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https://www.readbyqxmd.com/read/30097272/impact-of-an-emergency-medicine-pharmacist-on-empiric-antibiotic-prescribing-for-pneumonia-and-intra-abdominal-infections
#1
Benjamin D Kulwicki, Kasey L Brandt, Lauren M Wolf, Andrew J Weise, Lisa E Dumkow
PURPOSE: It is critical to engage ED providers in antimicrobial stewardship programs (ASP). Emergency medicine pharmacists (EMPs) play an important role in ASP by working with providers to choose empiric antimicrobials. This study aimed to determine the impact of an EMP on appropriate empiric antibiotic prescribing for community-acquired pneumonia (CAP) and intra-abdominal infections (CA-IAI). METHODS: A retrospective cohort study was conducted evaluating adult patients admitted with CAP or CA-IAI...
July 29, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30095871/how-much-training-in-ultrasound-would-emergency-nurses-need
#2
Tricia Scott
Ultrasound sonography, in which a high-pitched sound wave travels at different speeds through objects of variable density, offers effective clinical diagnostic applications to identify problems, such as free abdominal fluid following blunt trauma, cardiac effusion and long bone fractures.
July 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/30095796/initial-provider-specialty-is-associated-with-long-term-opiate-use-in-patients-with-newly-diagnosed-low-back-and-lower-extremity-pain
#3
Tej Azad, Daniel Vail, Jason Bentley, Summer Han, Paola Suarez, Kunal Varshneya, Vaishali Mittal, Anand Veeravagu, Manisha Desai, Jay Bhattacharya, John Ratliff
STUDY DESIGN: Retrospective longitudinal cohort analysis of patients diagnosed in 2010, with continuous enrollment six months prior to and 12 months following the initial visit. OBJECTIVE: To determine whether provider specialty influences patterns of opiate utilization long after initial diagnosis. SUMMARY OF BACKGROUND DATA: Patients with low back pain present to a variety of providers and receive a spectrum of treatments, including opiate medications...
August 7, 2018: Spine
https://www.readbyqxmd.com/read/30095658/improving-nontechnical-skills-of-an-interprofessional-emergency-medical-team-through-a-one-day-crisis-resource-management-training
#4
Teodora Sorana Truta, Cristian Marius Boeriu, Sanda-Maria Copotoiu, Marius Petrisor, Emilia Turucz, Dan Vatau, Marc Lazarovici
Errors are frequent in healthcare, but Emergency Departments are among the highest risk areas due to frequent changes in team composition, complexity and variety of cases, and difficulties encountered in managing multiple patients simultaneously.Crisis resource management (CRM) training has been associated with decreased error rates in the aviation industry as well as in certain areas of acute medical care, such as anesthesia and emergency medicine. In this study, we assessed whether a single day CRM training, combining didactic and simulation sessions, improves nontechnical skills (NTS) of interprofessional emergency medical teams...
August 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30095596/providers-ability-to-identify-sentinel-injuries-concerning-for-physical-abuse-in-infants
#5
Emily A Eismann, Robert A Shapiro, Jonathan Thackeray, Kathi Makoroff, Colleen J Bressler, Grace J Kim, Lori Vavul-Roediger, Paul McPherson, Eugene Izsak, Sandra P Spencer
OBJECTIVES: The objectives of this study were to assess the ability of pediatric health care providers and social workers to recognize sentinel injuries in infants under 6 months of age and to determine what factors influence their decision to evaluate for physical abuse. METHODS: A statewide collaborative focused on sentinel injuries administered a survey to pediatric health care providers and social workers in the emergency department, urgent care, and primary care...
August 8, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/30093514/development-of-a-simple-practice-based-tool-to-assess-quality-of-paediatric-emergency-care-delivery-in-resource-limited-settings-identifying-critical-actions-via-a-delphi-study
#6
Rajesh Kirit Daftary, Brittany Lee Murray, Teri Ann Reynolds
OBJECTIVE: Provision of timely, high-quality care for the initial management of critically ill children in African hospitals remains a challenge. Monitoring the completion of critical actions during resuscitations can inform efforts to reduce variability and improve outcomes. We sought to develop a practice-based tool based on contextually relevant actions identified via a Delphi process. Our goal was to develop a tool that could identify gaps in care, facilitate identification of training and standardised assessment to support quality improvement efforts...
August 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/30093336/does-a-written-tool-to-guide-structured-debriefing-improve-discourse-implications-for-interprofessional-team-simulation
#7
Ryan Thompson, Sarah Sullivan, Krystle Campbell, Ingie Osman, Brianna Statz, Hee Soo Jung
PURPOSE: Timely debriefing following a simulated event supports learners in critically reflecting on their performance and areas for improvement. Content of debriefing has been shown to affect learner skill acquisition and retention. The use of good judgment statements from debriefing facilitators is considered superior to judgmental or nonjudgmental statements. Ideally, the majority of the conversation will consist of learner self-reflection and focused facilitation rather than directive performance feedback...
August 6, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/30093180/comparison-of-pediatric-post-reduction-fluoroscopic-and-ultrasound-forearm-fracture-images
#8
Jonathan D Auten, John H Naheedy, Nicole D Hurst, Andrew T Pennock, Kathryn A Hollenbach, John T Kanegaye
OBJECTIVE: Emergency department (ED) reduction of pediatric fractures occurs most commonly in the forearm and can be challenging if fluoroscopy is not available. We sought to assess the ability of point of-care ultrasonography (POCUS) to predict adequacy of reduction by fluoroscopy. METHODS: We prospectively enrolled ED patients 0-17 years of age with radial and/or ulnar fractures requiring reduction under fluoroscopic guidance. Post-reduction POCUS (probe dorsal, volar, and coronal) and fluoroscopic (AP and lateral) fracture images were recorded...
July 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30092939/regional-anesthesia-and-analgesia-for-acute-trauma-patients
#9
REVIEW
Ian R Slade, Ron E Samet
Regional anesthesia for the acute trauma patient is increasing due to the growing appreciation of its benefits, development of newer techniques and equipment, and more robust training. Block procedures are expanding beyond perioperative interventions performed exclusively by anesthesiologists to paramedics on scene, emergency medicine physicians, and nurse-led services using these techniques early in trauma pain management. Special considerations and indications apply to trauma victims compared with the elective patient and must be appreciated to optimize safety and clinical outcomes...
September 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/30091549/lyme-disease-recognition-and-management-for-emergency-nurses
#10
Stephen McGhee, Connie Visovksy, Cheryl Zambroski, Alan Finnegan
Over the past ten years there has been a significant rise in the number of people who present to emergency departments with Lyme disease. Although some patients remain asymptomatic many present with a rash around a previous tick bite and others may present with a range of debilitating symptoms that can be problematic if left untreated. Due to the growing prevalence of Lyme disease in the UK and the US this article gives an overview of the vector-borne condition and provides emergency nurses with information about the pathophysiology, prevention, presenting signs and symptoms and management...
August 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/30091183/avoiding-anchoring-bias-by-moving-beyond-mechanical-falls-in-geriatric-emergency-medicine
#11
Guruprasad Nagaraj, Carolyn Hullick, Glenn Arendts, Ellen Burkett, Keith D Hill, Christopher R Carpenter
No abstract text is available yet for this article.
August 8, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/30089441/determining-the-initiation-of-opiate-misuse-resulting-in-opioid-use-disorder-in-pregnant-women
#12
Zachary W Walker, Abigail R Vinson, Dean Babcock, Tara Benjamin, David M Haas
The aim of this study was to explore the "opiate misuse footprint" made by obstetrics and gynecology physicians in prescribing opioid medications for postpartum pain control that led to opioid misuse and opioid use disorder. Data were collected using intake information and anonymous surveys administered to pregnant women at local methadone clinics in Indianapolis, Indiana, in 2016-2017. Results from this study revealed that 40% of the 33 participants stated that the first drug they became addicted to was prescription opioids; 71% stated that the first opiate they became addicted to was a prescription pain medication...
August 8, 2018: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/30088160/abcde-of-prehospital-ultrasonography-a-narrative-review
#13
REVIEW
Rein Ketelaars, Gabby Reijnders, Geert-Jan van Geffen, Gert Jan Scheffer, Nico Hoogerwerf
Prehospital point-of-care ultrasound used by nonradiologists in emergency medicine is gaining ground. It is feasible on-scene and during aeromedical transport and allows health-care professionals to detect or rule out potential harmful conditions. Consequently, it impacts decision-making in prioritizing care, selecting the best treatment, and the most suitable transport mode and destination. This increasing relevance of prehospital ultrasonography is due to advancements in ultrasound devices and related technology, and to a growing number of applications...
August 8, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/30086566/-emergency-medicine-in-remote-settings
#14
Andreas Leischker, Fritz Ge Holst
For many acute diseases and injuries, treatment does not differ between industrialised environment and wilderness setting. However, for some emergencies, treatment needs to be adapted if advanced medical care facilities cannot be reached within 4 hours.In these situations, dislocated joints and fractures should be reduced quickly. Contaminated wounds should be cleaned carefully, with drinking water being sufficient when no sterile solution is available. A patient with a contaminated wound should receive a systemic antibiotic coverage within one hour...
August 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/30086123/informing-the-revolution-a-needs-assessment-of-ultrasound-knowledge-and-skills-among-graduating-physician-assistant-students
#15
Melissa Barnett, M Tyson Pillow, Jennifer Carnell, Anita Rohra, Stephanie DeSandro, Aimee K Gardner
PURPOSE: We performed a needs assessment to understand how existing physician assistant (PA) program curricula and clinical training affect students' ultrasound knowledge, skills, and competence and prepare students for performing ultrasound techniques in clinical practice. METHODS: Students graduating from a PA program completed a 23-item questionnaire examining their ultrasound training experiences, their self-assessment of competency, and their demographics. Students also completed a 15-item ultrasound knowledge assessment...
August 6, 2018: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/30083959/task2heart-exploring-heart-rate-differences-with-time-motion-workflow-observations-of-emergency-medicine-physicians
#16
Allan Fong, Tracy C Kim, Raj M Ratwani, Kathryn M Kellogg
No abstract text is available yet for this article.
August 7, 2018: Journal of Medical Systems
https://www.readbyqxmd.com/read/30083721/diagnosis-of-kawasaki-disease-using-a-minimal-whole-blood-gene-expression-signature
#17
Victoria J Wright, Jethro A Herberg, Myrsini Kaforou, Chisato Shimizu, Hariklia Eleftherohorinou, Hannah Shailes, Anouk M Barendregt, Stephanie Menikou, Stuart Gormley, Maurice Berk, Long Truong Hoang, Adriana H Tremoulet, John T Kanegaye, Lachlan J M Coin, Mary P Glodé, Martin Hibberd, Taco W Kuijpers, Clive J Hoggart, Jane C Burns, Michael Levin
Importance: To date, there is no diagnostic test for Kawasaki disease (KD). Diagnosis is based on clinical features shared with other febrile conditions, frequently resulting in delayed or missed treatment and an increased risk of coronary artery aneurysms. Objective: To identify a whole-blood gene expression signature that distinguishes children with KD in the first week of illness from other febrile conditions. Design, Setting, and Participants: The case-control study comprised a discovery group that included a training and test set and a validation group of children with KD or comparator febrile illness...
August 6, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/30078653/emergency-medicine-practice-environment-and-impact-on-concert-examination-performance
#18
Catherine A Marco, Robert P Wahl, James D Thomas, Ramon W Johnson, O John Ma, Anne L Harvey, Earl J Reisdorff
OBJECTIVE: The ABEM ConCert Examination is a summative examination that ABEM-certified physicians are required to pass once in every 10-year cycle to maintain certification. This study was undertaken to identify practice settings of emergency physicians, and to determine if there was a difference in performance on the 2017 ConCert between physicians of differing practice types and settings. METHODS: This was a mixed methods cross sectional-study, using a post-examination survey and test performance data...
August 1, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30078457/ambulatory-emergency-medicine
#19
REVIEW
James E Bogan
While practicing exotic animal medicine as an ambulatory practitioner, veterinarians need to be prepared for the inevitable emergency call. Emergencies in exotic animal medicine come in all shapes and sizes and the veterinarian must be prepared for a variety of situations. With the proper training, equipment, and managing client expectations, an ambulatory exotics animal practitioner can successfully address emergencies. This article provides a brief overview in managing emergency cases in an ambulatory exotics animal practice...
September 2018: Veterinary Clinics of North America. Exotic Animal Practice
https://www.readbyqxmd.com/read/30075773/academic-career-preparation-for-residents-are-we-on-the-right-track-prevalence-of-specialized-tracks-in-emergency-medicine-training-programs
#20
Jaime Jordan, Michael Hwang, Wendy C Coates
BACKGROUND: Residency prepares trainees to deliver clinical care. It's unknown if there is adequate career preparation, particularly for academic medicine. Prior literature has shown that interest in pursuing an academic career wanes during residency. Few trainees believe residency provides them with the necessary skills to be successful in academic medicine. Formalized areas of concentration may allow for deepened experience and mentorship in a specific field and may contribute to increased scholarly productivity which has been associated with selecting an academic career...
August 3, 2018: BMC Medical Education
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