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Emergency Department Management

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https://www.readbyqxmd.com/read/28531866/bilateral-peritonsillar-abscess-a-case-report-and-pertinent-literature-review
#1
Ibrahim AlAwadh, Turki Aldrees, Saleh AlQaryan, Sami Alharethy, Hassan AlShehri
INTRODUCTION: The peritonsillar space is defined as the area between the palatine tonsillar capsule medially and the superior pharyngeal constrictor muscle laterally. Unilateral peritonsillar abscess (PTA) is more common than the bilateral condition. To the best of our knowledge, only 13 cases of bilateral PTA have been reported worldwide; this is the first case reported from Saudi Arabia. PRESENTATION OF CASE: We present a case involving a 16-year-old boy who presented to the emergency department with a5-day history of sore throat, dysphagia, trismus, drooling, and a muffled "hot-potato" voice, but with no symptoms of airway compromise...
May 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28530776/factors-affecting-mortality-among-victims-of-electrical-burns
#2
Çağrı Tiryaki, Mustafa Celalettin Haksal, Murat Burç Yazıcıoğlu, Ali Çiftçi, Osman Esen, Hamdi Taner Turgut, Abdullah Yıldırım, Murat Güven
BACKGROUND: The aim of this study was to determine the factors affecting mortality rate among patients with an electrical burn. METHODS: A total of 115 patients admitted to the emergency department and hospitalized in the Burn Treatment Center or Intensive Care Unit (ICU) due to the electrical burn, were included in the study. RESULTS: A total of 115 patients (4 female and 111 male) with a mean age of 32.88±12.87 years were included in the study...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530521/the-direct-cost-of-managing-a-rare-disease-assessing-medical-and-pharmacy-costs-associated-with-duchenne-muscular-dystrophy-in-the-united-states
#3
Sarah Thayer, Christopher Bell, Craig M McDonald
BACKGROUND: A Duchenne muscular dystrophy (DMD) cohort was identified using a claims-based algorithm to estimate health care utilization and costs for commercially insured DMD patients in the United States. Previous analyses have used broad diagnosis codes that include a range of muscular dystrophy types as a proxy to estimate the burden of DMD. OBJECTIVE: To estimate DMD-associated resource utilization and costs in a sample of patients identified via a claims-based algorithm using diagnosis codes, pharmacy prescriptions, and procedure codes unique to DMD management based on DMD clinical milestones...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530520/cardiovascular-disease-and-gout-real-world-experience-evaluating-patient-characteristics-treatment-patterns-and-health-care-utilization
#4
Michael H Pillinger, Sripal Bangalore, Alyssa B Klein, Scott Baumgartner, Robert Morlock
BACKGROUND: Gout, hyperuricemia, and cardiovascular disease (CVD) are prevalent conditions in the United States, and while they share common risk factors such as obesity, hypertension, hypercholesterolemia, and type 2 diabetes mellitus, relatively little is known about what patient and disease characteristics may link CVD with hyperuricemia and gout and how the presence of both diseases affects management decisions differently than for patients with gout alone. OBJECTIVE: To identify differences in patient characteristics, patterns of urate-lowering therapy (ULT) use, and gout control in gout patients with and without cardiovascular comorbidity...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28528621/using-lean-to-rapidly-and-sustainably-transform-a-behavioral-health-crisis-program-impact-on-throughput-and-safety
#5
Margaret E Balfour, Kathleen Tanner, Paul J Jurica, Dawn Llewellyn, Robert G Williamson, Chris A Carson
BACKGROUND: Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. METHODS: A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28527640/influences-on-patient-satisfaction-among-patients-who-use-emergency-departments-frequently-for-pain-related-complaints
#6
Patricia Newcomb, Marian Wilson, Ralph Baine, Terence McCarthy, Nicholas Penny, Caroline Nixon, Justin Orren
INTRODUCTION: The primary purpose of this study was to assess relationships between opioid prescribing practices, patient and ED attributes, and patient satisfaction ratings of nursing and physician care among patients with high utilization of the emergency department for pain relief. METHODS: A retrospective cohort study was conducted to examine 305 individual patient satisfaction surveys from users with high ED utilization for pain complaints. Responses were compared with an age-matched control group (n = 305) of nonfrequent ED users...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28527506/technology-enabled-population-health-management-two-communities-use-of-an-electronic-care-alert-system
#7
REVIEW
Todd Rowland, Jill Nielsen-Farrell, Kathy Church, Barbara Riddell
Population health management is an approach to improve the health outcomes of a specific group of people, such as frequent users of the emergency department or those at high-risk for hospital admissions. When combined with quality improvement strategies, the targeted application of health information exchange and health information technology (health IT) can swiftly move health care systems and providers from basic to advanced population health management. One such tool is an electronic alert system (alert system), which informs a provider or site about a patient's visit to the emergency department or hospital admission on a daily basis...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28526371/the-psychosocial-needs-of-adolescent-males-following-interpersonal-assault
#8
Rachel K Myers, Laura Vega, Alison J Culyba, Joel A Fein
PURPOSE: We examined the self-identified, postassault psychosocial needs of male adolescents to guide recovery and healing after being seen in an emergency department (ED) for a violence-related injury. METHODS: We analyzed deidentified data from 49 adolescent male adolescents who participated in a postdischarge case management program following a violence-related injury. Descriptive statistics summarized youths' demographic characteristics and self-identified needs and goals for postassault recovery...
May 8, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28525247/-evaluations-by-hospital-ward-physicians-of-patient-care-management-quality-for-patients-hospitalized-after-an-emergency-department-admission
#9
M Bartiaux, P Mols
BACKGROUND: patient management in the acute and sub-acute setting of an Emergency Department is challenging. An assessment of the quality of provided care enables an evaluation of failings. It contributes to the identification of areas for improvement. OBJECTIVES: to obtain an analysis, by hospital-ward physicians, of adult patient care management quality, as well as of the correctness of diagnosis made during emergency admissions. To evaluate the consequences of inadequate patient care management on morbidity, mortality and cost and duration of hospitalization...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28525195/-acute-colonic-diverticulitis-outcome-according-to-general-practice-management-prior-to-referral-and-criteria-predictive-of-complications-a-10-year-experience-in-a-university-hospital
#10
P Youatou, W Ngatchou, G Yondou, F Nde, P Mols, A S Ramadan, M Ngassa
INTRODUCTION: Ambulatory treatment of acute uncomplicated diverticulitis has been shown to be safe and effective by several recent studies. The aim of our study was to analyze the outcome of general practice management concerning the complications, the treatment modalities and the hospitalization duration during the first episode of acute diverticulitis. MATERIEL AND METHODS: A total of 176 medical files of patient presenting between January 2000 and December 2010 at the emergency department with a first episode of acute diverticulitis confirmed by an abdominal CT scan were analyzed...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28524888/reducing-unplanned-admissions-focusing-on-hospital-admissions-and-emergency-department-visits-for-patients-with-head-and-neck-cancer-during-radiation-therapy%C3%A2
#11
Lauren Terzo, Mary Fleming, Alekhya Yechoor, Jayne Camporeale, Miriam Troxler, Elaine Roth, Xianming Tan, Michael Pignone, Lawrence Marks, Bhishamjit S Chera
BACKGROUND: Head and neck cancer (HNC) treatments cause severe toxicities, leading to high rates of emergency department (ED) visits and unplanned hospital admissions (UHAs). 
. OBJECTIVES: The study aimed to evaluate a quality improvement project to reduce ED visits and UHAs.
. METHODS: A weekly nurse/nurse practitioner-led symptom management clinic was created for patients with HNC receiving radiation therapy deemed at high risk for an ED visit or UHA...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28524616/how-to-implement-live-video-recording-in-the-clinical-environment-a-practical-guide-for-clinical-services
#12
Adam Lloyd, Alistair Dewar, Simon Edgar, Dave Caesar, Paul Gowens, Gareth Clegg
BACKGROUND: The use of video in healthcare is becoming more common, particularly in simulation and educational settings. However, video recording live episodes of clinical care is far less routine. AIM: To provide a practical guide for clinical services to embed live video recording. MATERIALS AND METHODS: Using Kotter's 8-step process for leading change, we provide a 'how to' guide to navigate the challenges required to implement a continuous video-audit system based on our experience of video recording in our emergency department resuscitation rooms...
May 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28523083/association-of-midfacial-fractures-with-ophthalmic-injury
#13
REVIEW
Constantinus Politis, Alexandra Kluyskens, Titiaan Dormaar
The aim of this study is to evaluate the incidence of ophthalmic complications following midfacial fractures and investigate its relation to surgical or nonsurgical treatment. This article is a retrospective study, describing the spectrum and incidence of ophthalmic injury in 106 patients presenting with midfacial fractures at the Department of Oral and Maxillofacial Surgery of the University Hospitals Leuven over a period of 16 months (January 2013 to April 2014). The mean age of the patients was 45.6 years with a gender distribution of 68 men and 38 women...
June 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28523062/role-of-antimicrobials-in-the-treatment-of-adult-patients-presenting-to-the-emergency-department-with-acute-gastroenteritis-a-mini-review
#14
REVIEW
Omar Abbas Ahmed Malik
BACKGROUND & OBJECTIVE: Acute gastroenteritis is generally considered a self-limiting illness that does not require the use of antibiotics. However, many emergency departments in the country frequently prescribe antibiotics to patients presenting with diarrhoea. This review attempts to determine whether this practice is reasonable. Our objective was to determine the role of antimicrobials in the empiric management of acute gastroenteritis. METHODS: The online data base "PubMed", as well as the World Wide Web, were searched for relevant articles (RCTs, Reviews, Prospective studies, etc...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28522987/stroke-incidence-in-victoria-australia-emerging-improvements
#15
Benjamin B Clissold, Vijaya Sundararajan, Peter Cameron, John McNeil
BACKGROUND: Evidence of a decline in the incidence of stroke has emerged from population-based studies. These have included retrospective and prospective cohorts. However, in Australia and other countries, government bodies and stroke foundations predict a rise in the prevalence of stroke that is anticipated to increase the burden of stroke across the entire domain of care. This increase in prevalence must be viewed as different from the decline in incidence being observed, a measure of new stroke cases...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28521715/conducting-hiv-seroprevalence-and-behavioral-epidemiology-risk-surveys-sabers-among-partner-military-populations
#16
Caroline A Macera, Stanley I Ito, Braden R Hale, Richard A Shaffer, Anne G Thomas, Janet Dickieson
BACKGROUND: Characterizing HIV infection and associated risk behaviors within military populations is critical for understanding the epidemic and informing prevention activities. However, the prevalence of HIV and related risk behaviors is often unknown. Further, militaries may not have the systems in place or the staff expertise to conduct HIV surveillance and risk behavior studies. METHODS: The Department of Defense HIV/AIDS Prevention Program (DHAPP), funded by the President's Emergency Plan for AIDS Relief and the US Department of Defense, provides technical assistance, management and administrative support for HIV/AIDS prevention, care and treatment for approximately 65 partner militaries...
May 16, 2017: Current HIV Research
https://www.readbyqxmd.com/read/28515805/is-computed-tomography-defined-obstruction-a-predictor-of-urological-intervention-in-emergency-department-patients-presenting-with-renal-colic
#17
Peter Alexander Massaro, Avinash Kanji, Paul Atkinson, Ryan Pawsey, Tom Whelan
INTRODUCTION: Our objective was to determine whether unilateral calculus-induced ureteric obstruction on computed tomography (CT) was independently associated with the need for urological intervention and 30-day return to the emergency department (ED). METHODS: We performed a retrospective cohort study of patients with symptomatic urinary calculi diagnosed by unenhanced helical CT. Stepwise regression analysis was used to determine the predictors of urological intervention and 30-day return to the ED...
March 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28515753/traumatic-pneumatocele-in-an-11-year-old-boy-report-of-a-rare-case-and-review-of-the-literature
#18
Ewa Matuszczak, Marzanna Oksiuta, Adam Hermanowicz, Wojciech Dębek
The authors present a case of a pneumatocele associated with blunt trauma in a child. An 11-year-old boy was admitted to the emergency department after he was knocked over and his chest was trapped under a soccer goal. Chest computed tomography (CT) revealed several cavities in the lobes of both lungs. The CT of the abdomen revealed traumatic laceration of the liver. The patient was treated conservatively. His condition was stable and subsequently improved. He was discharged 19 days later. After nine months, a chest radiograph showed complete resolution of the pneumatocele, and abdominal ultrasound demonstrated complete resolution of the liver hematoma...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28514641/mapping-workforce-configuration-and-operational-models-in-australian-emergency-departments-a-national-survey
#19
Glenn Gardner, Anne Gardner, Sandy Middleton, Julie Considine, Gerard Fitzgerald, Luke Christofis, Anna Doubrovsky, Margaret Adams, Jane O'Connell
Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs.Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study...
May 18, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28514322/relationship-between-a-sepsis-intervention-bundle-and-in-hospital-mortality-among-hospitalized-patients-a-retrospective-analysis-of-real-world-data
#20
Priya A Prasad, Erica R Shea, Stephen Shiboski, Mary C Sullivan, Ralph Gonzales, David Shimabukuro
BACKGROUND: Sepsis is a systemic response to infection that can lead to tissue damage, organ failure, and death. Efforts have been made to develop evidence-based intervention bundles to identify and manage sepsis early in the course of the disease to decrease sepsis-related morbidity and mortality. We evaluated the relationship between a minimally invasive sepsis intervention bundle and in-hospital mortality using robust methods for observational data. METHODS: We performed a retrospective cohort study at the University of California, San Francisco, Medical Center among adult patients discharged between January 1, 2012, and December 31, 2014, and who received a diagnosis of severe sepsis/septic shock (SS/SS)...
May 12, 2017: Anesthesia and Analgesia
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