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https://www.readbyqxmd.com/read/30327779/performance-assessment-of-the-mortality-in-emergency-department-sepsis-score-modified-early-warning-score-rapid-emergency-medicine-score-and-rapid-acute-physiology-score-in-predicting-survival-outcomes-of-adult-renal-abscess-patients-in-the-emergency-department
#1
Su-Han Chang, Chiao-Hsuan Hsieh, Yi-Ming Weng, Ming-Shun Hsieh, Zhong Ning Leonard Goh, Hsien-Yi Chen, Tung Chang, Chip-Jin Ng, Joanna Chen-Yeen Seak, Chen-Ken Seak, Chen-June Seak
Background: Renal abscess is a relatively uncommon yet debilitating and potentially fatal disease. There is no clearly defined, objective risk stratification tool available for emergency physicians' and surgeons' use in the emergency department (ED) to quickly determine the appropriate management strategy for these patients, despite early intervention having a beneficial impact on survival outcomes. Objective: This case control study evaluates the performance of Mortality in Emergency Department Sepsis Score (MEDS), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), and Rapid Acute Physiology Score (RAPS) in predicting risk of mortality in ED adult patients with renal abscess...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29877873/terrorist-attacks-in-paris-managing-mass-casualties-in-a-remote-trauma-center
#2
Florent Femy, Arnaud Follin, Philippe Juvin, Anne-Laure Feral-Pierssens
OBJECTIVE: On 13 November 2015, Paris was the target of multiple terrorist attacks responsible for a massive influx of casualties in emergency departments (EDs). Because of the activation of a local crisis plan and the arrival of extra staff, our capacities increased markedly. Our aim was to analyze whether our center, in this challenging context, efficiently managed this massive influx of patients. PATIENTS AND METHODS: We carried out a monocentric retrospective study...
June 5, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29278979/impact-of-a-telemedicine-eicu-cart-on-sepsis-management-in-a-community-hospital-emergency-department
#3
Shana M Machado, Erika H Wilson, John O Elliott, Kim Jordan
Introduction Intensivist involvement for patients with sepsis is associated with decreased complications and mortality, and lower hospital resource utilization, but few studies have evaluated outcomes for patients exposed to electronic intensive care unit (eICU) telemedicine sepsis management in the emergency department (ED). In this study, we assess whether eICU cart exposure in the ED improved compliance with components of the 2010 Surviving Sepsis Campaign bundles, length of stay (LOS), disposition and hospital costs...
April 2018: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29091954/comparison-of-the-mortality-in-emergency-department-sepsis-score-modified-early-warning-score-rapid-emergency-medicine-score-and-rapid-acute-physiology-score-for-predicting-the-outcomes-of-adult-splenic-abscess-patients-in-the-emergency-department
#4
COMPARATIVE STUDY
Shang-Kai Hung, Chip-Jin Ng, Chang-Fu Kuo, Zhong Ning Leonard Goh, Lu-Hsiang Huang, Chih-Huang Li, Yi-Ling Chan, Yi-Ming Weng, Joanna Chen-Yeen Seak, Chen-Ken Seak, Chen-June Seak
BACKGROUND: Splenic abscess is rare but has mortality rates as high as 14% even with recent improvements in management. Early and appropriate intervention may improve patient outcomes, yet at present there is no identified method that can predict mortality risk rapidly and accurately for emergency physicians, surgeons, and intensivists to decide on the ideal course of action. OBJECTIVE: This study aims to evaluate the performance of Mortality in Emergency Department Sepsis Score (MEDS), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS) and Rapid Acute Physiology Score (RAPS) for predicting the mortality risk of adult splenic abscess patients...
2017: PloS One
https://www.readbyqxmd.com/read/28234130/4107-limited-echocardiogram-examinations-performed-by-intensivists-a-surgeon-driven-multidisciplinary-program
#5
Paula Ferrada, David Evans, Sara Parker, Sammy Pedram, Curtis N Sessler
Limited transthoracic echocardiogram (LTTE) has been introduced as a tool to direct resuscitation. At our institution, a multidisciplinary training program was instituted. Our hypothesis is that in spite all efforts for multidisciplinary training, certification, and credentialing, limited echocardiograms are under billed for. A training program was implemented in August 2010. This was followed by a process of credentialing and adding LTTE to the billing privileges for providers. Institutional Review Board approval was obtained to review all the studies performed from August 2010 to October 2014...
January 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/25303750/orotracheal-intubation-physicians-knowledge-assessment-and-clinical-practices-in-intensive-care-units
#6
Caroline Setsuko Yamanaka, Aécio Flávio Teixeira de Góis, Paulo César Bastos Vieira, Jane Cristina Dias Alves, Luciana Matias de Oliveira, Leila Blanes, Eliton Paulo Leite Lourenço, Murillo Assunção, Flavia Ribeiro Machado
OBJECTIVES: To assess the physician’s knowledge on intubation techniques and to identify the common practices. METHODS: This was a prospective study, involving three different intensive care units within a University hospital: Anesthesiology (ANEST), Pulmonology (PULMO) and Emergency Department (ED). All physicians working in these units and consenting to participate in the study completed a questionnaire with their demographic data and questions on orotracheal intubation...
June 2010: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/25161018/opinions-and-practice-of-stress-ulcer-prophylaxis-in-australian-and-new-zealand-intensive-care-units
#7
Glenn M Eastwood, Ed Litton, Rinaldo Bellomo, Michael J Bailey, Mario Festa, Richard W Beasley, Paul J Young
BACKGROUND: Intensivists frequently prescribe proton pump inhibitors (PPIs) or histamine-2 receptor blockers (H2RBs) to intensive care unit patients for stress ulcer prophylaxis (SUP). Despite the common use of SUP medicines, there is limited high-level evidence to support the choice between them. AIM: To describe self-reported practice of SUP by Australian and New Zealand intensivists. METHOD: An online questionnaire of intensivists between 13 January and 3 February 2014...
September 2014: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/25081496/race-against-the-clock-overcoming-challenges-in-the-management-of-anticoagulant-associated-intracerebral-hemorrhage
#8
REVIEW
Peter Le Roux, Charles V Pollack, Melissa Milan, Alisa Schaefer
Patients receiving anticoagulation therapy who present with any type of intracranial hemorrhage--including subdural hematoma, epidural hematoma, subarachnoid hemorrhage, and intracerebral hemorrhage (ICH)--require urgent correction of their coagulopathy to prevent hemorrhage expansion, limit tissue damage, and facilitate surgical intervention as necessary. The focus of this review is acute ICH, but the principles of management for anticoagulation-associated ICH (AAICH) apply to patients with all types of intracranial hemorrhage, whether acute or chronic...
August 2014: Journal of Neurosurgery
https://www.readbyqxmd.com/read/24694318/palliative-care-in-the-emergency-department
#9
Susanne M Mierendorf, Vinita Gidvani
The Emergency Department (ED) is the place where people most frequently seek urgent care. For patients living with chronic disease or malignancy who may be in a crisis, this visit may be pivotal in determining the patients' trajectory. There is a large movement in education of emergency medicine physicians, hospitalists, and intensivists from acute aggressive interventions to patient-goal assessment, recognizing last stages of life and prioritizing symptom management. Although the ED is not considered an ideal place to begin palliative care, hospital-based physicians may assist in eliciting the patient's goals of care and discussing prognosis and disease trajectory...
2014: Permanente Journal
https://www.readbyqxmd.com/read/24268427/uncontrolled-organ-donation-after-circulatory-determination-of-death-us-policy-failures-and-call-to-action
#10
Stephen P Wall, Kevin G Munjal, Nancy N Dubler, Lewis R Goldfrank
In the United States, more than 115,000 patients are wait-listed for organ transplants despite that there are 12,000 patients each year who die or become too ill for transplantation. One reason for the organ shortage is that candidates for donation must die in the hospital, not the emergency department (ED), either from neurologic or circulatory-respiratory death under controlled circumstances. Evidence from Spain and France suggests that a substantial number of deaths from cardiac arrest may qualify for organ donation using uncontrolled donation after circulatory determination of death (uDCDD) protocols that rapidly initiate organ preservation in out-of-hospital and ED settings...
April 2014: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/23680170/treatment-provider-is-most-predictive-of-ed-dismissal-in-minimally-injured-trauma-patients-a-retrospective-review
#11
Diane L S Hunt, Gina M Berg, Rosalee E Zackula, Francie H Ekengren, Diana Lippoldt, Elizabeth Ablah, Ruth Wetta
BACKGROUND: Secondary triage protocols have been described in the literature as physiologic (first-tier) criteria and mechanism-related (second-tier) criteria to determine the level of trauma activation. There is debate as to the efficiency of triage decisions based on mechanism of injury which may result in overtriage and overuse of limited trauma resources. Our institution developed and implemented an advanced three-tier trauma alert system in which stable patients presenting with blunt traumatic mechanism of injury would be evaluated by the emergency department (ED) physician rather than the trauma surgeon...
May 16, 2013: Journal of Trauma Management & Outcomes
https://www.readbyqxmd.com/read/23380127/ed-intensivists-and-ed-intensive-care-units
#12
Scott D Weingart, Robert L Sherwin, Lillian L Emlet, Isaac Tawil, Julie Mayglothling, Jon C Rittenberger
No abstract text is available yet for this article.
March 2013: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/22509296/variability-of-intensive-care-admission-decisions-for-the-very-elderly
#13
Ariane Boumendil, Derek C Angus, Anne-Laure Guitonneau, Anne-Marie Menn, Christine Ginsburg, Khalil Takun, Alain Davido, Rafik Masmoudi, Benoît Doumenc, Dominique Pateron, Maité Garrouste-Orgeas, Dominique Somme, Tabassome Simon, Philippe Aegerter, Bertrand Guidet
UNLABELLED: Although increasing numbers of very elderly patients are requiring intensive care, few large sample studies have investigated ICU admission of very elderly patients. Data on pre triage by physicians from other specialities is limited. This observational cohort study aims at examining inter-hospital variability of ICU admission rates and its association with patients' outcomes. All patients over 80 years possibly qualifying for ICU admission who presented to the emergency departments (ED) of 15 hospitals in the Paris (France) area during a one-year period were prospectively included in the study...
2012: PloS One
https://www.readbyqxmd.com/read/21554216/dosing-of-antibiotics-in-critically-ill-patients-undergoing-renal-replacement-therapy
#14
REVIEW
Jan T Kielstein, Olaf Burkhardt
On September 11, 1945 Maria Schafstaat was the first patient who successfully underwent a dialysis treatment for acute kidney injury (AKI), formerly known as acute renal failure. Since then, the number of patients with AKI is increasing worldwide. Today AKI is generally one feature of a multiple organ dysfunction syndrome (MODS), which develops in response to major surgery, cardiogenic shock or sepsis. Several clinical studies have shown that early and appropriate antibiotic therapy in those patients is of utter importance, yet it remains one of the most difficult challenges to meet...
December 2011: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/20853250/back-to-the-future-extended-dialysis-for-treatment-of-acute-kidney-injury-in-the-intensive-care-unit
#15
REVIEW
Jan T Kielstein, Mario Schiffer, Carsten Hafer
On September 11, 1945, Maria Schafstaat was the first patient who successfully underwent a dialysis treatment for acute kidney injury (AKI). The ingenious design of the first dialysis machine, made of cellophane tubing wrapped around a cylinder that rotated in a bath of fluid, together with the brave determination to treat patients with AKI, enabled the Dutch physician W.J. Kolff to save the life of the 67-year-old woman. By treating her for 690 minutes (i.e., 11.5 hours) with a blood flow rate of 116 ml/min, Kolff also set the coordinates of a renal replacement therapy that has enjoyed an unsurpassed renaissance over the last decade for treatment of severely ill patients with AKI in the intensive care unit (ICU)...
September 2010: Journal of Nephrology
https://www.readbyqxmd.com/read/19848033/ed-uses-virtual-icu-to-improve-patient-care
#16
(no author information available yet)
The use of remote monitoring and patient consultation can ease the caseload burden of your staff, improve the flow of resuscitative therapies, and help relieve the pressure on other departments in the hospital. * You can use technology and additional off-site staff to monitor progress of sepsis care, glucose control, and blood pressures. * Off-site intensivists also can serve as back-up by responding to staff requests to review steps they have taken in patient care. * Patients who otherwise would have been admitted into the intensive care unit may be resuscitated and discharged directly from the ED...
March 2007: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/19736574/oesophageal-doppler-ultrasound-in-the-assessment-of-haemodynamic-status-of-patients-admitted-to-the-medical-intensive-care-unit-with-septic-shock
#17
Huck Chin Chew, Anantham Devanand, Ghee Chee Phua, Chian Min Loo
INTRODUCTION: Haemodynamic monitoring is an essential element in the management of critically ill patients in the intensive care unit (ICU). However, there have been increasing concerns about the clinical utility and safety profile of the invasive pulmonary artery catheter (PAC). Oesophageal Doppler (ED) monitoring has emerged recently as a safer and less invasive tool which can be used by the intensivist to estimate cardiac output in the critically ill patient. Validation studies have thus far only been performed in surgical patients perioperatively and in mixed surgical/medical ICU patients...
August 2009: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/16365336/early-goal-directed-therapy-corticosteroid-and-recombinant-human-activated-protein-c-for-the-treatment-of-severe-sepsis-and-septic-shock-in-the-emergency-department
#18
H Bryant Nguyen, Stephen W Corbett, Kevin Menes, Thomas Cho, Jennifer Daugharthy, Walter Klein, William A Wittlake
OBJECTIVES: To describe our experience with early goal-directed therapy (EGDT), corticosteroid administration, and recombinant human activated protein C (rhAPC) administration in patients with severe sepsis or septic shock and an Acute Physiology and Chronic Health Evaluation (APACHE) II score > or =25 in the emergency department (ED). METHODS: This was a retrospective case series of a prospectively maintained ED sepsis registry. Data are presented as median (25th, 75th percentile)...
January 2006: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/16148486/critical-care-medicine-training-and-certification-for-emergency-physicians
#19
REVIEW
David T Huang, Tiffany M Osborn, Kyle J Gunnerson, Scott R Gunn, Stephen Trzeciak, Edward Kimball, Mitchell P Fink, Derek C Angus, R Phillip Dellinger, Emanuel P Rivers
Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine and critical care medicine. Demand for critical care services is increasing...
September 2005: Critical Care Medicine
https://www.readbyqxmd.com/read/16126127/critical-care-medicine-training-and-certification-for-emergency-physicians
#20
David T Huang, Tiffany M Osborn, Kyle J Gunnerson, Scott R Gunn, Stephen Trzeciak, Edward Kimball, Mitchell P Fink, Derek C Angus, R Phillip Dellinger, Emanuel P Rivers
Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine and critical care medicine. Critical care is a continuum that includes out-of-hospital, emergency department (ED), and ICU care teams...
September 2005: Annals of Emergency Medicine
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