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https://www.readbyqxmd.com/read/28328692/experience-with-a-care-process-model-in-the-evaluation-of-pediatric-musculoskeletal-infections-in-a-pediatric-emergency-department
#1
Lina Patel, Jeff Michael, Nancy Allen, Lisa Schroeder, Lisa Berglund, Jason G Newland
OBJECTIVES: Care process models (CPMs) for certain conditions have improved clinical outcomes in children. This study describes the implementation and impact of a CPM for the evaluation of musculoskeletal infections in a pediatric emergency department (ED). METHODS: A retrospective pre-post intervention study was performed to analyze the impact of a musculoskeletal infection CPM. Patients were identified retrospectively through electronic order history for imaging of an extremity or joint and recommended laboratory tests...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28326162/trauma-informed-care-for-children-in-the-ambulance-international-survey-among-pre-hospital-providers
#2
Eva Alisic, Mark P Tyler, Melita J Giummarra, Rahim Kassam-Adams, Juul Gouweloos, Markus A Landolt, Nancy Kassam-Adams
Background: Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families. Objective: Our goal was to examine (a) pre-hospital providers' knowledge of traumatic stress in children, attitudes towards psychosocial aspects of care, and confidence in providing psychosocial care, (b) variations in knowledge, attitudes, and confidence according to demographic and professional characteristics, and (c) training preferences of pre-hospital providers regarding psychosocial care to support paediatric patients and their families...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28317095/evaluating-helicopter-emergency-medical-missions-a-reliability-study-of-the-hems-benefit-and-naca-scores
#3
L Raatiniemi, J Liisanantti, M Tommila, S Moilanen, P Ohtonen, M Martikainen, V Voipio, J Reitala, T Iirola
BACKGROUND: The benefits of the Helicopter Emergency Medical Service (HEMS) and dispatch accuracy are continuously debated, and a widely accepted score to measure the benefits of the mission is lacking. The HEMS Benefit Score (HBS) has been used in Finnish helicopter emergency medical services, but studies are lacking. The National Advisory Committee for Aeronautics (NACA) score is widely used to measure the severity of illness or injury in the pre-hospital setting, but it has many critics due to its subjectivity...
March 19, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28314465/data-capture-and-communication-during-transfers-to-definitive-care-in-an-inclusive-trauma-system
#4
Nori L Bradley, Naisan Garraway, Nathaniel Bell, Nasira Lakha, S Morad Hameed
INTRODUCTION: Background trauma survivors in rural areas transferred to urban centers have higher mortality than trauma patients admitted directly to urban centers. Transfer data in trauma registries is important for injury control. Prehospital and early physiologic data may reflect processes of pre-hospital care. British Columbia currently has no standardized process for trauma patient data transfer. PATIENTS AND METHODS: We performed a retrospective data analysis for major trauma patients (ISS>15) transferred to a Level I trauma center over a 1year period (n=243)...
November 5, 2016: Injury
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#5
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28303214/evidence-based-management-and-controversies-in-blunt-splenic-trauma
#6
REVIEW
D C Olthof, C H van der Vlies, J C Goslings
PURPOSE OF REVIEW: The study aims to describe the evidence-based management and controversies in blunt splenic trauma. RECENT FINDINGS: A shift from operative management to non-operative management (NOM) has occurred over the past decades where NOM has now become the standard of care in haemodynamically stable patients with blunt splenic injury. Splenic artery embolisation (SAE) is generally believed to increase the success rate of NOM. Not all the available evidence is that optimistic about SAE however...
2017: Current Trauma Reports
https://www.readbyqxmd.com/read/28302125/joint-longitudinal-data-analysis-in-detecting-determinants-of-cd4-cell-count-change-and-adherence-to-highly-active-antiretroviral-therapy-at-felege-hiwot-teaching-and-specialized-hospital-north-west-ethiopia-amhara-region
#7
Awoke Seyoum, Principal Ndlovu, Zewotir Temesgen
BACKGROUND: Adherence and CD4 cell count change measure the progression of the disease in HIV patients after the commencement of HAART. Lack of information about associated factors on adherence to HAART and CD4 cell count reduction is a challenge for the improvement of cells in HIV positive adults. The main objective of adopting joint modeling was to compare separate and joint models of longitudinal repeated measures in identifying long-term predictors of the two longitudinal outcomes: CD4 cell count and adherence to HAART...
March 16, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28301629/antidote-availability-in-the-municipality-of-campinas-s%C3%A3-o-paulo-brazil
#8
Luciane Cristina Rodrigues Fernandes, Taís Freire Galvão, Adriana Safioti Toledo Ricardi, Eduardo Mello De Capitani, Stephen Hyslop, Fábio Bucaretchi
CONTEXT AND OBJECTIVE: The lack of availability of antidotes in emergency services is a worldwide concern. The aim of the present study was to evaluate the availability of antidotes used for treating poisoning in Campinas (SP). DESIGN AND SETTING: This was a cross-sectional study of emergency services in Campinas, conducted in 2010-2012. METHODS: The availability, amount in stock, place of storage and access time for 26 antidotal treatments was investigated...
March 13, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28291728/variation-in-emergency-percutaneous-coronary-intervention-in-ventilated-patients-in-the-uk-insights-from-a-national-database
#9
John Rawlins, Peter F Ludman, Darragh O'Neil, Mamas A Mamas, Mark de Belder, Simon Redwood, Adrian Banning, Andrew Whittaker, Nick Curzen
AIMS: Pre-procedural ventilation is a marker of high risk in PCI patients. Causes include out-of-hospital cardiac arrest (OHCA) and cardiogenic shock. OHCA occurs in approximately 60,000 patients in the UK per annum. No consensus exists regarding the need/timing of coronary angiography ± revascularization without ST elevation. The aim was to describe the national variation in the rate of emergency PCI in ventilated patients. METHODS AND RESULTS: Using the UK national database for PCI in 2013, we identified all procedures performed as 'emergency' or 'salvage' for whom ventilation had been initiated before the PCI...
February 13, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28291647/health-professional-feedback-on-hpv-vaccination-roll-out-in-a-developing-country
#10
Collette Venturas, Kanayo Umeh
BACKGROUND: Worldwide, Zambia has the highest cervical cancer incidence rates (58.4/100,000 per year) and mortality rates (36.2/100,000 per year). The human papilloma virus (HPV) vaccine is considered a vital preventative measure against cervical cancer, particularly in sub-Saharan countries, such as Zambia. Past research suggests health professionals' experiences with HPV vaccination rollout can have practical implications for effective delivery. OBJECTIVE: To explore health professionals' perspectives on the HPV vaccination programme in Zambia...
March 10, 2017: Vaccine
https://www.readbyqxmd.com/read/28290164/risk-factors-for-permanent-pacemaker-after-implantation-of-surgical-or-percutaneous-self-expanding-aortic-prostheses
#11
Emmanuel Villa, Alberto Clerici, Antonio Messina, Luca Testa, Francesco Bedogni, Andrea Moneta, Francesco Donatelli, Giovanni Troise
BACKGROUND: The use of transcatheter aortic valve implantation (TAVI) following the introduction of Nitinol autoexpandable devices has spread rapidly during recent years. In addition, cardiac surgery has been revolutionized due to the use of Nitinol-based sutureless prostheses for aortic valve replacement (AVR). During the same period, however, permanent pacemaker (PPM) implantation has emerged as a frequent complication. The study aim was to identify the risk factors of PPM following the implantation of a Nitinol self-expanding prosthesis (for AVR or TAVI)...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28286827/doing-pre-operative-investigations-in-emergency-department-a-clinical-audit
#12
Muhammad Salman Rafiq, Maria Rafiq, Muhammad Imran Rafiq, Seema Gul Salman, Sania Hafeez
INTRODUCTION: Pre-operative investigations for emergency surgical patients differ between centers. Following established guidelines can reduce unnecessary investigation, cost of treatment and hospital stay. The present audit was carried out to evaluate the condition of doing pre-operative investigations for three common surgical emergencies compared to National Institute for Health and Care Excellence (NICE) guidelines and local criteria. METHODS: A retrospective clinical audit of acute-appendicitis, abscess and hernia patients admitted to the emergency department was carried out over a one-year period from July 2014 to July 2015...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286822/ability-of-ultrasonography-in-detection-of-different-extremity-bone-fractures-a-case-series-study
#13
Farzad Bozorgi, Massoud Shayesteh Azar, Seyed Hossein Montazer, Aroona Chabra, Seyed Farshad Heidari, Alireza Khalilian
INTRODUCTION: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. METHODS: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286810/epidemiology-and-related-risk-factors-of-preterm-labor-as-an-obstetrics-emergency
#14
Ali Asghar Halimi Asl, Saeed Safari, Mohsen Parvareshi Hamrah
INTRODUCTION: Preterm birth is still a major health problem throughout the world, which results in 75% of neonatal mortality. Preterm labor not only inflicts financial and emotional distress, it may also lead to permanent disability. The present study was conducted to determine the related risk factors and preventive measures of preterm labor. METHODS: This retrospective cross-sectional study assessed all preterm labors, as well as an equal number of term labors, during seven years, at an educational hospital...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285563/impact-of-introduction-of-xpert-flu-assay-for-influenza-pcr-testing-on-obstetric-patients-a-quality-improvement-project
#15
Eimear Linehan, Marian Brennan, Sadhbh O'Rourke, Suzie Coughlan, Lisa Clooney, David LeBlanc, Joanna Griffin, Maeve Eogan, Richard J Drew
OBJECTIVE: The aim of this project was to assess the implementation of a quality improvement project regarding the introduction of on-site influenza PCR testing in a stand-alone obstetric hospital. METHODS: As part of a quality improvement project on the management of influenza in obstetric patients, the Xpert Flu assay (Cepheid, USA) was introduced on-site and it replaced the previous method of PCR testing which was off-site. The main outcome measures were duration of antimicrobials, rate of admission and administration of oseltamavir in the emergency department...
March 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28283611/bacteremia-in-children-3-to-36-months-old-after-introduction-of-conjugated-pneumococcal-vaccines
#16
Tara L Greenhow, Yun-Yi Hung, Arnd Herz
BACKGROUND AND OBJECTIVES: In June 2010, Kaiser Permanente Northern California replaced all 7-valent pneumococcal conjugate vaccine (PCV7) vaccines with the 13-valent pneumococcal conjugate vaccine (PCV13). Our objectives were to compare the incidence of bacteremia in children 3 to 36 months old by 3 time periods: pre-PCV7, post-PCV7/pre-PCV13, and post-PCV13. METHODS: We designed a retrospective review of the electronic medical records of all blood cultures collected on children 3 to 36 months old at Kaiser Permanente Northern California from September 1, 1998 to August 31, 2014 in outpatient clinics, in emergency departments, and in the first 24 hours of hospitalization...
March 10, 2017: Pediatrics
https://www.readbyqxmd.com/read/28282553/challenges-in-the-treatment-of-convulsive-status-epilepticus
#17
REVIEW
Gaetano Zaccara, Gianfranco Giannasi, Roberto Oggioni, Eleonora Rosati, Luciana Tramacere, Pasquale Palumbo
Convulsive status epilepticus (CSE) is a medical emergency associated with high mortality and morbidity. The most recent definition of CSE is a convulsive seizure lasting more than 5min or consecutive seizures without recovery of consciousness. In adults, for the treatment of the early stages of CSE, diazepam, lorazepam or midazolam are the most common treatments, although the choice of agent seems less important than rapid treatment. Midazolam, when administered intramuscularly (best evidence), buccally, or nasally, is effective and safe in the pre-hospital setting...
February 28, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28280651/prehospital-systolic-hypertension-and-outcomes-in-patients-with-spontaneous-intracerebral-hemorrhage
#18
Stacy Hatcher, Connie Chen, Prasanthi Govindarajan
BACKGROUND: It is well known that hematoma volume and expansion is associated with poor outcomes in patients with spontaneous intracerebral hemorrhage (sICH). The factors associated with hematoma volume and possible expansion include the use of anticoagulant medications, autoimmune or bacterial diseases that reduce platelet production, and genetic defects of Von Willebrand factor causing inhibition or reduction of platelet aggregation. However, little is known about the role of elevated systolic blood pressure (SBP) on hematoma volume and its ultimate role on sICH when identified in the prehospital setting...
January 26, 2017: Curēus
https://www.readbyqxmd.com/read/28279592/older-red-cell-units-are-associated-with-an-increased-incidence-of-infection-in-chronically-transfused-adults-with-sickle-cell-disease
#19
Matthew S Karafin, Erica Carpenter, Amy Pan, Pippa Simpson, Joshua J Field
BACKGROUND: In adults with sickle cell disease (SCD), the effects of the red cell storage lesion are not well defined. The objectives of this study were to: (1) describe the distribution of storage ages provided to adults with SCD, and (2) evaluate clinical outcomes associated with storage age. PATIENTS AND METHODS: We performed a retrospective cohort study of adults with SCD managed with prophylactic simple transfusion regimens. Units were universally pre-storage leukocyte reduced and CEK-matched...
February 9, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28279553/portable-near-infrared-rapid-detection-of-intracranial-hemorrhage-in-chinese-population
#20
Long Xu, Xiaogang Tao, Weiming Liu, Yanong Li, Jun Ma, Te Lu, Bo Han, Baiyun Liu, Yuanli Zhao, Jingsheng Li, Jizong Zhao
BACKGROUND: Secondary brain injury is the main cause of mortality from traumatic brain injury (TBI). One hallmark of TBI is intracranial hemorrhage, which occurs in 40-50% of severe TBI cases. Early identification of intracranial hematomas in TBI patients allows early surgical evacuation, and can reduce the case-fatality rate of TBI. Since pre-hospital care is the weakest part of Chinese emergency care, there is an urgent need for a capability to detect brain hematomas early. The purpose of this observational study was to evaluate the performance of a near infrared (NIR) based, device to screen for traumatic intracranial hematomas in Chinese population...
March 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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