
Amy Hai Yan Chan, Alistair William Stewart, Jeff Harrison, Peter Nigel Black, Edwin Arthur Mitchell, Juliet Michelle Foster
BACKGROUND: To investigate the performance and patient acceptability of an inhaler electronic monitoring device in a real-world childhood asthma population. METHODS: Children 6 to 15 years presenting with asthma to the hospital emergency department and prescribed inhaled corticosteroids were included. Participants were randomized to receive a device with reminder features enabled or disabled for use with their preventer. Device quality control tests were conducted...
April 24, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28433250/public-private-implementation-of-integrated-emergency-response-services-case-study-of-gvk-emergency-management-and-research-institute-in-karnataka-india
#10
Veena M Sriram, Gopalkrishna Gururaj, Adnan A Hyder
BACKGROUND: Emergency medical services are important to the functioning of health systems, but these services tend to be neglected in low- and middle-income countries, such as India. In recent years, several models of pre-hospital emergency medical services have emerged in India. Research on these models holds important lessons for existing and future emergency medical service programs in low- and middle-income countries. Our objective was to provide a comprehensive description of the organizational structure and service delivery model of a public-private partnership in the southern Indian state of Karnataka, GVK Emergency Management and Research Institute, with a particular focus on its operations in Bengaluru...
April 19, 2017: Surgery
https://www.readbyqxmd.com/read/28431508/association-between-cardiopulmonary-resuscitation-duration-and-one-month-neurological-outcomes-for-out-of-hospital-cardiac-arrest-a-prospective-cohort-study
#11
Masahiro Kashiura, Yuichi Hamabe, Akiko Akashi, Atsushi Sakurai, Yoshio Tahara, Naohiro Yonemoto, Ken Nagao, Arino Yaguchi, Naoto Morimura
BACKGROUND: The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. METHODS: Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan...
April 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28431426/anesthesiologists-and-disaster-medicine-a-needs-assessment-for-education-and-training-and-reported-willingness-to-respond
#12
Heather K Hayanga, Daniel J Barnett, Natasha R Shallow, Michael Roberts, Carol B Thompson, Itay Bentov, Gozde Demiralp, Bradford D Winters, Deborah A Schwengel
BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Frequencies, percentages, and odds ratios (ORs) were used to assess self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, employee development, professional obligation, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond (WTR)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28429355/lewy-pathological-study-on-%C3%AE-synuclein-in-gastrointestinal-tissues-of-prodromal-parkinson-s-disease
#13
Q-B Lu, Z-F Zhu, H-P Zhang, W-F Luo
OBJECTIVE: In the gastrointestinal neural system, the emergence of Lewy Body (LB) is usually earlier than the clinical diagnosis of Parkinson (PD) motor symptoms. Therefore, this study is aimed to explore whether the LB in the gastrointestinal tract of prodromal PD patients. PATIENTS AND METHODS: 98 paraffin embedded tissue specimens from 57 PD patients were collected in the Second Affiliated Hospital of Soochow University archives, as well as 98 tissue specimens of 90 non-PD patients undergone surgical resection...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28428643/-misscare-survey-italian-version-findings-from-an-italian-validation-study
#14
Luisa Sist, Carla Contini, Anna Bandini, Stefania Bandini, Licia Massa, Roberta Zanin, Rita Maricchio, Gloria Gianesini, Erika Bassi, Daniela Tartaglini, Alvisa Palese, Annamaria Ferraresi
BACKGROUND: The Missed Nursing Care (MNC) refers to nursing interventions that are not completed, partially completed, or postponed. Despite the relevance of MNC, no assessment tools are available in the Italian context, and no data regarding the occurrence of this phenomenon has been documented on a large scale to date. OBJECTIVES: The study aims were: (1) to validate the Italian version of the MISSCARE Survey tool; (2) to measure the prevalence of missed interventions and reasons for missed care as perceived by clinical nurses working in Italian health care settings...
January 2017: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/28422541/evaluation-of-the-implementation-of-the-trauma-triage-and-destination-plan-on-the-field-triage-of-injured-patients-in-north-carolina
#15
Jane H Brice, Frances S Shofer, Christopher Cowden, E Brooke Lerner, Matthew Psioda, Meredith Arasaratanam, N Clay Mann, Antonio R Fernandez, Anna Waller, Chailee Moss, Michael Mian
OBJECTIVE: Timely triage and appropriate destination decision making for injured patients are central challenges faced by emergency medical services (EMS) systems. In 2010, North Carolina (NC) adopted a statewide Trauma Triage and Destination Plan (TTDP) based on the CDC's Field Triage Guidelines to better address these challenges. We sought to characterize the implementation of these guidelines by quantifying their effect on multiple metrics of patient care. METHODS: We employed a retrospective pre-post study design utilizing a statewide EMS medical record database...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#16
John W Scott, Jeanne D'Arc Nyinawankusi, Samuel Enumah, Rebecca Maine, Eric Uwitonze, Yihan Hu, Ignace Kabagema, Jean Claude Byiringiro, Robert Riviello, Sudha Jayaraman
INTRODUCTION: Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. MATERIALS AND METHODS: The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28416852/-first-aid-system-for-trauma-development-and-status
#17
D K Chen, W C Lin, P Zhang, S J Kuang, W Huang, T B Wang
With the great progress of the economy, the level of industrialization has been increasing year by year, which leads to an increase in accidental trauma accidents. Chinese annual death of trauma is already more than 400 000, which makes trauma the fifth most common cause of death, following malignant tumor, heart, brain and respiratory diseases. Trauma is the leading cause of the death of young adults. At the same time, trauma has become a serious social problem in peace time. Trauma throws great treats on human health and life...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28416178/the-effect-of-time-to-surgery-on-functional-ability-at-six-weeks-in-a-hip-fracture-population-in-mid-west-ireland
#18
Audrey Butler, Sinead Hahessy, Finbarr Condon
Patients with a hip fracture may be appropriately delayed for surgery as they require optimisation or clinical interventions to treat acute medical illnesses (Moja et al., 2012). Other patients are inappropriately delayed due to hospital factors (Brener, 2013; Lee & Elfar, 2014). Timely efficient admission and surgery is well documented as the best course of management for these patients. The aim of this prospective cohort longitudinal follow-up study was to establish if a relationship existed between duration of time spent in the Emergency Department (ED), time to surgery and functional ability in patients with hip fractures and to examine the effect prolonged waits may have on ability to return home...
March 9, 2017: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28414164/a-pre-hospital-extracorporeal-cardio-pulmonary-resuscitation-ecpr-strategy-for-treatment-of-refractory-out-hospital-cardiac-arrest-an-observational-study-and-propensity-analysis
#19
Lionel Lamhaut, Alice Hutin, Etienne Puymirat, Jérome Jouan, Jean-Herlé Raphalen, Romain Jouffroy, Murielle Jaffry, Christelle Dagron, Kim An, Florence Dumas, Eloi Marijon, Wulfran Bougouin, Jean-Pierre Tourtier, Frédéric Baud, Xavier Jouven, Nicolas Danchin, Christian Spaulding, Pierre Carli
BACKGROUND: Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28413515/outcome-of-out-of-hospital-cardiac-arrest-after-fibrinolysis-with-reteplase-in-comparison-to-the-return-of-spontaneous-circulation-after-cardiac-arrest-score-in-a-geographic-region-without-emergency-coronary-intervention
#20
Thomas Luiz, Alexander Wilhelms, Christian Madler, Gregor Pollach, Bernd Haaff, Joachim Grüttner, Tim Viergutz
Coronary occlusion and pulmonary embolism are responsible for the majority of cases of out-of-hospital cardiac arrest (OHCA). Despite previous favourable results of pre-hospital fibrinolysis in cases of OHCA, the benefit could not be confirmed in a large controlled study using the fibrinolytic tenecteplase. For reteplase (r-PA), there are hardly any data regarding pre-hospital fibrinolysis during ongoing resuscitation. The present study reported results using r-PA therapy in a German physician-supported Emergency Medical Services system...
April 2017: Experimental and Therapeutic Medicine
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