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"Triage" AND "Emergency"

Mhd Wasem Alsabbagh, Sherilyn K D Houle
BACKGROUND: Pharmacists have been shown to be beneficial for inclusion in emergency department (ED) services; however, little has been done to assess these benefits with pharmacists having even wider scopes of practice, including limited prescribing authority. OBJECTIVES: The aims of this study were to determine the proportion of ED visits that can potentially be managed by pharmacists, the most prevalent conditions within these cases, and the factors associated with patients presenting with such cases to the ED...
December 7, 2018: Research in Social & Administrative Pharmacy: RSAP
Jorge César Correia, Olivia Braillard, Christophe Combescure, Eric Gerstel, Hervé Spechbach
BACKGROUND: Literature provides mixed results regarding the influence of large-scale sporting events on emergency department attendance. To contribute to the research on the subject, we sought to evaluate whether the broadcasting of major tennis tournaments, one of the most popular sports in Switzerland, has an impact on patient admission rates in emergency units in Geneva including 1) type of match 2) the role of a Swiss player, 3) degree of triage, 4) reason of attendance and 5) age of patients...
December 13, 2018: BMC Emergency Medicine
Khic-Houy Prang, Rachel Canaway, Marie Bismark, David Dunt, Margaret Kelaher
BACKGROUND: In 2011, the Australian government introduced national healthcare reforms aimed at increasing the timeliness and quality of hospital care. The healthcare reforms included, but were not limited to, emergency department (ED) time-based targets, financial incentives, and public performance reporting of hospital data. We sought to evaluate the impact of the national healthcare reforms on ED time-based process outcomes. METHODS: A quasi-experimental study of ED presentations from 2006 to 2016 in the state of Victoria, Australia...
2018: PloS One
Francesca Mataloni, Paola Colais, Claudia Galassi, Marina Davoli, Danilo Fusco
BACKGROUND AND AIMS: Patients who leave Emergency Department before physician's visit (LWBS) or during treatment (LDT) represent a useful indicator of the emergency care's quality. The profile of patients LWBS was described: they are generally males, young, with lower urgency triage allocation and longer waiting time. They have a greater risk of ED re-admission compared to discharged patients, but effect on hospitalization and mortality are more controversial. The aims of this study are to identify determinants and adverse short term outcomes for LWBS and LDT patients...
2018: PloS One
Maria Clara de Magalhães-Barbosa, Arnaldo Prata-Barbosa, Carlos Eduardo Raymundo, Antonio José Ledo Alves da Cunha, Claudia de Souza Lopes
OBJECTIVE: To assess the validity and reliability of a triage system for pediatric emergency care (CLARIPED) developed in Brazil. METHODS: Validity phase: prospective observational study with children aged 0 to 15 years who consecutively visited the pediatric emergency department (ED) of a tertiary hospital from July 2 to 18, 2013. We evaluated the association of urgency levels with clinical outcomes (resource utilization, ED admission rate, hospitalization rate, and ED length of stay); and compared the CLARIPED performance to a reference standard...
October 2018: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
Jiri Polivka, Jiri Polivka, Vladimir Rohan
The model of centralized stroke care in the Czech Republic was created in 2010-2012 by Ministry of Health (MH) in cooperation with professional organization-Cerebrovascular Section of the Czech Neurological Society (CSCNS). It defines priorities of stroke care, stroke centers, triage of suspected stroke patients, stroke care quality indicators, their monitoring, and reporting. Thirteen complex cerebrovascular centers (CCC) provide sophisticated stroke care, including intravenous thrombolysis (IVT), mechanical thrombectomy (MTE), as well as other endovascular (stenting, coiling) and neurosurgical procedures...
December 2018: EPMA Journal
Beata Morawiec, Brygida Przywara-Chowaniec, Piotr Muzyk, Mariusz Opara, Lam Ho, Lui Chun Tat, Olivier Muller, Ewa Nowalany-Kozielska, Damian Kawecki
Background: Clinical short-term risk stratification is a recommended approach in patients with chest pain and possible acute myocardial infarction (AMI) to further improve high safety of biomarker-based rule-out algorithms. The study aim was to assess clinical performance of baseline concentrations of high-sensitivity cardiac troponin T (hs-TnT) and copeptin and the modified HEART score (mHS) in early presenters to the emergency department with chest pain. Methods: This cohort study included patients with chest pain with onset maximum of 6 h before admission and no persistent ST-segment elevation on electrocardiogram...
2018: Disease Markers
Cynthia L Holle, Mary A Turnquist, James L Rudolph
Natural disasters impact people of every age in the communities where they occur, with older adults being a vulnerable subset of the population. Most disaster shelter volunteer nurses are experienced in addressing common health needs of older adult clients such as diabetes, hypertension, and pulmonary disease. These nurses also have the requisite training to respond to more acute medical events, including the symptoms of a heart attack or stroke. They provide care and comfort to those suffering from the distress, anxiety, and fear caused by disasters...
December 9, 2018: Nursing Forum
Álvaro Soto V, Gladys Morales I, Claudio Vega C, Gonzalo Echeverría V, María Belén Colinas G, Pedro Canales O, Daniela Contreras B
BACKGROUND: Neurological emergencies constitute 10-15% of medical emergencies. Doctor Hernán Henríquez Aravena Hospital has in house neurologists present permanently at the Emergency Room since July 2013. AIM: To estimate the waiting times for neurological consultations; to compare the waiting times between neurovascular (UV) and non-vascular (UNV) emergencies; and to compare the waiting times of two prioritization (triage) models. MATERIAL AND METHODS: A convenience sample of the consultations made during shift # 1 at the emergency room between January and December 2016, was analyzed...
July 2018: Revista Médica de Chile
Jill Crosby, Dagmawi Werku, Tigist Zewdu, Grace Wanjiku, Jessica Schmidt
Introduction: The term acute abdomen refers to a clinical syndrome of sudden onset, severe abdominal pain. The differential diagnosis for this presentation is broad, but most cases require emergent medical or surgical management. Especially in cases of ischaemic bowel, time to diagnosis can mean the difference between survival and death. As a result, mortality remains high in resource-limited settings. Case report: We describe the case of a 28-year-old male who presented to an urban Ethiopian emergency centre with three days of vomiting, bloody diarrhoea, and abdominal pain...
December 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Gareth D Meyer, Tabitha Nadishani Meyer, Charles Benjamin Gaunt
Introduction: The implementation of a triage system is a vital step in improving the functioning and patient flow of the emergency centre in a rural district hospital. The South African Triage Scale (SATS) is a well validated and reliable tool used widely in South Africa and other low- and middle-income countries. This study aims to assess the validity of the SATS in a rural district hospital context. Methods: This is a cross-sectional study. All patients presenting to the Zithulele Hospital emergency centre from 1 October 2015 to 31 December 2015 were triaged using the SATS system, routinely collected data was used to determine the correlation between assigned acuity and outcome to determine rates of under- and over-triage...
December 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Eleanor L DiBiasio, Mahesh V Jayaraman, Lori Oliver, Gino Paolucci, Michael Clark, Cristina Watkins, Karen DeLisi, Ann Wilks, Shadi Yaghi, Morgan Hemendinger, Grayson L Baird, J Adam Oostema, Ryan A McTaggart
BACKGROUND: Following the results of randomized clinical trials supporting the use of mechanical thrombectomy (MT) with tissue plasminogen activator for emergent large vessel occlusion (ELVO), our state Stroke Task Force convened to: update legislation to recognize differences between Primary Stroke Centers (PSCs) and Comprehensive Stroke Centers (CSCs); and update Emergency Medical Services (EMS) protocols to triage direct transport of suspected ELVO patients to CSCs. PURPOSE: We developed a single-session training curriculum for EMS personnel focused on the Los Angeles Motor Scale (LAMS) score, its use to correctly triage patients as CSC-appropriate in the field, and our state-wide EMS stroke protocol...
December 7, 2018: Journal of Neurointerventional Surgery
Bhagavatula Indira Devi, Dhaval P Shukla, Dhananjaya I Bhat, Manjul Tripathi, Amara Warren, Nagesh C Shanbhag, Subhas K Konar, Anne L Stake, Ruchika Singhal
BACKGROUND: With increasing population, motorization and road traffic accidents, neurotrauma is on rise in India. Inadequate triage and under-utilization of locally available resources at all healthcare levels has led to a non-uniform neurotrauma care delivery. We present our experience in a tertiary care hospital (NIMHANS) in Bengaluru, India, and evaluate the referral pattern of mild traumatic brain injury (mTBI) cases to enable adequate care to moderate and severely injured TBI patients...
December 6, 2018: World Neurosurgery
Hiren Patel, Sebastian Suarez, Lance Shaull, Jeffrey Edwards, Zaid Altawil, Joseph Owuor, Debora Rogo, Kevin Schwartz, Luate Richard, Thomas F Burke
BACKGROUND: Emergency care is a neglected area of focus in many low- and middle-income countries. There is a paucity of research on types and frequencies of acute illnesses and injuries in low-resource settings. OBJECTIVE: The primary objective of this study was to describe the demographic characteristics and emergency conditions of patients that presented to a new emergency care center (ECC) at Sagam Community Hospital in Luanda, Kenya. METHODS: Patient demographic characteristics, modes of arrival, chief symptoms, triage priorities, self-reported human immunodeficiency virus status, tests performed, interventions, discharge diagnoses, and dispositions were collected for all patients that presented to the Sagam Community Hospital ECC...
December 4, 2018: Journal of Emergency Medicine
Ashley S Mogul, David M Cline, Jennifer Gabbard, Casey Bryant
BACKGROUND: Early integration of palliative care from the emergency department (ED) is an underutilized care modality with potential benefits, but few studies have identified who is appropriate for such care. OBJECTIVE: Our hypothesis is that patients aged 65 years or older who present to the ED as level I Emergency Severity Index from a long-term care (LTC) facility have high resource utilization and mortality and may benefit from early palliative care involvement...
December 6, 2018: Journal of Emergency Medicine
Cecily DuPree, Aaron Pinnola, Stefanie Gibson, Keely Muertos, John M Davis, Jason D Sciarretta
BACKGROUND: Mass casualty events are infrequent and create an abrupt surge of patients requiring emergency medical services within a brief period. We hypothesize that implementation of a controlled "traffic loop" pattern during a planned high-volume motorcycle rally could improve overall mortality and impact patient outcomes. MATERIALS AND METHODS: We performed a retrospective analysis of all motorcycle-related injuries during the city's annual motorcycle rally over a 4-y period...
February 2019: Journal of Surgical Research
Gyorgy Papai, Gabor Csato, Ildiko Racz, Gabor Szabo, Tamas Barany, Agnes Racz, Miklos Szokol, Balazs Sarman, Istvan F Edes, Daniel Czuriga, Rudolf Kolozsvari, Istvan Edes
INTRODUCTION: The transtelephonic electrocardiogram has been shown to have a great value in the management of out-of-hospital chest pain emergencies. In our previous study it not only improved the pre-hospital medical therapy and time to intervention, but also the in-hospital mortality in ST-segment elevation myocardial infarction. It was hypothesised that the higher in-hospital survival rate could be due to improved transtelephonic electrocardiogram-based pre-hospital management (electrocardiogram interpretation and teleconsultation) and consequently, better coronary perfusion of patients at the time of hospital admission...
December 10, 2018: Journal of Telemedicine and Telecare
Kathleen Grisanti, Lisa Martorano, Margaret Redmond, Rebecca Scherzer, Kasey Strothman, Lauren Malthaner, James Davis, Songzhu Zhao, David Kline, Julie C Leonard
OBJECTIVE: Anaphylaxis is a medical emergency requiring prompt recognition and treatment with intramuscular epinephrine to optimize outcomes. To date, there is a paucity of data regarding the demographic characteristics of the subset of patients calling 911 for allergic reactions and the emergency medical services (EMS) dispatcher's adherence to national protocols for their response to a suspected allergic reaction. METHODS: We conducted a retrospective review of dispatch calls to a local municipality that were dispatched with an impression of an "allergic reaction" or "difficulty breathing related to a suspected allergic reaction" from January 2016 to June 2016...
December 11, 2018: Prehospital Emergency Care
H X Shi, J Z Wu, G B Chen, B Z Zhu, W Y Yan, L Chen, Y J Xiao, L Y Zhang
Objective: To assess the effectiveness in optimizing resources and shortening critical children's waiting time in pediatric emergency department (PED) with five-level pediatric emergency triage system (PETS). Methods: This retrospective study was conducted in the First Affiliated Hospital of Xiamen University after PETS was applied. The data of patients who visited the pediatric emergency department from January 2015 to December 2017 were collected and analyzed, including age, sex, diseases, visiting time, triage rate and destination...
December 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
General Leung, Dragos Duta, Julie Perry, Lorenzo Leonardi, Joel Fish, Karen Cross
Burns are a frequent cause of traumatic injury, accounting for an average of 1,230 visits to the emergency department every day in the United States. While many of these injuries will heal spontaneously, nearly 1 in 10 are severe enough to require hospitalization or transfer to a specialized burn center. The early surgical management of a severe burn is critical to patient outcome, but few tools exist for triaging viable and non-viable tissue at early time-points post-injury. Without a validated outcome measure, even experienced burn surgeons diagnose tissue viability with an accuracy of only 50-70%, with significant consequences for patient morbidity, mortality and cost to the healthcare system...
2018: International Journal of Burns and Trauma
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