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https://www.readbyqxmd.com/read/29775642/national-early-warning-score-news-in-a-finnish-multidisciplinary-emergency-department-and-direct-vs-late-admission-to-intensive-care
#1
Mikko Kivipuro, Joonas Tirkkonen, Timo Kontula, Juuso Solin, Jari Kalliomäki, Satu-Liisa Pauniaho, Heini Huhtala, Arvi Yli-Hankala, Sanna Hoppu
OBJECTIVES: We investigated the national early warning scores (NEWSs) and related outcomes of patients in a tertiary referral center's multidisciplinary emergency department (ED). Patients were further categorized into three groups: triaged directly to intensive care unit (EDICU), triaged to general ward with later ICU admission (EDwardICU) and triaged to general ward (EDward). NEWSs and subsequent outcomes among these sub groups were compared. METHODS: We conducted a prospective one-month cohort study in Tampere University Hospital's ED, Finland...
May 15, 2018: Resuscitation
https://www.readbyqxmd.com/read/29773253/-reception-the-first-element-of-care-in-emergency-departments
#2
Ségolène Delaby
The mission of an emergency department is to attend to any person arriving, at any time, whatever their condition, with the aim of treating them or transferring them to the most appropriate department. The approach often requires the provision of technical care meaning that relational care frequently takes a back seat. When the patient first arrives, the care is different, the patient-nurse interaction is essential. The role and the missions accorded to the triage nurse are fundamental in ensuring the patient receives quality care at this stage...
May 2018: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29773252/-the-emergency-department-triage-nurse-a-constantly-evolving-role
#3
Claire Maillard Acker
The number of patients attending emergency departments is constantly growing. They are fast becoming a place of primary care. Early assessment of patients must guarantee the safety of their care. The triage nurse uses a clinical examination and a triage chart to classify the patients. The reception of the patients by the triage nurse is professional. With tension often high in emergency departments, triage nurses play a role in defusing situations, which could constitute the next area of focus of their professionalization...
May 2018: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29770092/canada-s-pandemic-influenza-preparedness-laboratory-strategy
#4
B Henry
The Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector (CPIP) is a guidance document that outlines key health sector preparedness activities designed to ensure Canada is ready to respond to the next influenza pandemic. This article outlines Canada's pandemic influenza laboratory strategy as described in the CPIP Laboratory Annex . Laboratory identification and characterization of an influenza pandemic virus is critical to detect the pandemic, develop a vaccine, detect antiviral resistance and inform surveillance functions such as monitoring the geographic spread of the disease...
January 4, 2018: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
https://www.readbyqxmd.com/read/29769803/gender-dysphoria-assessment-and-action-for-youth-review-of-health-care-services-and-experiences-of-trans-youth-in-manitoba
#5
Jack Heard, Amanda Morris, Nicole Kirouac, Jennifer Ducharme, Simon Trepel, Brandy Wicklow
Objectives: To describe the paediatric transgender population accessing health care through the Manitoba Gender Dysphoria Assessment and Action for Youth (GDAAY) program, and report youth's experiences accessing health care in Manitoba. Methods: Demographic, medical, surgical and mental health information was extracted from the medical records of youth referred to the GDAAY program (n=174). A 77-item online survey was conducted with a subset of those youth (n=25) to identify common health care experiences and perceptions of trans youth in Manitoba...
May 2018: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29769024/hems-inter-facility-transfer-a-case-mix-analysis
#6
Damien Di Rocco, Mathieu Pasquier, Eric Albrecht, Pierre-Nicolas Carron, Fabrice Dami
BACKGROUND: Helicopter emergency medical services (HEMS) are popular rescue systems despite inconsistent evidence in the scientific literature to support their use for primary interventions, as well as for inter-facility transfer (IFT). There is little research about IFT by HEMS, hence questions remain about the appropriateness of this method of transport. The aim of this study was to describe a case-mix of operational and medical characteristics for IFT activity of a sole HEMS base, and identify indicators of over-triage...
May 16, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29768477/faster-clinical-response-to-the-onset-of-adverse-events-a-wearable-metacognitive-attention-aid-for-nurse-triage-of-clinical-alarms
#7
Daniel C McFarlane, Alexa K Doig, James A Agutter, Lara M Brewer, Noah D Syroid, Ranjeev Mittu
OBJECTIVE: This study evaluates the potential for improving patient safety by introducing a metacognitive attention aid that enables clinicians to more easily access and use existing alarm/alert information. It is hypothesized that this introduction will enable clinicians to easily triage alarm/alert events and quickly recognize emergent opportunities to adapt care delivery. The resulting faster response to clinically important alarms/alerts has the potential to prevent adverse events and reduce healthcare costs...
2018: PloS One
https://www.readbyqxmd.com/read/29768291/quality-of-the-triage-of-children-with-anaphylaxis-at-the-emergency-department
#8
Esozia Arroabarren, Jorge Alvarez-Garcia, Marta Anda, Montserrat de Prada, Maria Carmen Ponce, Miriam Palacios
OBJECTIVE: Early recognition of symptoms is essential in anaphylaxis management. The Canadian Paediatric Emergency Triage and Acuity Scale prioritizes anaphylaxis to level I or II (resuscitation or emergency). We analyzed the accuracy of pediatric anaphylaxis triage. METHODS: This was a retrospective review of the triage charts (adaptation of the Canadian Paediatric Emergency Triage and Acuity Scale) of 137 children attended for anaphylaxis at our pediatric emergency department...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29767322/management-of-cardiogenic-shock-complicating-myocardial-infarction
#9
REVIEW
Alexandre Mebazaa, Alain Combes, Sean van Diepen, Alexa Hollinger, Jaon N Katz, Giovanni Landoni, Ludhmila Abrahao Hajjar, Johan Lassus, Guillaume Lebreton, Gilles Montalescot, Jin Joo Park, Susanna Price, Alessandro Sionis, Demetris Yannopolos, Veli-Pekka Harjola, Bruno Levy, Holger Thiele
Up to 10% of acute coronary syndromes are complicated by cardiogenic shock (CS) with contemporary mortality rates of 40-50%. The extent of ischemic myocardium has a profound impact on the initial, in-hospital, and post-discharge management and prognosis in this patient population. Individualized patient risk assessment plays an important role in determining appropriate revascularization, drug treatment with inotropes and vasopressors, mechanical circulatory support, intensive care support of other organ systems, hospital level of care triage, and allocation of clinical resources...
May 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29766138/risk-stratification-tools-in-emergency-general-surgery
#10
REVIEW
Joaquim Michael Havens, Alexandra B Columbus, Anupamaa J Seshadri, Carlos V R Brown, Gail T Tominaga, Nathan T Mowery, Marie Crandall
The use of risk stratification tools (RST) aids in clinical triage, decision making and quality assessment in a wide variety of medical fields. Although emergency general surgery (EGS) is characterized by a comorbid, physiologically acute patient population with disparately high rates of perioperative morbidity and mortality, few RST have been explicitly examined in this setting. We examined the available RST with the intent of identifying a tool that comprehensively reflects an EGS patients perioperative risk for death or complication...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29765393/support-of-new-triage-protocol-among-acute-stroke-care-providers
#11
Haitham M Hussein, David C Anderson
Objective: We conducted an online survey to gauge the acceptance of sending acute stroke patients with suspected large vessel occlusion (LVO) directly to an endovascular-capable hospital (ECH) even if that means bypassing a closer alteplase-capable hospital (ACH) without endovascular capability. Methods: The survey was composed of two cases of acute stroke, one with cortical symptoms suggestive of LVO and the other without. In each case, responders were asked to choose between triaging to a closer ACH or an ECH that is further away and to provide an opinion regarding the maximum extra travel time they would tolerate if they chose the ECH...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29764723/frailty-assessment-to-help-predict-patients-at-risk-of-delirium-when-consulting-the-emergency-department
#12
Marianne Giroux, Marie-Josée Sirois, Valérie Boucher, Raoul Daoust, Émilie Gouin, Mathieu Pelletier, Simon Berthelot, Philippe Voyer, Marcel Émond
BACKGROUND: Delirium is underdiagnosed in seniors at emergency departments (EDs) even though it is a frequent complication and is associated with functional and cognitive decline. As frailty is an independent predictor of adverse events in seniors, screening for frailty in EDs may help identify those at risk of delirium. OBJECTIVES: To assess if screening older patients for frailty in EDs could help identify those at risk of delirium. METHODOLOGY: This study was part of the multicenter prospective cohort INDEED study...
May 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29764629/an-open-randomized-controlled-study-comparing-an-online-text-based-scenario-and-a-serious-game-by-belgian-and-swiss-pharmacy-students
#13
Jérôme Berger, Noura Bawab, Jeremy De Mooij, Denise Sutter Widmer, Nicolas Szilas, Carine De Vriese, Olivier Bugnon
INTRODUCTION: To compare online learning tools, looped, branch serious game (SG) and linear text-based scenario (TBS), among a sample of Belgian and Swiss pharmacy students. METHODS: Open randomized controlled study. The lesson was based on the case of a benign cough in a healthy child. A randomized sample of 117 students: only the Swiss students had attended a previous lecture on coughs. Participation rate, pre- and post-experience Likert scales and students' clinical knowledge were measured...
March 2018: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29763994/decision-making-about-hospital-arrival-among-low-risk-nulliparous-women-after-spontaneous-labor-onset-at-home
#14
Joyce K Edmonds, Kathleen Miley, Kimberly J Angelini, Neel T Shah
INTRODUCTION: Postponing hospital admission until the active phase of labor is a recommended strategy to safely reduce the incidence of primary cesarean births. Success of this strategy depends on women's decisions about when to transfer from home to the hospital, a process that is largely absent from research about childbirth. This study aimed to determine the decision-making criteria used by women about when to go to the hospital after the self-identification of labor onset at home...
May 15, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29763390/what-are-ethical-implications-of-regionalization-of-trauma-care
#15
Sandra R DiBrito, Christian Jones
Outcomes for severely injured patients are improved when they are treated at trauma centers. However, interfacility transfers can delay time-sensitive treatments not requiring the resources of tertiary institutions. Regionalized trauma systems allow physicians to decrease delays in care, prevent inadequate treatment, and ultimately reduce preventable deaths. Although precise risks and benefits of triage choices are unknowable, estimating them is a process well known to surgeons. Recognizing patient transfers as integral to optimal care delivery systems, rather than as detracting from them, is essential...
May 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29758205/performance-of-p16-ki67-dual-staining-in-triaging-hr-hpv-positive-population-during-cervical-cancer-screening-in-the-younger-women
#16
Qiu-Ping Qian, Xiaoan Zhang, Bo Ding, Shi-Wen Jiang, Ze-Min Li, Mu-Lan Ren, Yang Shen
BACKGROUND: Cervical cancer is the most common malignancy from the female reproductive tract, and usually develops from low-grade or high-grade squamous intraepithelial lesions (LSIL or HSIL). Detecting the precancerous lesion during the LSIL-HSIL-invasive cancer sequelae can effectively interrupt the oncogenesis and decrease the incidence of invasive carcinoma. The aim of this study is to evaluate the performance of P16/Ki67 dual staining in triaging hr-HPV-positive population. METHODS: Conventional gynecological examination, cervical cytology and hr-HPV testing were given to all patients...
May 11, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29756678/current-management-of-adhesive-small-bowel-obstruction
#17
REVIEW
Jakob Köstenbauer, Philip G Truskett
Small bowel obstruction is a common and significant surgical presentation. Approximately 30% of presentations will require surgery during admission. The great challenge of adhesive small bowel obstruction (ASBO) management is the early detection of silent intestinal ischaemia in patients initially deemed suitable for conservative therapy. Recent literature emphasizes the effectiveness of computed tomography enterography and water-soluble contrast studies in the management of ASBO. Low-volume undiluted water-soluble contrast has been shown to have both triage and therapeutic value in the management of ASBO...
May 14, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29756491/innovative-healthy-lifestyles-school-based-public-private-partnerships-designed-to-curb-the-childhood-obesity-epidemic-globally-lessons-learned-from-the-mondel%C3%A4-z-international-foundation
#18
Rafael Pérez-Escamilla
Public-private partnerships (PPPs) have been recognized as central for addressing the childhood obesity epidemic. However, very few real-world examples have been published documenting the workings of effective PPPs. The objective of this article is to identify the factors that enabled the successful implementation of school-based PPPs focusing mainly on nutrition and physical activity in 7 countries located in Asia (China and India), Africa (South Africa), Europe (Germany, United Kingdom), and Latin America (Brazil and Mexico)...
January 1, 2018: Food and Nutrition Bulletin
https://www.readbyqxmd.com/read/29753877/developing-a-decision-support-system-for-patients-with-severe-infection-conditions-in-prehospital-care
#19
Niclas Johansson, Carl Spindler, John Valik, Veronica Vicente
OBJECTIVE: To develop and validate a prehospital decision support system (DSS) for the emergency medical services (EMS), enabling identification and steering of patients with critical infectious conditions - severe respiratory tract infections, severe CNS-infections and sepsis - to a specialized emergency department (ED) for infectious diseases. METHODS: The development process has involved four consecutive steps. The first step was gathering data from the electronic Patient Care Record on patients transported by the EMS, to identify retrospectively appropriate patient categories for steering...
May 10, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29753611/neo-adjuvant-platinum-based-chemotherapy-followed-by-chemoradiation-and-radical-surgery-in-locally-advanced-cervical-cancer-lacc-patients-a-phase-ii-study
#20
Gabriella Ferrandina, Eleonora Palluzzi, Valerio Gallotta, Maria Antonietta Gambacorta, Rosa Autorino, Luigi Carlo Turco, Gabriella Macchia, Francesco Cosentino, Benedetta Gui, Maria Vittoria Mattoli, Graziana Ronzino, Vincenzo Valentini, Giovanni Scambia
PURPOSE: The aim of this Phase II, non-randomized study was to assess activity and safety of neoadjuvant chemotherapy (NACT) before chemoradiation (CT/RT) followed by radical surgery (RS) in locally advanced cervical cancer (LACC) patients. METHODS AND MATERIALS: The primary end point was rate of pathologic complete response (pCR). FIGO Stage IB2-IVA patients were administered NACT chemotherapy (paclitaxel 80 mg/m2 , carboplatin AUC 2), for 6 weeks, followed by Intensity Modulated Radiotherapy plus simultaneous boost (total dose of 50...
May 3, 2018: European Journal of Surgical Oncology
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