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Emergency medicine AND critical care

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https://www.readbyqxmd.com/read/29159555/use-of-a-hands-free-instantaneous-closed-loop-communication-device-improves-perception-of-communication-and-workflow-integration-in-an-academic-teaching-hospital-a-pilot-study
#1
Daniel Z Fang, Teja Patil, Ilana Belitskaya-Levy, Marianne Yeung, Keith Posley, Nazima Allaudeen
Efficient and effective communication between providers is critical to quality patient care within a hospital system. Hands free communication devices (HFCD) allow instantaneous, closed-loop communication between physicians and other members of a multidisciplinary team, providing a communication advantage over traditional pager systems. HFCD have been shown to decrease emergency room interruptions, improve nursing communication, improve speed of information flow, and eliminate health care waste. We evaluated the integration of an HFCD with an existing alphanumeric paging system on an acute inpatient medicine service...
November 17, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29159006/the-sound-games-introducing-gamification-into-stanford-s-orientation-on-emergency-ultrasound
#2
Viveta Lobo, Andrew Q Stromberg, Peter Rosston
Point-of-care ultrasound is a critical component of graduate medical training in emergency medicine. Innovation in ultrasound teaching methods is greatly needed to keep up with a changing medical landscape. A field-wide trend promoting simulation and technology-enhanced learning is underway in an effort to improve patient care, as well as patient safety. In an effort to both motivate students and increase their skill retention, training methods are shifting towards a friendly competition model and are gaining popularity nationwide...
September 18, 2017: Curēus
https://www.readbyqxmd.com/read/29157598/chinese-vietnamese-and-asian-indian-parents-perspectives-about-well-child-visits-a-qualitative-analysis
#3
Maya Ragavan, Wendy Li, A Rani Elwy, John Cowden, Megan Bair-Merritt
OBJECTIVES: Well-child visits are a critical component of pediatric healthcare; however, disparities in attendance and quality of care exist for Asian children. Limited research has explored Asian immigrant parents' perspectives about their well-child visit experience. METHODS: Qualitative interviews were conducted with Chinese, Vietnamese, and Asian Indian immigrant parents. Participants were recruited from community-based organizations in the Boston area. Interviews focused on parents' perceptions about well-child visits, including individual attitudes, social and cultural factors impacting their opinions, perceived behavioral control, and improving visits for Asian immigrant families...
November 17, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29152261/copd-management-as-a-model-for-all-chronic-respiratory-conditions-report-of-the-4-th-consensus-conference-in-respiratory-medicine
#4
Stefano Nardini, Fernando De Benedetto, Claudio M Sanguinetti, Salvatore Bellofiore, Stefano Carlone, Salvatore Privitera, Luciano Sagliocca, Emmanuele Tupputi, Claudio Baccarani, Gennaro Caiffa, Maria Consiglia Calabrese, Antonio Capuozzo, Salvatore Cauchi, Valentina Conio, Giuseppe Coratella, Franco Crismancich, Roberto W Dal Negro, Franco Dellarole, Maurizio Delucchi, Carlo Favaretti, Silvia Forte, Franca Matilde Gallo, Riccardo Giuliano, Marco Grandi, Antonino Grillo, Maria Rosaria Gualano, Enrico Guffanti, Salvatore Locicero, Francesco Paolo Lombardo, Marco Mantero, Roberto Marasso, Laura Martino, Michele Mastroberardino, Carlo Mereu, Roberto Messina, Margherita Neri, Bruno Franco Novelletto, Paolo Parente, Sergio Pasquinucci, Massimo Pistolesi, Mario Polverino, Agnese Posca, Luca Richeldi, Fernando Roccia, Ettore Saffi Giustini, Michelangelo Salemi, Salvatore Santacroce, Mario Schisano, Matteo Schisano, Eleonora Selvi, Andrea Silenzi, Patrizio Soverina, Claudio Taranto, Marta Ugolini, Piero Visaggi, Alessandro Zanasi
Background: Non-communicable diseases (NCDs) kill 40 million people each year. The management of chronic respiratory NCDs such as chronic obstructive pulmonary disease (COPD) is particularly critical in Italy, where they are widespread and represent a heavy burden on healthcare resources. It is thus important to redefine the role and responsibility of respiratory specialists and their scientific societies, together with that of the whole healthcare system, in order to create a sustainable management of COPD, which could become a model for other chronic respiratory conditions...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/29151003/lung-ultrasound-in-the-critically-ill-luci-a-translational-discipline
#5
Daniel A Lichtenstein, Manu L N G Malbrain
In the early days of ultrasound, it was not a translational discipline. The heart was claimed by cardiologists, with others, such as gynaecologists, urologists and vascular surgeons claiming their part while the rest was given to radiologists. Only recently, ultrasound transgressed and crossed the usual borders between the different disciplines, such as emergency and critical care medicine. The advent of portable machines in the early 1980s, allowed the critical care physician to perform bedside ultrasound, and the development of whole body critical care ultrasound (CCUS) was born...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29145705/review-article-critical-care-airway-management-elearning-modules
#6
REVIEW
Deepak Doshi, Sally McCarthy, Elizabeth Mowatt, Angela Cahill, Bronwyn Peirce, Geoff Hawking, Ruth Osborne, Belinda Hibble, Katharine Ebbs
The Australasian College for Emergency Medicine (ACEM) has recently launched the Critical Care Airway Management eLearning modules to support emergency medicine trainees in developing their airway management skills in the ED. A team of emergency physicians and trainees worked collaboratively to develop the eLearning resources ensuring extensive stakeholder consultation. A comprehensive resource manual was written to provide learners with knowledge that underpins the modules. ACEM provided project coordination as well as administrative and technical team support to the production...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29144490/neonatal-lung-ultrasound-exam-guidelines
#7
D Kurepa, N Zaghloul, L Watkins, J Liu
Point-of-care ultrasound (POC-US) is increasingly used especially in emergency and critical-care medicine. It is focused, quick and does not expose patients to ionizing radiation. It encompasses all organ systems and has well-defined indications. Lung ultrasound (LUS) represents one of the most exciting applications in the field of POC-US. It is particularly important to emphasize the role of LUS in neonatology due to the specific pathology inherent in lung immaturity as well as in the particular sensitivity of neonates to repeated radiation exposure...
November 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29131530/biomarkers-for-immune-checkpoint-inhibitors-the-importance-of-tumor-topography-and-the-challenges-to-cytopathology
#8
REVIEW
Douglas P Clark
The recent emergence of immune checkpoint inhibitors for cancer therapy has created much excitement among cancer patients, drug and diagnostic developers, and health care professionals. This is due largely to the dramatic and sustained responses among some advanced cancers that were previously refractory to therapy. Unfortunately, these responses are difficult to predict, so the goal of the right drug for the right patient at the right time remains elusive. This is in part due to the complexity of the tumor immune microenvironment and its role in drug efficacy...
November 13, 2017: Cancer
https://www.readbyqxmd.com/read/29131347/critical-care-ultrasound-a-national-survey-across-specialties
#9
Jeffrey R Stowell, Ross Kessler, Resa E Lewiss, Igor Barjaktarevic, Bikash Bhattarai, Napatkamon Ayutyanont, John L Kendall
PURPOSE: Management of the critically ill patient requires rapid assessment and differentiation. Point-of-care ultrasound (POCUS) improves diagnostic accuracy and guides resuscitation. This study sought to describe the use of critical care related POCUS amongst different specialties. METHODS: This study was conducted as an online 18-question survey. Survey questions queried respondent demographics, preferences for POCUS use, and barriers to implementation. RESULTS: 2735 recipients received and viewed the survey with 416 (15...
November 13, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29128035/bedside-identification-of-massive-pulmonary-embolism-with-point-of-care-transesophageal-echocardiography
#10
Tomislav Jelic, Melanie Baimel, Jordan Chenkin
BACKGROUND: Pulmonary embolism can be difficult to diagnose, particularly in those who are hemodynamically unstable and cannot be imaged to confirm the diagnosis. Echocardiography can allow for rapid assessment of patients in shock, but requires adequate transthoracic windows to obtain clinically useful information. Emergency physician-performed transesophageal echocardiography (TEE) may be a useful tool when transthoracic echocardiography fails. CASE REPORT: An 86-year-old woman presented to the emergency department after a fall at home...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29114347/examining-critical-factors-affecting-graduate-retention-from-an-emergency-training-program-in-addis-ababa-ethiopia-a-qualitative-study-of-stakeholder-perspectives
#11
Meredith Kuipers, Amira Eapen, Joel Lockwood, Sara Berman, Samuel Vaillancourt, James Maskalyk, Aklilu Azazh, Megan Landes
Background: In Ethiopia, improvement and innovation of the emergency care system is hindered by lack of specialist doctors trained in emergency medicine, underdeveloped emergency care infrastructure, and resource limitations. Our aim was to examine the critical factors affecting retention of graduates from the Addis Ababa University (AAU) post-graduate emergency medicine (EM) training program within the Ethiopian health care system. Methods: One post-graduate trainee and one program manager from the AAU and the University of Toronto (UT) partnership conducted qualitative interviews with current AAU EM residents and stakeholders in Ethiopian EM...
April 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/29097859/quantifying-burnout-among-emergency-medicine-professionals
#12
William Wilson, Jeffrey Pradeep Raj, Girish Narayan, Murtuza Ghiya, Shakuntala Murty, Bobby Joseph
Background: Burnout is a syndrome explained as serious emotional depletion with poor adaptation at work due to prolonged occupational stress. It has three principal components namely emotional exhaustion(EE), depersonalization(DP) and diminished feelings of personal accomplishment(PA). Thus, we aimed at measuring the degree of burnout in doctors and nurses working in emergency medicine department (EMD) of 4 select tertiary care teaching hospitals in South India. Methods: A cross sectional survey was conducted among EMD professionals using a 30-item standardized pilot tested questionnaire as well as the Maslach burnout inventory...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29095726/high-quality-of-evidence-is-uncommon-in-cochrane-systematic-reviews-in-anaesthesia-critical-care-and-emergency-medicine
#13
Aaron Conway, Zachary Conway, Kathleen Soalheira, Joanna Sutherland
BACKGROUND: The association between the quality of evidence in systematic reviews and authors' conclusions regarding the effectiveness of interventions relevant to anaesthesia has not been examined. OBJECTIVE: The objectives of this study were: to determine the proportion of systematic reviews in which the authors made a conclusive statement about the effect of an intervention; to describe the quality of evidence derived from outcomes in reviews that used the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) working group system for grading the quality of evidence; and to identify review characteristics associated with conclusiveness...
December 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29095391/acute-illness-protocol-for-maple-syrup-urine-disease
#14
Lance H Rodan, Saud H Aldubayan, Gerard T Berry, Harvey L Levy
Inborn errors of metabolism (IEMs) are genetic disorders that disrupt enzyme activity, cellular transport, or energy production. They are individually rare but collectively have an incidence of 1:1000. Most patients with IEMs are followed up by a physician with expertise in biochemical genetics (metabolism), but may present outside this setting. Because IEMs can present acutely with life-threatening crises that require specific interventions, it is critical for the emergency medicine physician, pediatrician, internist, and critical care physician as well as the biochemical geneticist to have information on the initial assessment and management of patients with these disorders...
October 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29095057/high-inpatient-utilization-among-veterans-health-administration-patients-with-substance-use-disorders-and-co-occurring-mental-health-conditions
#15
Janelle M Painter, Carol A Malte, Anna D Rubinsky, Timothy R Campellone, Amanda K Gilmore, John S Baer, Eric J Hawkins
BACKGROUND: Substance-use disorders (SUDs) are common and costly conditions. Understanding high inpatient utilization (HIU) among patients with SUD can inform the development of treatment approaches designed to reduce healthcare expenditures and improve service quality. OBJECTIVES: To examine the prevalence, type, and predictors of HIU among patients with SUD and co-occurring mental health conditions. METHODS: Service utilization and demographic and clinical variables were extracted from a national sample of Veterans Health Administration (VA) patients with SUD-only [n = 148,960 (98...
November 2, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/29084236/derivation-and-validation-of-a-preoperative-risk-model-for-postoperative-mortality-sampe-model-an-approach-to-care-stratification
#16
Luciana Cadore Stefani, Claudia De Souza Gutierrez, Stela Maris de Jezus Castro, Rafael Leal Zimmer, Felipe Polgati Diehl, Leonardo Elman Meyer, Wolnei Caumo
Ascertaining which patients are at highest risk of poor postoperative outcomes could improve care and enhance safety. This study aimed to construct and validate a propensity index for 30-day postoperative mortality. A retrospective cohort study was conducted at Hospital de Clínicas de Porto Alegre, Brazil, over a period of 3 years. A dataset of 13524 patients was used to develop the model and another dataset of 7254 was used to validate it. The primary outcome was 30-day in-hospital mortality. Overall mortality in the development dataset was 2...
2017: PloS One
https://www.readbyqxmd.com/read/29075634/emergency-and-critical-care-medicine-an-essential-component-of-all-specialties-and-practices
#17
EDITORIAL
Karol Ann Mathews
No abstract text is available yet for this article.
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29072885/cardiopulmonary-ultrasound-for-critically-ill-adults-improves-diagnostic-accuracy-in-a-resource-limited-setting-the-africa-trial
#18
Torben K Becker, Chelsea A Tafoya, Maxwell Osei-Ampofo, Matthew J Tafoya, Ross A Kessler, Nikhil Theyyunni, Hussein A Yakubu, Daniel Opuni, Daniel J Clauw, James A Cranford, Chris K Oppong, Rockefeller A Oteng
OBJECTIVE: To assess the effects of a cardiopulmonary ultrasound (CPUS) examination on diagnostic accuracy for critically ill patients in a resource-limited setting. METHODS: Approximately half of the emergency medicine resident physicians at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, were trained in a CPUS protocol. Adult patients triaged to the resuscitation area of the emergency department (ED) were enrolled if they exhibited signs or symptoms of shock or respiratory distress...
October 26, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29071767/communicating-value-in-simulation-cost-benefit-analysis-and-return-on-investment
#19
Carl V Asche, Minchul Kim, Alisha Brown, Antoinette Golden, Torrey A Laack, Javier Rosario, Christopher Strother, Vicken Y Totten, Yasuharu Okuda
Value-based health care requires a balancing of medical outcomes with economic value. Administrators need to understand both the clinical and economic effects of potentially expensive simulation programs to rationalize the costs. Given the often-disparate priorities of clinical educators relative to health care administrators, justifying the value of simulation requires the use of economic analyses few physicians have been trained to conduct. Clinical educators need to be able to present thorough economic analyses demonstrating returns on investment and cost effectiveness to effectively communicate with administrators...
October 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29068247/australian-elapid-snake-envenomation-in-cats-clinical-priorities-and-approach
#20
Trudi J Mcalees, Linda A Abraham
Practical relevance: No fewer than 140 species of terrestrial snakes reside in Australia, 92 of which possess venom glands. With the exception of the brown tree snake, the venom-producing snakes belong to the family Elapidae. The venom of a number of elapid species is more toxic than that of the Indian cobra and eastern diamondback rattle snake, which has earned Australia its reputation for being home to the world's most venomous snakes. Clinical challenges: The diagnosis of elapid snake envenomation is not always easy...
November 2017: Journal of Feline Medicine and Surgery
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