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https://www.readbyqxmd.com/read/28550970/thoracotomy-in-the-emergency-department-for-resuscitation-of-the-mortally-injured
#1
J Christopher DiGiacomo, L D George Angus
PURPOSE: Emergency department resuscitative thoracotomy is an intervention of last resort for the acutely dying victim of trauma. In light of improvements in pre-hospital emergency systems, improved operative strategies for survival such as damage control and improvements in critical care medicine, the most extreme of resuscitation efforts should be re-evaluated for the potential survivor, with success properly defined as the return of vital signs which allow transport of the patient to the operating room...
May 10, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28547840/performance-of-norwegian-civilian-emts-and-army-medics-in-penetrating-trauma-a-controlled-simulation-based-assessment
#2
S W Blix, J Melau, I Lund-Kordahl
BACKGROUND: Penetrating trauma kills rapidly. Thorough and efficient examination and aggressive hemorrhage control is important to save lives. The aim of this study was to assess the skills of civilian Emergency Medical Technicians (EMTs) in bleeding examination and control compared to Army Medics. Our hypothesis was that civilian pre-hospital systems perform at a lower level compared to an expert group, and did not have sufficient focus on education and training in examination and treatment of penetrating injuries...
May 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28545831/pre-post-evaluation-of-effects-of-a-titanium-dioxide-coating-on-environmental-contamination-of-an-intensive-care-unit-the-titanic-study
#3
B de Jong, A M Meeder, K W A C Koekkoek, M A Schouten, P Westers, A R H van Zanten
BACKGROUND: Among patients admitted to European hospitals or intensive care units (ICUs), 5.7% and 19.5% will encounter healthcare-associated infections (HAIs), respectively, and antimicrobial resistance is emerging. As hospital surfaces are contaminated with potentially pathogenic bacteria, environmental cleanliness is an essential aspect to reduce HAIs. AIM: To address the efficacy of a titanium dioxide coating in reducing the microbial colonization of environmental surfaces in an ICU...
April 15, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28542661/-benign-acute-childhood-myositis-clinical-series-and-literature-review
#4
Felipe Cavagnaro S M, Alejandra Aird G, Ingrid Harwardt R, Carmen Gloria Marambio Q
Benign acute childhood myositis (BACM) is a rare clinical condition that mainly affects pre-school and school age-children. It is usually preceded by a viral illness, particularly influenza virus infection. OBJECTIVE: To describe a cluster of BACM cases that were seen in a paediatric unit. PATIENTS AND METHODS: A retrospective series of cases that presented with a clinical picture suggestive of BACM between August and November 2012 in the paediatric emergency department of a private clinic...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28534558/-proposing-a-physiological-model-for-emergency-department-operating-principles-classification-of-overcrowding-and-guidelines-for-redesign
#5
M Herrera Carranza, F Aguado Correa, N Padilla Garrido, F López Camacho
The operation of Emergency Departments (ED) is determined by demand, their own organizational structures and the connection to other medical care levels. When these elements are not simultaneous, it hinders patient flow and decreases capacity, making it necessary to employ a systemic approach to the chain of emergency care as a single operational entity. With this theoretical orientation, we suggest a conceptual model similar to the physiological cardiac output, in which the preload is the demand, the contractile or flow pump is the organizational structure, the afterload is the hospital, the pre-ED valve is primary care and outpatient emergencies, and the post-ED valve is the diagnostic support services and the specialist consultants...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28528282/management-options-in-the-treatment-of-femoral-pseudoaneurysms-secondary-to-intravenous-drug-abuse-a-case-series
#6
James Rammell, Nisheeth Kansal, Vish Bhattacharya
INTRODUCTION: Infected femoral pseudoaneurysms are a common presentation in intravenous drug users with little consensus as to the optimum management of these patients. Whilst emergency revascularisation options are available, excision and ligation of the femoral artery remains the most common operative intervention but risks leaving the patient with critical ischaemia or intermittent claudication. This case series reviewed the outcomes of 4 patients who underwent excision-ligation without revascularisation of an infected femoral pseudoaneurysm at a district general hospital...
May 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28526917/do-we-know-the-outcome-predictors-for-cauda-equine-syndrome-ces-a-retrospective-single-center-analysis-of-60-patients-with-ces-with-a-suggestion-for-a-new-score-to-measure-severity-of-symptoms
#7
Alexander König, Lisa Amelung, Marco Danne, Ullrich Meier, Johannes Lemcke
OBJECTIVE: Despite the awareness and familiarity of almost every medical professional with the cauda equine compression syndrome (CES), risk factors for a poor prognosis of the disease remain elusive. Even the relationship between subsequent outcome and the time elapsed from the time of appearance of symptoms to surgery taking place remain obscure. The aim of our study, therefore, was to analyze a relatively large population of our own patients studied consecutively, to identify outcome predictors for CES and to propose a clinical score for CES symptoms (Berlin CES score)...
May 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#8
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28521746/survival-rates-and-predictors-of-survival-among-colorectal-cancer-patients-in-a-malaysian-tertiary-hospital
#9
Bello Arkilla Magaji, Foong Ming Moy, April Camilla Roslani, Chee Wei Law
BACKGROUND: Colorectal cancer is the third most commonly diagnosed malignancy and the fourth leading cause of cancer-related death globally. It is the second most common cancer among both males and females in Malaysia. The economic burden of colorectal cancer is likely to increase over time owing to its current trend and aging population. Cancer survival analysis is an essential indicator for early detection and improvement in cancer treatment. However, there was a scarcity of studies concerning survival of colorectal cancer patients as well as its predictors...
May 18, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28515604/development-and-psychometric-evaluation-of-the-pre-hospital-medical-emergencies-early-warning-scale
#10
Abbasali Ebrahimian, Gholamreza Masoumi, Roohangiz Jamshidi-Orak, Hesam Seyedin
INTRODUCTION: The number of requests for emergency medical services (EMSs) has increased during the past decade. However, most of the transports are not essential. Therefore, it seems crucial to develop an instrument to help EMS staff accurately identify patients who need pre-hospital care and transportation. The aim of this study was to develop and evaluate the psychometric properties of the Pre-hospital Medical Emergencies Early Warning Scale (Pre-MEWS). MATERIALS AND METHODS: This mixed-method study was conducted in two phases...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28513518/firearm-injuries-received-in-emergency-room-of-a-nigerian-teaching-hospital-aanalysis-of-pattern-morbidity-and-mortality
#11
N I Omoke
BACKGROUND: The morbidity and mortality associated with civilian firearm injury in developing countries is appreciable. The increasing incidence of gunshot casualties received in hospital emergency rooms is an emerging concern. The aim of this study was to determine the pattern and outcome of firearm injuries in a civilian setting of a developing country. MATERIALS AND METHOD: This was a retrospective analysis of data on the entire patients with firearm injury received in the emergency room of Federal Teaching Hospital Abakaliki from January 2005 to December 2014...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28513357/nursing-students-experience-of-research-during-clinical-placements
#12
Claire Louise Whitehouse
Aim To investigate pre-registration nursing students' experience of research during clinical placements, and to identify any positive aspects or barriers to gaining experience of research during clinical placements. Method Qualitative, phenomenological, semi-structured interviews were undertaken with preregistration degree-level nursing students. The students were attending one university in the east of England, and were on clinical placements at one of three hospital sites in two trusts. Data were reviewed using thematic analysis...
May 17, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28504487/haemophilus-influenzae-type-b-meningitis-is-there-a-re-emergence-24-years-of-experience-in-a-children-s-hospital
#13
Angela Gentile, Ana C Martínez, María Del V Juarez, María F Lución, Candela Burgo, María P Della Latta, Solana Rapapor, Viviana Romanin, Marisa Turco
INTRODUCTION: Haemophilus influenzae type B (Hib) used to be the main cause of bacterial meningitis in children younger than 5 years old. Following the introduction of the Hib vaccine in the immunization schedule (1998), its incidence reduced significantly but it has increased over the last years. The objectives of this study included describing the characteristics and analyzing the epidemic curve of Haemophilus influenzae type B (Hib) meningitis by comparing the pre- and postimmunization periods...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28499510/effect-of-policy-change-on-the-use-of-long-distance-transport-and-follow-up-care-for-patients-with-traumatic-finger-amputations
#14
Michael T Nolte, Melissa J Shauver, Kevin C Chung, Aviram M Giladi
PURPOSE: In January 2006, the American College of Emergency Physicians released updated guidelines for air transfer. Digit amputation and near-amputation were no longer an indication for this costly service. We analyzed the effect of this update on the use of air transport and associated care outcomes for finger amputation patients and examined factors involved in providing follow-up care for these patients. METHODS: A retrospective chart review identified all patients treated for traumatic finger amputation between 1995 and 2012 at a major hand trauma referral center...
May 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28499459/dispatch-and-prehospital-transport-for-acute-septic-patients-an-observational-study
#15
Peter Bank Pedersen, Daniel Pilsgaard Henriksen, Søren Mikkelsen, Annmarie Touborg Lassen
BACKGROUND: In order to dispatch ambulances with the correct level of urgency, the dispatch center has to balance the perceived urgency and traffic safety considerations with the available resources. As urgency is not clear in all clinical situations, some high urgency patients may end up with a suboptimal mode of transport. Patients with severe sepsis or septic shock suffer from highly time dependent conditions but they present with a wide range of symptoms, which might be difficult to identify in the dispatch system...
May 12, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28499358/can-we-predict-functional-decline-in-hospitalized-older-people-admitted-through-the-emergency-department-reanalysis-of-a-predictive-tool-ten-years-after-its-conception
#16
Isabelle De Brauwer, Pascale Cornette, Benoît Boland, Franck Verschuren, William D'Hoore
BACKGROUND: In the Emergency Department (ED), early and rapid identification of older people at risk of adverse outcomes, who could best benefit from complex geriatric intervention, would avoid wasting time, especially in terms of prevention of adverse outcomes, and ensure optimal orientation of vulnerable patients. We wanted to test the predictive ability of a screening tool assessing risk of functional decline (FD), named SHERPA, 10 years after its conception, and to assess the added value of other clinical or biological factors associated with FD...
May 12, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28498904/the-acef-ii-risk-score-for-cardiac-surgery-updated-but-still-parsimonious
#17
Marco Ranucci, Valeria Pistuddi, Sabino Scolletta, Carlo de Vincentiis, Lorenzo Menicanti
Aims: The age, creatinine, and ejection fraction (ACEF) score was introduced in 2009 and is presently included in the guidelines for myocardial revascularization of the European Society of Cardiology and Association for Cardio-Thoracic Surgery as a risk stratification tool for surgical and percutaneous myocardial revascularization. The present study introduces an updated version of the ACEF (ACEF II) inclusive of emergency surgery and pre-operative anaemia. Methods and results: The development series includes 7011 consecutive cardiac surgery patients operated at a single institution...
May 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28498094/predictors-of-all-cause-30-day-readmission-among-medicare-patients-with-type-2-diabetes
#18
Jenna Collins, Ibrahim M Abbass, Raymond Harvey, Brandon Suehs, Claudia Uribe, Jonathan Bouchard, Todd Prewitt, Tony DeLuzio, Elsie Allen
OBJECTIVE: Readmission is costly among patients with type 2 diabetes (T2DM) in Medicare Advantage Prescription Drug Plans; identifying high-risk patients is necessary for targeting reduction programs. The objective of this study was to develop a claims-based algorithm to predict all-cause 30-day readmission among patients with T2DM. METHODS: This study used administrative data from 1/1/2012 through 1/31/2014. The cohort included hospitalized T2DM patients, aged 18-90 with ≥12 months' continuous-enrollment before an unplanned hospital admission and ≥1 month of enrollment post-discharge, excluding patients in long-term care >30 days pre-index...
May 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28496344/adherence-to-disease-modifying-therapies-and-its-impact-on-relapse-health-resource-utilization-and-costs-among-patients-with-multiple-sclerosis
#19
Jack Burks, Thomas S Marshall, Xiaolan Ye
PURPOSE: To evaluate adherence to disease-modifying therapies (DMTs) among patients with multiple sclerosis (MS) initiating oral and injectable DMTs, and to estimate the impact of adherence on relapse, health resource utilization, and medical costs. PATIENTS AND METHODS: Commercially insured MS patients (aged 18-65 years, two or more MS diagnoses, one or more DMT claims) with continuous eligibility 12 months before and after the first DMT claim date (index date) and no DMT claim during the pre-index period were identified from a large commerical claims database for the period from January 1, 2008, to September 30, 2015...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28495487/effect-of-psychiatric-illness-on-acute-care-utilization-at-end-of-life-from-serious-medical-illness
#20
Kyle Lavin, Dimitry S Davydow, Lois Downey, Ruth A Engelberg, Ben Dunlap, James Sibley, William B Lober, Kelson Okimoto, Nita Khandelwal, Elizabeth T Loggers, Joan M Teno, J Randall Curtis
CONTEXT: Little is known about psychiatric illness and utilization of end-of-life care. OBJECTIVES: We hypothesized that pre-existing psychiatric illness would increase hospital utilization at end-of-life among patients with chronic medical illness due to increased severity of illness and care fragmentation. METHODS: We reviewed electronic health records to identify decedents with one or more of eight chronic medical conditions based on International Classification of Diseases (ICD)-9 codes...
May 8, 2017: Journal of Pain and Symptom Management
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