Read by QxMD icon Read

ED critical care

Susan M Peterson, Cathi A Harbertson, James J Scheulen, Gabor D Kelen
OBJECTIVES: To meet the unique comparative data needs of academic emergency departments, we describe the recent five-year national and regional trends for adult emergency patients' characteristics and operational parameters at academic emergency medical centers. METHODS: Data collected from the recent five-year period academic year (AY) 2012 through AY 2016 of the Academy of Administrators in Academic Emergency Medicine (AAAEM) and the Association of Academic Chairs of Emergency Medicine (AACEM) Academic Emergency Medicine Benchmarking Survey were analyzed for trends in 1) ED volumes and modes of arrival 2) triage acuity level 3) trends in ED professional fee billing and 4) disposition patterns of ED patients including admission rates and walkouts...
August 13, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Annette Ilg, Ari Moskowitz, Varun Konanki, Parth V Patel, Maureen Chase, Anne V Grossestreuer, Michael W Donnino
STUDY OBJECTIVE: Confusion, uremia, elevated respiratory rate, hypotension, and aged 65 years or older (CURB-65) is a clinical prediction rule intended to stratify patients with pneumonia by expected mortality. We assess the predictive performance of CURB-65 for the proximal endpoint of receipt of critical care intervention in emergency department (ED) patients admitted with community-acquired pneumonia. METHODS: We performed a retrospective analysis of electronic health records from a single tertiary center for ED patients admitted as inpatients with a primary diagnosis of pneumonia from 2010 to 2014...
August 2, 2018: Annals of Emergency Medicine
Kathryn Hawk, Gail D'Onofrio
The emergency department (ED) has long been recognized as providing critical access to the health care system for many, yet only in the past few decades has the ED visit been recognized as an opportunity to identify and link patients to care for substance use disorders (SUDs). This review explores the evidence for ED-based screening, psychosocial and pharmacological interventions, and linkage to treatment for the spectrum of SUDs including high risk alcohol use and alcohol, opioid, tobacco and other SUDs. Despite knowledge gaps, methodological challenges and some inconsistency across interventions studied, opportunities for EDs to improve the care of patients across the spectrum of SUDs are robust...
August 6, 2018: Addiction Science & Clinical Practice
Eleonora M Guzmán, Katherine M Tezanos, Bernard P Chang, Christine B Cha
OBJECTIVE: The emergency department (ED) offers a critical and unique opportunity to assess and intervene on suicide risk. Despite its potential benefits, the ED setting presents several potential sources of stress. The present paper calls attention to how suicidal patients may be especially vulnerable to stressful ED experiences. METHOD: This research synthesis cites the growing literature on ED-related stressors, as they have been shown to affect both psychiatric and nonpsychiatric patient populations...
July 22, 2018: General Hospital Psychiatry
Diane Pilkey, Christy Edwards, Rachel Richards, Lenora M Olson, Michael Ely, Elizabeth A Edgerton
PURPOSE: Critical Access Hospitals (CAHs), often the first point of access for emergency care, see few children and are challenged to remain proficient in caring for pediatric patients. Our analysis provides guidance to facilitate increasing CAHs staffs' ability to provide effective pediatric emergency care. METHODS: The National Pediatric Readiness Project (NPRP) assessment of 4,146 emergency departments (EDs) was linked with the CAHs list from Centers for Medicare and Medicaid Services...
July 30, 2018: Journal of Rural Health
John P Mulhall, Annamaria Giraldi, Geoff Hackett, Wayne J G Hellstrom, Emmanuele A Jannini, Eusebio Rubio-Aurioles, Landon Trost, Tarek A Hassan
INTRODUCTION: Erectile dysfunction (ED) is a common condition the treatment of which over the years has expanded from specialty care settings to various other clinical settings. A Process of Care Model was developed in 1999 to provide primary care physicians with guidance in the diagnosis and management of ED. AIM: This update to the Process of Care Model aims to reflect current ED management practices, because the study of ED has changed since 1999. METHODS: Updates to the Process of Care Model were developed during a meeting of international experts from diverse disciplines...
July 26, 2018: Journal of Sexual Medicine
Delia L Gold, Jennifer R Marin, Demetris Haritos, L Melissa Skaugset, Jennifer M Kline, Rachel M Stanley, David P Way, David P Bahner
Objectives: Point-of-care ultrasound (POCUS) has been identified as a critical skill for pediatric emergency medicine (PEM) physicians. The purpose of this study was to profile the current status of PEM POCUS in pediatric emergency departments (EDs). Methods: An electronic survey was distributed to PEM fellows and attending physicians at four major pediatric academic health centers. The 24-item questionnaire covered professional demographics, POCUS experience and proficiency, and barriers to the use of POCUS in pediatric EDs...
October 2017: AEM education and training
Raziye Gizem Yüksel Gök, Alper Gök, Mehtap Bulut
INTRODUCTION: In this study our purpose is to examine the effectiveness and reliability of MEWS (Modified Early Warning Score), REMS (Rapid Emergency Medicine Score) and WPS (Worthing Physiological Scoring System) scoring systems for prediction of the prognosis and mortality rate of critically ill patients scheduled to be admitted to intensive care unit (ICU) among emergency department (ED) patients. METHODS: This single-centered retrospective study was performed on medical, surgical and trauma patients referred to the ED and admitted to ICU of University Hospital between 23 July 2013 and 26 November 2015...
July 21, 2018: International Emergency Nursing
Derek L Isenberg, Katrina M Kissman, Ellie P Salinski, Mark A Saks, Loreen B Evans
Introduction: In 2013 the Society for Critical Care Medicine (SCCM) published guidelines for the management of pain and agitation in the intensive care unit (ICU). These guidelines recommend using an analgesia-first strategy in mechanically ventilated patients as well as reducing the use of benzodiazepines. Benzodiazepines increase delirium in ICU patients thereby increasing ICU length of stay. We sought to determine whether a simple educational intervention for emergency department (ED) staff, as well as two simple changes in workflow, would improve adherence to the SCCM guidelines...
July 2018: Western Journal of Emergency Medicine
Victoria L Allgar, Hong Chen, Ed Richfield, David Currow, Una Macleod, Miriam J Johnson
BACKGROUND: The assessment of patients' needs for care is a critical step in achieving patient-centred cancer care. Tools can be used to assess needs and inform care planning. The Needs Assessment Tool: Progressive Disease- Cancer (NAT: PD-C) is an Australian oncology clinic tool for assessment by clinicians of patients' and carers' palliative care needs. This has not been validated in the UK Primary Care setting. AIM: To test the psychometric properties and acceptability of a UK primary-care adapted NAT:PD-C...
July 12, 2018: Journal of Pain and Symptom Management
Donna Lester, Tonja Hartjes, Amanda Bennett
: Sepsis is an extreme response to infection that can cause tissue damage, organ failure, and death if not treated promptly and appropriately. Each year in the United States, sepsis affects more than 1.5 million people and kills roughly 250,000. Prompt recognition and treatment of sepsis are essential to saving lives, and nurses play a critical role in the early detection of sepsis, as they are often first to recognize the signs and symptoms of infection. Here, the authors review recent revisions to the sepsis care bundles and discuss screening and assessment tools nurses can use to identify sepsis in the ICU, in the ED, on the medical-surgical unit, and outside the hospital...
August 2018: American Journal of Nursing
P Sandler, L N Goldstein
BACKGROUND: Point-of-care blood gas analysis plays an integral role in the management of critically ill and injured patients presenting to the emergency department (ED). While the use of specially manufactured syringes containing electrolyte-balanced dried heparin is recommended when processing these specimens, alternatives including manually self-prepared syringes washed with liquid heparin or heparin vacutainers are still often used. OBJECTIVES: To assess the effect of two concentrations of liquid heparin and the use of heparin vacutainers on the reliability of blood gas analysis results compared with the recommended standard of dried heparin syringes in the ED setting...
February 27, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
John Sather, Craig Rothenberg, Emily B Finn, Kevin N Sheth, Charles Matouk, Laura Pham, Vivek Parwani, Andrew Ulrich, Arjun K Venkatesh
Critically ill patients may be exposed to unique safety threats as a result of the complexity of interhospital and intrahospital transitions involving the emergency department (ED). Real-time surveys were administered to clinicians in the ED and neuroscience intensive care unit of a tertiary health care system to assess perceptions of handoff safety and quality in transitions involving critically ill neurologic patients. In all, 115 clinical surveys were conducted among 26 patient transfers. Among all clinician types, 1 in 5 respondents felt the handoff process was inadequate...
July 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Andrea K Graham, Mickey Trockel, Hannah Weisman, Ellen E Fitzsimmons-Craft, Katherine N Balantekin, Denise E Wilfley, C Barr Taylor
OBJECTIVE: As eating disorders (EDs) often emerge during college, managing EDs would ideally integrate prevention and treatment. To achieve this goal, an efficient tool is needed that detects clinical symptoms and level of risk. This study evaluated the performance of a screen designed to identify individuals at risk for or with an ED. PARTICIPANTS: Five hundred forty-nine college-age women. METHODS: Participants completed a screen and diagnostic interview...
July 6, 2018: Journal of American College Health: J of ACH
Tadahiro Goto, Carlos A Camargo, Mohammad Kamal Faridi, Brian J Yun, Kohei Hasegawa
OBJECTIVE: The prediction of emergency department (ED) disposition at triage remains challenging. Machine learning approaches may enhance prediction. We compared the performance of several machine learning approaches for predicting two clinical outcomes (critical care and hospitalization) among ED patients with asthma or COPD exacerbation. METHODS: Using the 2007-2015 National Hospital and Ambulatory Medical Care Survey (NHAMCS) ED data, we identified adults with asthma or COPD exacerbation...
June 28, 2018: American Journal of Emergency Medicine
Annika Brucksch, Falk Hoffmann, Katharina Allers
BACKGROUND: Nursing home residents (NHRs) are often transferred to emergency departments (EDs). A great proportion of ED visits is considered inappropriate. There is evidence that male NHRs are more often hospitalised, but this is less clear for ED visits. It is unclear, which influence age has on ED visits. We aimed to study the epidemiology of ED visits in NHRs focusing on age- and sex-specific differences. METHODS: A systematic review was carried out based on articles found in MEDLINE (via PubMed), CINAHL and Scopus...
July 3, 2018: BMC Geriatrics
Nicholas M Mohr, Tracy Young, Karisa K Harland, Brian Skow, Amy Wittrock, Amanda Bell, Marcia M Ward
BACKGROUND: Meeting time goals for patients with time-sensitive conditions can be challenging in rural emergency departments (EDs), and adopting policies is critical. ED-based telemedicine has been proposed to improve quality and timeliness of care in rural EDs. INTRODUCTION: The objective of this study was to test the hypothesis that diagnostic testing in telemedicine-supplemented ED care for patients with myocardial infarction (MI) and stroke would be faster than nontelemedicine care in rural EDs...
June 29, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Vikas Bansal, Emir Festić, Muhammad A Mangi, Nicholl A Decicco, Ashley N Reid, Elizabeth L Gatch, James M Naessens, Pablo Moreno-Franco
OBJECTIVE: To investigate the statistical measures of the performance of 2 interventions: a) early sepsis identification by a computerized sepsis "sniffer" algorithm (CSSA) in the emergency department (ED) and b) human decision to activate a multidisciplinary early resuscitation sepsis and shock response team (SSRT). METHODS: This study used a prospective and historical cohort study design to evaluate the performance of two interventions. INTERVENTION: A computerized sepsis sniffer algorithm (CSSA) to aid in early diagnosis and a multidisciplinary sepsis and shock response team (SSRT) to improve patient care by increasing compliance with Surviving Sepsis Campaign (SSC) bundles...
May 2018: Acta Medica Academica
Monika Mitra, Susan L Parish, Ilhom Akobirshoev, Eliana Rosenthal, Tiffany A Moore Simas
Objectives This study examined the risk of postpartum hospital admissions and emergency department (ED) visits among US women with intellectual and developmental disabilities (IDD). Methods We used the 2002-2012 Pregnancy to Early Life Longitudinal Data System and identified deliveries to women with and without IDD. Women with IDD (n = 1104) or case subjects were identified from the International Classification of Diseases and Related Health Problems 9th Revision (ICD-9 CM) codes. The study primary outcome measures were any postpartum hospital admission and any ED visit during three critical postpartum periods (1-42, 43-90, and 1-365 days)...
June 9, 2018: Maternal and Child Health Journal
Anna S M Dobbe, Renate Stolmeijer, Jan C Ter Maaten, Jack J M Ligtenberg
BACKGROUND: Liberal use of oxygen in an emergency situation is common. Today, most health care professionals do not adjust the amount of oxygen given when a saturation of 100% or a PaO2 which exceeds the normal range is reached- which may result in hyperoxia. There is increasing evidence for the toxic effects of hyperoxia. Therefore, it seems justified to aim for normoxia when giving oxygen. This study evaluates whether it is feasible to aim for normoxia when giving oxygen therapy to patients at the emergency department (ED)...
June 26, 2018: BMC Emergency Medicine
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"