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"Triage" AND "Emergency"

Vincent A Verheij, Jan-Erik Scholtz, Nandini M Meyersohn, Blair A Parry, Udo Hoffmann, Brian B Ghoshhajra, John T Nagurney
BACKGROUND: Several large trials demonstrated that coronary computed tomography angiography (CTA) in a triage strategy could lead to increased secondary cardiac risk stratifying testing (SCRST). Whether this is true for routine clinical care remains unclear. We measured SCRSTs after coronary CTA was implemented in our emergency department (ED) practice by CTA result, and if locally existing management recommendations for a structured post CTA diagnostic strategy were followed. METHODS: This single site retrospective cohort study included all our ED patients who received coronary CTA between October 1, 2012 and September 30, 2016...
October 11, 2018: Journal of Cardiovascular Computed Tomography
Christopher R McLaughlin, Michelle Biehl, Brian J Chan, Sarah J Mullen, Lily Zhao, Laura Donaldson, Nirojini Sivachandran, Prima Moinul, Joshua Barbosa, Varun Chaudhary
OBJECTIVE: To characterize emergency optometrist referrals triaged at a tertiary ophthalmology care centre by physical examination findings and provisional diagnosis accuracy. DESIGN: Prospective case review. PARTICIPANTS: Consecutive patients referred to a tertiary eye care clinic for an after-hours ocular consult. METHODS: Variables extracted from the patient charts included date of referral, age, sex, eye(s) under examination, referral visual acuity (VA), referral intraocular pressure (IOP), the referring optometrist's provisional diagnosis, VA at the time of the ophthalmologist consultation, IOP at the time of the ophthalmologist consultation, number of days between referral and ophthalmic consultation, and the ophthalmologist's diagnosis...
October 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Carl Magnusson, Johan Herlitz, Thomas Karlsson, Christer Axelsson
BACKGROUND: The assessment of children in the Emergency Medical Service (EMS) is infrequent representing 5.4% of the patients in an urban area in the western part of Sweden. In Sweden, patients are assessed on scene by an EMS nurse whom independently decides on interventions and level of care. To aid the EMS nurse in the assessment a triage instrument, Rapid Emergency Triage and Treatment System-paediatrics (RETTS-p) developed for Emergency Department (ED) purpose has been in use the last 5 years...
October 19, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Kaynan Doctor, Kristen Breslin, James M Chamberlain, Deena Berkowitz
OBJECTIVES: Rising costs in healthcare have focused attention on interventions to optimize efficiency of patient care, including decreasing unnecessary diagnostic testing. The primary objective of this study was to determine the variability of laboratory and radiology testing among licensed independent providers (LIPs) with different training backgrounds treating low-acuity patients in a pediatric emergency department (PED). METHODS: We performed a retrospective review of the electronic health records of all encounters with patients 21 years or younger, triaged as low-acuity, visiting 2 urban, academic PEDs from January 2012 to December 2013...
October 17, 2018: Pediatric Emergency Care
Hailun Liang, Lei Tao, Eric W Ford, May A Beydoun, Shaker M Eid
BACKGROUND: Optimal cancer care entails coordination among multiple providers and continued follow-up and surveillance over time. The patient-centered care brings opportunities to improve the delivery of cancer care. The adoption of patient-centered oncology care (PCOC) is in its infancy. Evidence synthesis on the model's effectiveness is scant. PURPOSES: This is the first systemic review and meta-analysis on associations of PCOC with cancer patients' adverse health care utilization, cost, patient satisfaction, and quality of care...
October 17, 2018: Health Care Management Review
David A Drummond, Lindsay B Carey
With the emerging incorporation of spiritual care into the allied health stream, there is a need for a clear and validated process of spiritual review that can be understood across multidisciplinary teams. The aim and purpose of this paper was to critically review the literature regarding spiritual screening, history-taking and assessment, and explore the merits of developing a brief instrument focussed on assessing and improving the spiritual well-being of consumers within residential aged care. Following an exploratory review of the literature, the results indicate that effective processes are noted regarding the triage and identification of the needs and spiritual assessment of consumers; however, many of these tools are overly religious in content, unwieldy in size, or not specifically aimed at identifying the immediate crisis confronting the consumer...
October 17, 2018: Journal of Religion and Health
Alberto Carli, Francesca Moretti, Giulia Giovanazzi, Valentina Niero, Valeria Perilli, Giovanna Ghirlanda, Chiara Bovo, Stefano Tardivo
BACKGROUND AND AIM: Patients could leave ED not receiving the desired care either Without Being Seen by a doctor (LWBS) or Against Medical Advice (DAMA). In term of care quality, LWBS may be related to inappropriate access and process of care, while DAMA may lead to increased risk of mortality and re-admissions. This study aims to identify frequency of patients who leave ED, determine their characteristics and identify associated factor. METHODS: This was a retrospective observational study of patients that attended EDs of University Hospital Trust of Verona in 2017...
October 8, 2018: Acta Bio-medica: Atenei Parmensis
Melanie Lloyd, Alexandra Mackintosh, Catherine Grant, Fiona McManus, Anne-Maree Kelly, Harin Karunajeewa, Clarice Y Tang
AIM: To determine whether patients presenting to the emergency department (ED) with possible benign paroxysmal positional vertigo (BPPV) are managed in accordance with best practice guidelines, and whether physiotherapists are involved in their care. DESIGN: Retrospective observational study. PARTICIPANTS: Ninety-six consecutive patients presenting to one of three EDs with vertigo, dizziness or imbalance symptoms documented at triage. Individuals with a clear non-vestibular cause of symptoms were excluded...
October 17, 2018: Physiotherapy Theory and Practice
Anne Kristine Servais Iversen, Michael Kristensen, Rebecca Monett Østervig, Lars Køber, György Sölétormos, Jakob Lundager Forberg, Jesper Eugen-Olsen, Lars Simon Rasmussen, Morten Schou, Kasper Karmark Iversen
OBJECTIVE: To compare the Danish Emergency Process Triage (DEPT) with a quick clinical assessment (Eyeball triage) as predictors of short-term mortality in patients in the emergency department (ED). METHODS: The investigation was designed as a prospective cohort study conducted at North Zealand University Hospital. All patient visits to the ED from September 2013 to December 2013 except minor injuries were included. DEPT was performed by nurses. Eyeball triage was a quick non-systematic clinical assessment based on patient appearance performed by phlebotomists...
October 16, 2018: Emergency Medicine Journal: EMJ
Priti P Parikh, Pratik Parikh, Logan Mamer, Mary C McCarthy, Joseph V Sakran
Importance: Studies show that secondary overtriage (SO) contributes significantly to the economic burden of injured patients; thus, the association of SO with use of the trauma system has been examined. However, the association of the underlying trauma system design with such overtriage has yet to be evaluated. Objectives: To evaluate whether the distribution of trauma centers in a statewide trauma system is associated with SO and to identify clinical and demographic factors that may lead to SO...
September 19, 2018: JAMA Surgery
Rym Hamed, Amel Maaref, Feten Amira, Houssem Aouni, Imen Mekki, Amina Jebali
BACKGROUND: Severe Trauma is a misleading cause of death in young people. Early assessment of prognosis is the cornerstone in the management of such patients. Several prognostic scores have been proposed during the last decade. AIM: To evaluate the prognostic performance of trauma scores in terms of mortality in severe trauma patients admitted to the emergency department. METHODS: This was a prospective, observational and prognostic study with inclusion of severe trauma patients admitted to the emergency department over a 20 months period...
March 2018: La Tunisie Médicale
Eileen Shu, Crystal Ives Tallman, William Frye, Jonathan G Boyajian, Leyla Farshidpour, Megann Young, Danielle Campagne
BACKGROUND: The quick sequential organ failure assessment score (qSOFA) has been proposed as a simple tool to identify patients with sepsis who are at risk for poor outcomes. Its utility in the pre-hospital setting has not been fully elucidated. METHODS: This is a retrospective observational study of adult patients arriving by ambulance in September 2016 to an academic emergency department in Fresno, California. The qSOFA score was calculated from pre-hospital vital signs...
September 18, 2018: American Journal of Emergency Medicine
Shannon Hextrum, José Biller
Non-stroke conditions may present in ways suggestive of ischemic stroke (ie, stroke mimic). Alternatively, the clinical presentation of ischemic stroke can vary considerably and may appear similar to another condition (ie, stroke chameleon). Common and uncommon mimics and chameleons are presented with discussion of key considerations to improve diagnostic accuracy.
November 2018: Neuroimaging Clinics of North America
Joon-Myoung Kwon, Youngnam Lee, Yeha Lee, Seungwoo Lee, Hyunho Park, Jinsik Park
AIM: Triage is important in identifying high-risk patients amongst many less urgent patients as emergency department (ED) overcrowding has become a national crisis recently. This study aims to validate that a Deep-learning-based Triage and Acuity Score (DTAS) identifies high-risk patients more accurately than existing triage and acuity scores using a large national dataset. METHODS: We conducted a retrospective observational cohort study using data from the Korean National Emergency Department Information System (NEDIS), which collected data on visits in real time from 151 EDs...
2018: PloS One
Rashid Baig, Khabir Ahmad, Sidra Zafar, Nadeem Ullah Khan, Areeb Ashfaq
OBJECTIVE: To examine the frequency of ocular emergencies received in a tertiary care setting.. METHODS: This retrospective clinical audit was undertaken at the Emergency Department of the Aga Khan University Hospital, Karachi, and comprised data of all individuals who presented between January and October 2016. The department's triage database was used to retrieve the data on patient's age, gender, presenting complaints, time and date of presentation. Data was analyzed using SPSS 19...
October 2018: JPMA. the Journal of the Pakistan Medical Association
Rehan Quadri, Vasantha Vasan, Caitlin Hester, Matthew Porembka, Julia Fielding
Acute appendicitis is the most common abdominal surgical emergency in the United States with approximately 250,000 cases annually. Computed Tomography (CT) has emerged as the most accurate diagnostic test to triage these patients for emergent surgery. Although the radiology search pattern is prioritized to detect an inflamed appendix, not all appearances equate to a typical surgical appendicitis. There are a select set of atypical pathologies involving the appendix that have subtle differences on CT, but can have catastrophic complications if treated with emergent appendectomy...
August 30, 2018: Clinical Imaging
Mücahit Harmankaya, Jakob Ohm Oreskov, Jakob Burcharth, Ismail Gögenur
BACKGROUND: Patients undergoing major open emergency abdominal surgery experience high morbidity and mortality rates and often have sepsis at admission. The purpose of this study was to evaluate the association between antibiotic timing and in-hospital outcomes such as complications, need for reoperation, length of stay, and 30-day mortality. METHODS: This retrospective observational cohort study was conducted between January 2010 and December 2015 including patients that were triaged through the emergency department for subsequent major open abdominal surgery...
October 11, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Wen Pan, Miaolue Wu, Zhiqiang Ye, Xiaoyu Qiao, Kouxing Zhang
OBJECTIVE: To evaluate whether patients aged over 70 years old is an independent predictor for prolonging the waiting time, and to know whether the population can be prioritized in the emergency grading system. METHODS: A retrospective analysis was conducted. All the clinical data of adult visitors to the emergency department of the Third Affiliated Hospital of Sun Yat-sen University from January 1st in 2016 to December 31st in 2017 were collected. All the patients received four emergency first aid triages and treated according to the emergency classification results...
September 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Wahid Bouida, Kaouthar Beltaief, Mohamed Amine Msolli, Maryem Ben Marzouk, Hamdi Boubaker, Mohamed Habib Grissa, Asma Zorgati, Mehdi Methamem, Riadh Boukef, Asma Belguith, Semir Nouira
OBJECTIVES: To evaluate the effect of pain treatment starting at triage on opioid requirement, and satisfaction in emergency department(ED) patients with acute pain. METHODS: This is a single-blind, randomized, prospective study conducted in ED. The included patients were randomly assigned to single oral dosed of placebo, acetaminophen or tramadol/acetaminophen combination. Protocol treatment was given at the triage.The primary outcome is the need for rescue morphine during EDstay...
October 10, 2018: Pain Practice: the Official Journal of World Institute of Pain
Lodovico Rossetti, Moira Franchini, Chiara Conti, Federica Tosini, Fabio Cominelli
. Patients classification according the intensity of care in an Emergency Department. INTRODUCTION: The increasing number of Emergency Department (ED) admittances coupled with the limited availability of hospital beds requires a patients classification according their intensity of care. Among the available classification systems the Tri-Co (Corridor triage) system, could fit ED patients and was therefore progressively adapted and tested to be used in the ED. AIM: To assess the correct allocation of patients according to the intensity of care...
July 2018: Assistenza Infermieristica e Ricerca: AIR
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