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Ambulance triage

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https://www.readbyqxmd.com/read/29038180/appropriateness-of-cases-presenting-in-the-emergency-department-following-ambulance-service-secondary-telephone-triage-a-retrospective-cohort-study
#1
Kathryn Eastwood, Karen Smith, Amee Morgans, Johannes Stoelwinder
OBJECTIVE: To investigate the appropriateness of cases presenting to the emergency department (ED) following ambulance-based secondary telephone triage. DESIGN: A pragmatic retrospective cohort analysis of all the planned and unplanned ED presentations within 48 hours of a secondary telephone triage. SETTING: The secondary telephone triage service, called the Referral Service, and the hospitals were located in metropolitan Melbourne, Australia and operated 24 hours a day, servicing 4...
October 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28955508/mobile-real-time-tracking-of-acute-stroke-patients-and-instant-secure-inter-team-communication-the-join-app
#2
Stephan A Munich, Lee A Tan, Danilo M Nogueira, Kiffon M Keigher, Michael Chen, R Webster Crowley, James J Conners, Demetrius K Lopes
PURPOSE: The primary correlate to survival and preservation of neurologic function in patients suffering from an acute ischemic stroke is time from symptom onset to initiation of therapy and reperfusion. Communication and coordination among members of the stroke team are essential to maximizing efficiency and subsequently early reperfusion. In this work, we aim to describe our preliminary experience using the Join mobile application as a means to improve interdisciplinary team communication and efficiency...
September 2017: Neurointervention
https://www.readbyqxmd.com/read/28915163/do-prehospital-providers-and-emergency-nurses-agree-on-triage-assignment-an-efficacy-study
#3
Helene Skjøt-Arkil, Louise L Pontoppidan, Jens O Laursen, Matthias Giebner, Jesper D Andersen, Christian B Mogensen
OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage? METHODS: The study was a prospective and observational efficacy study...
September 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28892188/person-centred-climate-and-psychometrical-exploration-of-person-centredness-and-among-patients-not-conveyed-by-the-ambulance-care-service
#4
Andreas Rantala, Anna Forsberg, Anna Ekwall
BACKGROUND: What already is known is that as many as 50% of all Swedish Ambulance Care Service assignments are considered as non-emergency. Therefore, due to medical protocols and triage system, patients are refused conveyance to the Accident and Emergency Department by the Ambulance Care Service. AIM: The aim of this study was to psychometrically explore the construct validity of a possible dimension of person-centredness, developed from a previous published qualitative study in a nonemergency ambulance care context...
September 11, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28781912/nursing-review-section-of-surgical-neurology-international-part-1-lumbar-disc-disease
#5
Nancy E Epstein, Renee D Hollingsworth
BACKGROUND: Patients with lumbar disc disease may present with low back pain, pain that radiates down into the lower extremity (radiculopathy), and leg pain that increases with ambulation (neurogenic claudication). Patients may first undergo diagnostic studies [(magnetic resonance imaging (MRI) and computed tomographic (CT) examinations] to determine whether there is any significant nerve root or thecal sac compression. METHODS: Increasingly, patients with low back pain with/without radiculopathy are being screened by nurses rather than by neurologists or neurosurgeons/orthopedists...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28777117/delays-in-treatment-seeking-decisions-among-women-with-myocardial-infarction
#6
Cynthia Arslanian-Engoren, Linda D Scott
BACKGROUND: Minimizing the time from myocardial infarction (MI) symptom onset to the implementation of lifesaving interventions decreases morbidity and mortality of women who experience an MI. However, not all women seek timely evaluation and treatment for their MI symptoms. OBJECTIVES: The aim of this article is to describe reasons for decision treatment delays among women who experience an initial MI. METHOD: A secondary analysis of narrative data collected as part of a qualitative study examining the triage experiences of women (N = 14) who presented to the emergency department with symptoms of acute MI...
September 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28720723/profile-and-outcomes-of-critically-ill-children-in-a-lower-middle-income-country
#7
Muhammad Irfan Habib, Khalid Mehmood A Khan
OBJECTIVE: To determine the clinical profile and outcome of critically ill children presenting to a paediatric ED in a lower middle-income country. METHODS: We performed a retrospective analysis of children (<14 years) presenting to the ED of the National Institute of Child Health, Karachi, between January and December 2014 who were assigned to acuity 1 (requiring immediate life-saving interventions) according to the Emergency Severity Index. Data included demographic variables, presenting complaints, interventions and outcomes in the ED...
July 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28670809/inaccurate-diagnosis-of-paediatric-anaphylaxis-in-three-australian-emergency-departments
#8
Hector Thomson, Robert Seith, Simon Craig
AIM: To determine the accuracy of emergency department (ED) paediatric anaphylaxis diagnosis, and to identify factors associated with misdiagnosis. METHODS: Retrospective chart review of children aged 0-18 years with allergic presentations to three Victorian EDs in 2014. Cases were included if an ED diagnosis of anaphylaxis was recorded, or the presentation met international consensus criteria for anaphylaxis. RESULTS: Of the 60 143 paediatric ED presentations during the study period, 1551 allergy-related presentations were identified and reviewed...
July 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28649936/berlin-prehospital-or-usual-delivery-of-acute-stroke-care-study-protocol
#9
Martin Ebinger, Peter Harmel, Christian H Nolte, Ulrike Grittner, Bob Siegerink, Heinrich J Audebert
Rationale Prehospital stroke care in specialized ambulances increases thrombolysis rates, reduces alarm-to-treatment times, and improves the prehospital triage. Preliminary analyses suggest cost-effectiveness. However, scientific proof of better functional outcome compared to usual care is still lacking. Aim To prove better functional outcomes after deployment of the Stroke Emergency Mobile compared to regular ambulances. Sample size estimates A sample size of 686 patients will be required in each arm (Stroke Emergency Mobile group vs...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28513414/-prehospital-triage-in-trauma-patients-ambulance-care-and-deployment-of-a-mobile-medical-team
#10
M van Heijl, D den Hartog
- The prehospital trauma triage system consisting of regional ambulance services and overarching availability of mobile medical teams, the level criteria for trauma centres and in-hospital care for trauma patients are well-organised in the Netherlands.- However, the quality of prehospital triage in the Netherlands is inadequate at the moment, with an average under-triage rate of more than 30%. There is, thus, much room for improvement in the quality of prehospital triage.- Research in this area is now taking off, partly because of the arrival of a new quality indicator from the Netherlands National Health Care Institute, which states that at least 90% of multiple-trauma patients should be primarily taken to a level 1 trauma centre...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28507997/recognizing-sudden-cardiac-arrest-may-require-more-than-two-questions-during-telephone-triage-developing-a-complementary-checklist
#11
Amir Mirhaghi, Hojjat Shafaee, Javad Malekzadeh, Farzaneh Hasanzadeh
OBJECTIVE: To develop decision-support tools to identify patients experiencing sudden cardiac arrest (SCA). METHODS: Eighty calls related to SCA were content analyzed, and the contextual patterns that emerged were organized into a checklist. Two researchers independently analyzed the recorded calls and compared their findings. Eighteen dispatchers scored 20 cases (which included SCA and non-SCA cases) both with and without the checklist. Correct responses for each case and agreement among dispatchers have been reported...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28506282/under-triage-in-telephone-consultation-is-related-to-non-normative-symptom-description-and-interpersonal-communication-a-mixed-methods-study
#12
Hejdi Gamst-Jensen, Freddy K Lippert, Ingrid Egerod
BACKGROUND: Telephone consultation and triage are used to limit the workload on emergency departments. Lack of visual cues and clinical tests put telephone consultations to a disadvantage compared to face-to-face consultations increasing the risk of under-triage. Under-triage occurs in telephone triage; however why under-triage happens is not explored yet. The aim of the study was to describe situations of under-triage in context, to assess the quality of under-triaged calls, and to identify communication patterns contributing to under-triage in a regional OOH service in the capital region of Denmark...
May 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28495830/establishing-recommendations-for-stroke-systems-in-the-thrombectomy-era-the-upstate-new-york-stakeholder-proceedings
#13
Zainab Magdon-Ismail, Curtis Benesch, Jeremy T Cushman, Ian Brissette, Andrew M Southerland, Ethan S Brandler, Cemal B Sozener, Sue Flor, Roseanne Hemmitt, Kathleen Wales, Krystal Parrigan, Steven R Levine
BACKGROUND AND PURPOSE: The American Heart Association/American Stroke Association and Department of Health Stroke Coverdell Program convened a stakeholder meeting in upstate NY to develop recommendations to enhance stroke systems for acute large vessel occlusion. METHODS: Prehospital, hospital, and Department of Health leadership were invited (n=157). Participants provided goals/concerns and developed recommendations for prehospital triage and interfacility transport, rating each using a 3-level impact (A [high], B, and C [low]) and implementation feasibility (1 [high], 2, and 3 [low]) scale...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28494665/remote-clinical-decision-making-a-clinician-s-definition
#14
Mike Brady, Kate Northstone
Aims Remote clinical decision-making (RCDM), commonly known as 'telephone triage' or 'hear and treat', describes clinicians' non-face-to-face involvement with patient care, and is an established strategy in UK ambulance services for managing increasing demand. However, there is no suitable definition of RCDM that fully explains the roles undertaken by clinicians in 999 hubs, or for its use as an ambulance quality indicator (AQI). The aim of this study, which is part of a larger evaluation of a new RCDM module in higher education, is to determine how clinicians define RCDM...
May 12, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28483035/management-of-patients-brought-in-by-ambulance-to-the-emergency-department-role-of-the-advanced-musculoskeletal-physiotherapist
#15
Rita Kinsella, Tom Collins, Bridget Shaw, James Sayer, Belinda Cary, Andrew Walby, Sallie Cowan
Objective The aim of the present study was to evaluate the role of the Advanced Musculoskeletal Physiotherapist (AMP) in managing patients brought in by ambulance to the emergency department (ED).Methods This study was a dual-centre observational study. Patients brought in by ambulance to two Melbourne hospitals over a 12-month period and seen by an AMP were compared with a matched group seen by other ED staff. Primary outcome measures were wait time and length of stay (LOS) in the ED.Results Data from 1441 patients within the Australasian Triage Scale (ATS) Categories 3-5 with musculoskeletal complaints were included in the analysis...
May 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28467581/can-we-make-an-early-do-not-resuscitate-decision-in-severe-burn-patients
#16
Yücel Yüce, Hakan Ahmet Acar, Kutlu Hakan Erkal, Erhan Tuncay
BACKGROUND: The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. METHODS: Between January 2009 and December 2014, 29 patients (3...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28459301/role-of-guideline-adherence-in-improving-field-triage
#17
Craig D Newgard, Rongwei Fu, E Brooke Lerner, Mohamud Daya, Jonathan Jui, Lynn Wittwer, Terri A Schmidt, Dana Zive, Eileen M Bulger, Ritu Sahni, Craig Warden, Nathan Kuppermann
OBJECTIVE: To compare the sensitivity of current field triage practices for identifying high-risk trauma patients to strict guideline adherence, including changes in triage specificity, ambulance transport patterns, and trauma center volumes. METHODS: This was a pre-planned secondary analysis of an out-of-hospital prospective cohort of injured children and adults transported by 44 EMS agencies to 28 trauma and non-trauma hospitals in 7 Northwest U.S. counties from January 1, 2011 through December 31, 2011...
September 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28455884/two-hour-evaluation-and-referral-model-for-shorter-turnaround-times-in-the-emergency-department
#18
John A Burke, Jaimi Greenslade, Jadwiga Chabrowska, Katherine Greenslade, Sally Jones, Jacqueline Montana, Anthony Bell, Alan O'Connor
OBJECTIVE: The objective of this study was to assess the implementation of a novel ED model of care, which combines clinical streaming, team-based assessment and early senior consultation to reduce length of stay. METHODS: A pre-post-intervention study was used to compare ED performance following an extensive clinical redesign programme. Clinical teams and work sequences were reconfigured to promote the role of the staff specialist, with a focus on earlier decisions regarding disposition...
June 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28420688/can-a-partnership-between-general-practitioners-and-ambulance-services-reduce-conveyance-to-emergency-care
#19
Manuel Villarreal, Jonathan Leach, Kandala Ngianga-Bakwin, Jeremy Dale
BACKGROUND: Emergency services are facing increasing workload pressures, and new models of care are needed. We evaluate the impact of a service development involving a partnership between emergency ambulance crews and general practitioners (GPs) on reducing conveyance rates to the Hospital Emergency Department(ED) . METHODS: The service model was implemented in the West Midlands of England. Call handlers identified patients with needs that could be addressed by a GP using locally agreed criteria...
July 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28399897/prehospital-ambulance-stroke-test-pilot-study-of-a-novel-stroke-test
#20
Gunnar Andsberg, Magnus Esbjörnsson, Arne Olofsson, Arne Lindgren, Bo Norrving, Mia von Euler
BACKGROUND: There is a need for a prehospital stroke test that in addition to high sensitivity for stroke, also is able to communicate stroke severity similar to the National Institute of Health Stroke Scale (NIHSS). METHODS: The PreHospital Ambulance Stroke Test (PreHAST), an eight item test based on NIHSS, which scores stroke severity from 0-19 points, was designed and adapted for the ambulance services. In the pilot study the ambulance nurses used PreHAST to assess patients with suspected stroke in the prehospital setting...
April 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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