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Emergency Department Management

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https://www.readbyqxmd.com/read/28346519/views-of-senior-health-personnel-about-quality-of-emergency-obstetric-care-a-qualitative-study-in-nigeria
#1
Friday Okonofua, Abdullahi Randawa, Rosemary Ogu, Kingsley Agholor, Ola Okike, Rukayat Adeola Abdus-Salam, Mohammed Gana, Eghe Abe, Adetoye Durodola, Hadiza Galadanci
BACKGROUND: Late arrival in hospital by women experiencing pregnancy complications is an important background factor leading to maternal mortality in Nigeria. The use of effective and timely emergency obstetric care determines whether women survive or die, or become near-miss cases. Healthcare managers have the responsibility to deploy resources for implementing emergency obstetric care. OBJECTIVES: To determine the nature of institutional policies and frameworks for managing obstetric complications and reducing maternal deaths in Nigeria...
2017: PloS One
https://www.readbyqxmd.com/read/28346243/modeling-flowsheet-data-to-support-secondary-use
#2
Bonnie L Westra, Beverly Christie, Steven G Johnson, Lisiane Pruinelli, Anne LaFlamme, Suzan G Sherman, Jung In Park, Connie W Delaney, Grace Gao, Stuart Speedie
The purpose of this study was to create information models from flowsheet data using a data-driven consensus-based method. Electronic health records contain a large volume of data about patient assessments and interventions captured in flowsheets that measure the same "thing," but the names of these observations often differ, according to who performs documentation or the location of the service (eg, pulse rate in an intensive care, the emergency department, or a surgical unit documented by a nurse or therapist or captured by automated monitoring)...
March 24, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28345066/correlation-of-central-venous-pressure-with-venous-blood-gas-analysis-parameters-a-diagnostic-study
#3
Sima Rahim-Taleghani, Alireza Fatemi, Mostafa Alavi Moghaddam, Majid Shojaee, Abdelrahman Ibrahim Abushouk, Mohammad Mehdi Forouzanfar, Alireza Baratloo
OBJECTIVE: This study was conducted to assess the correlation between central venous pressure (CVP) and venous blood gas (VBG) analysis parameters, to facilitate management of severe sepsis and septic shock in emergency department. MATERIAL AND METHODS: This diagnostic study was conducted from January 2014 until June 2015 in three major educational medical centers, Tehran, Iran. For patients selected with diagnosis of septic shock, peripheral blood sample was taken for testing the VBG parameters and the anion gap (AG) was calculated...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343815/soft-tissue-oxygen-saturation-to-predict-admission-from-the-emergency-department-a-prospective-observational-study
#4
William T Davis, Josh Lospinso, Robert M Barnwell, John Hughes, Steven G Schauer, Thomas B Smith, Michael D April
OBJECTIVE: We evaluated a soft tissue oxygen saturation (Sto2) measurement at triage for predicting admission to the hospital in adults presenting to the emergency department (ED) in addition to data routinely gathered at triage. METHODS: This was a prospective, observational, single center study of adults presenting to the ED for evaluation. Research assistants obtained thenar eminence Sto2 measurements on subjects in ED triage. ED providers not involved in the study then made all management and disposition decisions...
March 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343661/variability-in-surgical-management-of-benign-ovarian-neoplasms-in-children
#5
Dani O Gonzalez, Jennifer N Cooper, Jennifer H Aldrink, Geri D Hewitt, Mary E Fallat, Peter C Minneci, Katherine J Deans
BACKGROUND/PURPOSE: Although most pediatric ovarian neoplasms are benign and may be treated with ovary-sparing surgery (OSS), consensus is lacking on the optimal surgical approach. We aimed to determine the proportion of pediatric benign ovarian neoplasms managed with OSS and to assess variability in management across hospitals and specialties. METHODS: Using the Pediatric Health Information System, we studied patients aged 6-21 years treated in 2006-2014 for a benign ovarian neoplasm with oophorectomy or OSS...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28342626/understanding-the-health-care-utilization-of-children-who-require-medical-technology-a-descriptive-study-of-children-who-require-tracheostomies
#6
Regena Spratling
Children who require medical technology have complex chronic illnesses. This medical technology, including ventilators, oximeters, tracheostomy tubes, and feeding tubes, allows children and their families to live at home; however, the management of the children's care by informal caregivers is complex with the need for intensive, specialized care. The purpose of this study was to examine the sociodemographic and clinical characteristics that affect health care utilization in a population of children who require medical technology...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28341982/pocket-sized-point-of-care-cardiac-ultrasound-devices-role-in-the-emergency-department
#7
A Colclough, P Nihoyannopoulos
BACKGROUND: Acute breathlessness accounts for 8% of accident and emergency attendances. Point-of-care cardiac ultrasound (US) effectively reduces time to diagnosis. Fast and practical information via pocket-sized cardiac US devices may better the diagnosis in this complex patient group. METHODS: We prospectively enrolled 40 consecutive patients presenting with shortness of breath at the emergency department (ED). Divided into two groups were all adult patients over 18 with acute breathing difficulties (triage category 1-3): 21 patients received a short focused cardiac US scan using a pocket-sized Vscan and 19 patients received no scan...
March 24, 2017: Herz
https://www.readbyqxmd.com/read/28341587/impact-of-rapid-molecular-respiratory-virus-testing-on-real-time-decision-making-in-a-pediatric-emergency-department
#8
Daniel T Rogan, Mohit S Kochar, Samuel Yang, James V Quinn
Acute respiratory illnesses (ARIs) are usually viral [influenza, respiratory syncytial virus (RSV)] and account for 25% of emergency department (ED) peak-season visits. Laboratory respiratory PCR testing is accurate albeit slow for ED management, whereas rapid antigen testing is inaccurate. We determined the impact of bedside influenza/RSV PCR (molecular point-of-care test; mPOCT) on pediatric ARI management. This was a prospective cohort study of consecutive pediatric patients with ED-ordered respiratory PCR test, enrolled over 9 weeks during peak flu season...
March 21, 2017: Journal of Molecular Diagnostics: JMD
https://www.readbyqxmd.com/read/28341086/recurrent-priapism-gone-wrong-st-elevation-myocardial-infarction-and-cardiogenic-shock-after-penile-corporal-phenylephrine-irrigation
#9
S Tyler Constantine, Anand Gopalsami, Gregg Helland
BACKGROUND: Recurrent priapism secondary to sickle cell trait in an African-American male has been reported in the literature. A common treatment for these low-flow priapism cases is aspiration and injection of the corpus cavernosum with a sympathomimetic agent. We report a rare complication not described previously in the literature of ST-elevation myocardial infarction (STEMI) and cardiogenic shock in a 29-year-old male with sickle cell trait undergoing a routine detumescence procedure...
March 21, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28338589/managing-hip-fracture-and-lower-limb-surgery-in-the-emergency-setting-potential-role-of-non-vitamin-k-antagonist-oral-anticoagulants
#10
William Fisher
Trauma, immobilization, and subsequent surgery of the hip and lower limb are associated with a high risk of developing venous thromboembolism (VTE). Individuals undergoing hip fracture surgery (HFS) have the highest rates of VTE among orthopedic surgery and trauma patients. The risk of VTE depends on the type and location of the lower limb injury. Current international guidelines recommend routine pharmacological thromboprophylaxis based on treatment with heparins, fondaparinux, dose-adjusted vitamin K antagonists and acetylsalicylic acid for patients undergoing emergency HFS; however, not all guidelines recommend pharmacological prophylaxis for patients with lower limb injuries...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338416/impact-of-a-complex-care-management-model-on-cost-and-utilization-among-adolescents-and-young-adults-with-special-care-and-health-needs
#11
Daniel D Maeng, Susan R Snyder, Thomas W Davis, Janet F Tomcavage
Adolescents and young adults with special care and health needs in the United States-many of whom have Medicaid coverage-at the transition phase between pediatric and adult care often experience critical care gaps. To address this challenge, a new model-referred to as Comprehensive Care Clinic (CCC)-has been developed and implemented by Geisinger Health System since 2012. CCC comprises a care team, consisting of a generalist physician, advanced practitioner, pharmacist, and a nurse case manager, that develops and closely follows a coordinated care plan...
March 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28337004/adequacy-and-clarity-of-information-on-out-of-hours-emergency-dental-services-at-greater-manchester-nhs-dental-practices-a-cross-sectional-study
#12
S N Aldallal, F N Aldallal, A S Khajah
Objective To perform an evaluation of the information given to patients seeking emergency dental services during out-of-hours periods in Greater Manchester.Method This is a cross-sectional study. A list of all NHS dental practices in Greater Manchester was obtained from the NHS website. The investigators then accessed websites and voicemails of all practices to assess the information given to patients.Results The study shows that most practices have voicemail, which includes varying information on how to access emergency dental services during out-of-hours periods...
March 24, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28336507/planking-or-the-lying-down-game-two-case-reports
#13
Stefania Barbieri, Paolo Feltracco, Luca Omizzolo, Rossella Snenghi, Rafi El Mazloum, Gianna Vettore, Mauro Bergamini, Armando Stefanati, Daniele Donato, Cecilia Ferronato, Francesco Maria Avato, Alberto Tredese, Rosa Maria Gaudio
BACKGROUND: The monitoring and management of risks regarding children and young people admitted to the emergency department as a result of dangerous behaviors distributed via the Internet should be based on clinical reasoning and knowledge about these social media-related phenomena. Here we examine 2 cases of teenagers who reported severe injuries while performing the "planking" craze, a challenge that consists in lying face-down stiffly like a board on any kind of surface. OBJECTIVE: Our objective is to examine and describe the Internet craze called planking, also known as the "lying-down game," through 2 case reports from our experience, enriching this study with information gained through discussions with secondary school teenagers...
March 23, 2017: Interactive Journal of Medical Research
https://www.readbyqxmd.com/read/28336155/emergency-nurses-perceptions-of-emergency-department-preparedness-for-an-ebola-outbreak-a-qualitative-descriptive-study
#14
Mihirika Sds Pincha Baduge, Cheryle Moss, Julia Morphet
BACKGROUND: Ebola Virus Disease is highly contagious and has high mortality. In 2014, when the outbreak in West Africa was declared a public health emergency, emergency departments in Australia commenced preparation and vigilance for people presenting with ebola like symptoms, to limit spread of the disease. RESEARCH AIM: To examine Australian emergency nurses' perceptions regarding their own and their emergency departments' preparedness to manage an ebola outbreak...
March 20, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28335913/clinical-policy-critical-issues-in-the-diagnosis-and%C3%A2-management-of-the-adult-psychiatric-patient-in%C3%A2-the-emergency-department
#15
REVIEW
Devorah J Nazarian, Joshua S Broder, Molly E W Thiessen, Michael P Wilson, Leslie S Zun, Michael D Brown
No abstract text is available yet for this article.
April 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28335446/knowledge-self-confidence-and-attitudes-towards-suicidal-patients-at-emergency-and-psychiatric-departments-a-randomised-controlled-trial-of-the-effects-of-an-educational-poster-campaign
#16
Renate van Landschoot, Gwendolyn Portzky, Kees van Heeringen
Educational posters are used to enhance knowledge, attitudes and self-confidence of patients. Little is known on their effectiveness for educating health care professionals. As these professionals may play an important role in suicide prevention, the effects of a poster and accompanying evaluation and triage guide on knowledge, self-confidence and attitudes regarding suicidal thoughts and behaviours, were studied in a multicentre cluster randomised controlled trial, involving staff from 39 emergency and 38 psychiatric departments throughout Flanders (n = 1171)...
March 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28334590/a-prospective-emergency-department-quality-improvement-project-to-improve-the-treatment-of-vaso-occlusive-crisis-in-sickle-cell-disease-lessons-learned
#17
Paula Tanabe, Caroline E Freiermuth, David M Cline, Susan Silva
BACKGROUND: Guidelines recommend rapid, aggressive management of vaso-occlusive crisis (VOC) for patients with sickle cell disease (SCD). A large prospective research and quality improvement (QI) project was conducted to measure changes in clinical outcomes in two EDs-academic medical centers with emergency medicine residency programs and Level 1 trauma centers-during a 2.5-year time period (October 2011-March 2014). METHODS: A QI team used a Plan-Do-Study-Act approach to modify and implement changes to opioid analgesic protocols for the emergency department (ED) treatment of VOC...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334427/capnography-versus-standard-monitoring-for-emergency-department-procedural-sedation-and-analgesia
#18
REVIEW
Brian F Wall, Kirk Magee, Samuel G Campbell, Peter J Zed
BACKGROUND: Procedural sedation and analgesia (PSA) is used frequently in the emergency department (ED) to facilitate painful procedures and interventions. Capnography, a monitoring modality widely used in operating room and endoscopy suite settings, is being used more frequently in the ED setting with the goal of reducing cardiopulmonary adverse events. As opposed to settings outside the ED, there is currently no consensus on whether the addition of capnography to standard monitoring modalities reduces adverse events in the ED setting...
March 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28333367/community-paramedicine-applied-in-a-rural-community
#19
Kevin J Bennett, Matt W Yuen, Melinda A Merrell
RESEARCH OBJECTIVE: Abbeville County Emergency Management Services (ACEMS) began a community paramedicine (CP) program to utilize trained paramedics to serve patients who frequently use the emergency department (ED) and have 1 or more of the following diagnoses: hypertension, diabetes, chronic heart failure, asthma, and chronic obstructive pulmonary disease. The objective of this study was to determine if the CP program reduced ED visits in Abbeville while improving patient outcomes. DESIGN: A pre/posttest with a comparison group study design was used to evaluate the CP program...
March 23, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28330802/orofacial-trauma-in-rural-india-a-clinical-study
#20
Sunita Malik, Gurdarshan Singh, Gagandeep Kaur, Sunil Yadav, Hitesh C Mittal
PURPOSE: Orofacial trauma is becoming a leading medical problem worldwide. Most of the studies pertaining to orofacial trauma have been done in urban areas but very little scientific literature is available for rural areas. METHODS: A prospective medical institute-based study of orofacial injury patients was carried out from May 2013 to April 2016 (36 Months). Data regarding incidence, age and sex distribution, causes, types and site of injury, treatment modalities and trauma associated complications were collected and analysed...
February 24, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
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