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Emergency medicine administration

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https://www.readbyqxmd.com/read/28342177/career-development-awards-in-emergency-medicine-resources-and-challenges
#1
Bryn E Mumma, Anna Marie Chang, Bory Kea, Megan L Ranney
OBJECTIVES: In the United States, emergency medicine researchers hold proportionately fewer federal career development awards than researchers in other specialties. Others hypothesize this deficit may partly be attributed to lack of mentors, departmental resources, and qualified applicants. Our objectives were to examine the association between departmental and institutional resources and career development awards and to describe the barriers to conducting research and obtaining grants in emergency medicine...
March 25, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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
#2
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/28333820/committee-opinion-no-692-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#3
(no author information available yet)
Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333812/committee-opinion-no-692-summary-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#4
(no author information available yet)
Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28330460/sepsis-recognition-in-the-emergency-department-impact-on-quality-of-care-and-outcome
#5
Marius Morr, Alexander Lukasz, Eva Rübig, Hermann Pavenstädt, Philipp Kümpers
BACKGROUND: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED). METHODS: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#6
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28306496/use-of-magnetic-resonance-imaging-guided-biopsy-of-a-vertebral-body-mass-to-diagnose-osteosarcoma-in-a-rottweiler
#7
Rebecca A Krimins, Jan Fritz, Larry A Gainsburg, Patrick R Gavin, Elizabeth A Ihms, David L Huso, Dara L Kraitchman
CASE DESCRIPTION A 9-year-old spayed female Rottweiler with hind limb ataxia was examined because of anorexia and an acute onset of hind limb paresis. CLINICAL FINDINGS Neurologic evaluation revealed hind limb ataxia and symmetric paraparesis with bilaterally abnormal hind limb postural reactions including hopping, hemiwalking, hemistanding, and delayed proprioception, which were suggestive of a lesion somewhere in the T3-L3 segment of the spinal cord. Thoracolumbar radiography revealed an abnormal radiopacity suggestive of a mass at T11...
April 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28301267/hypotonic-hyporesponsive-episodes-after-administration-of-hexavalent-dtp-based-combination-vaccine-a-description-of-12-cases
#8
Alessandro Vigo, Giulia Costagliola, Elisa Ferrero, Silvia Noce
Hypotonic-hyporesponsive (HHE) episodes are known and recognized phenomena, which typically occur within 48 hours of immunisation..Our aim is to describe 12 cases of HHE brought to the Center of Pediatric Sleep Medicine, with attention to the clinical features of the episode and their follow-up. Medical charts of infants visited between 2005-2015 were reviewed. Twelve infants showed a HHE using HHE using Brighton Collaboration Criteria. All infants received a Hexavalent diphtheria -tetanus -pertussis acellular component -hepatitis B-,inactivated poliovirus- Haemophilus influenzae type-b conjugate vaccine...
February 21, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28297572/safety-and-efficacy-of-megakaryocytes-induced-from-hematopoietic-stem-cells-in-murine-and-nonhuman-primate-models
#9
Xin Guan, Meng Qin, Yu Zhang, Yanan Wang, Bin Shen, Zhihua Ren, Xinxin Ding, Wei Dai, Yongping Jiang
Because of a lack of platelet supply and a U.S. Food and Drug Administration-approved platelet growth factor, megakaryocytes have emerged as an effective substitute for alleviating thrombocytopenia. Here, we report the development of an efficient two-stage culture system that is free of stroma, animal components, and genetic manipulations for the production of functional megakaryocytes from hematopoietic stem cells. Safety and functional studies were performed in murine and nonhuman primate models. One human cryopreserved cord blood CD34(+) cell could be induced ex vivo to produce up to 1...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28291033/assessing-suicide-risk-what-is-commonly-missed-in-the-emergency-room
#10
Nazanin Alavi, Taras Reshetukha, Eric Prost, Kristen Antoniak, Dianne Groll
OBJECTIVE: Although risk assessment for suicide has been extensively studied, it is still an inexact process. The current study determined how busy emergency clinicians actually assessed and documented suicide risk, while also examining the differences between psychiatric and emergency medicine opinions on the importance of various suicide predictors. METHOD: Phase 1 of the study involved the administration of a survey on the relative importance of various suicide predictors for the specialties of psychiatry and emergency medicine...
March 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28286823/protocol-adherence-for-severe-sepsis-and-septic-shock-management-in-the-emergency-department-a-clinical-audit
#11
Mostafa Alavi-Moghaddam, Ali Anvari, Reaza Soltani Delgosha, Hamid Kariman
INTRODUCTION: Although significant development in the field of medicine is achieved, sepsis is still a major issue threatening humans' lives. This study was aimed to audit the management of severe sepsis and septic shock patients in emergency department (ED) according to the present standard guidelines. METHOD: This is a prospective audit on approaching adult septic patients who were admitted to ED. The audit checklist was created based on the protocols of Surviving Sepsis Campaign and British Royal College recommendations...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28283339/prinzmetal-angina-coronary-vasospasm-associated-with-5-fluorouracil-chemotherapy
#12
Maxim Ben-Yakov, Amal Mattu, William J Brady, Sarah B Dubbs
Several chemotherapeutic agents are known to be cardiotoxic. One of them, 5-fluorouracil (5-FU), has been associated with coronary ischemia and reversible vasospasm. In this report, we describe a 54-year-old man with rectal cancer who developed chest pain during 5-FU infusion. His initial electrocardiogram (ECG), obtained while he was experiencing chest pain, showed hyperacute T waves in the anterolateral leads. Those waves disappeared along with the chest pain after administration of sublingual nitroglycerine...
March 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28282104/retrospective-analysis-of-emerging-drugs-use-in-a-quebec-women-s-and-children-s-university-hospital-and-perspectives-for-safe-and-optimal-drug-use
#13
Jennifer Corny, Elaine Pelletier, Denis Lebel, Jean-François Bussières
BACKGROUND: Only few medicines are licensed for children. The use of emerging drugs (unmarketed drug, off-label drug with poorly documented use, and/or costly drugs) might represent an essential alternative for pediatric patients. OBJECTIVES: The objective of the study was to assess emerging drug uses rate and profile in our women's and children's centre to support the implementation of an appropriate policy. METHODS: We identified retrospectively emerging drugs used between 2013-01-01 and 2014-02-28, using computerized pharmacist software extraction of drugs used...
March 10, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28274145/emerging-monoclonal-antibodies-against-clostridium-difficile-infection
#14
Séverine Péchiné, Claire Janoir, Anne Collignon
Clostridium difficile infections are characterized by a high recurrence rate despite antibiotic treatments and there is an urgent need to develop new treatments such as fecal transplantation and immonotherapy. Besides active immunotherapy with vaccines, passive immunotherapy has shown promise, especially with monoclonal antibodies. Areas covered: Herein, the authors review the different assays performed with monoclonal antibodies against C. difficile toxins and surface proteins to treat or prevent primary or recurrent episodes of C...
April 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28259526/review-of-intranasally-administered-medications-for-use-in-the-emergency-department
#15
Abby M Bailey, Regan A Baum, Karolyn Horn, Tameka Lewis, Kate Morizio, Amy Schultz, Kyle Weant, Stephanie N Justice
BACKGROUND: Intranasal (IN) medication delivery is a viable alternative to other routes of administration, including intravenous (IV) and intramuscular (IM) administration. The IN route bypasses the risk of needle-stick injuries and alleviates the emotional trauma that may arise from the insertion of an IV catheter. OBJECTIVE: This review aims to evaluate published literature on medications administered via the IN route that are applicable to practice in emergency medicine...
March 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28257612/health-care-in-high-school-athletics-in-west-virginia
#16
Kyle Schneider, Wesley Meeteer, Jill A Nolan, H David Campbell
INTRODUCTION: The purpose of this study was to determine the level of implementation of emergency preparedness procedures and administrative procedures to provide appropriate medical coverage to high school athletics in the predominantly rural US state of West Virginia. Particular attention was given to determine the extent to which the schools provided the recommendations for best practice in the National Athletic Trainers Association consensus statement outlining appropriate medical coverage for high school athletics...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28257405/the-mecklenburg-county-interlocal-agreement-an-18-year-collaboration-between-medicine-and-public-health
#17
Crystal N Piper, Marcus Plescia, Stephen R Keener, Mark DeHaven
CONTEXT: Better integration of public health and medical services has been a long-standing goal in the United States and has been widely discussed in the scientific literature. OBJECTIVE: To identify key lessons and outcomes of the Mecklenburg County Interlocal Agreement, one of the longest running efforts integrating health care delivery and public health services in a major metropolitan area. DESIGN: In-depth key informant interviews and brief questionnaires of leaders involved in the Mecklenburg County Interlocal Agreement...
March 1, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28225541/perceived-barriers-to-adherence-to-tuberculosis-infection-control-measures-among-health-care-workers-in-the-dominican-republic
#18
Helena J Chapman, Bienvenido A Veras-Estévez, Jamie L Pomeranz, Eddy N Pérez-Then, Belkys Marcelino, Michael Lauzardo
INTRODUCTION Health care workers have an increased risk of infection due to occupational Mycobacterium tuberculosis exposure, including multidrug-resistant strains. Health care workers' risk of developing tuberculosis is greater than that of the general population, whether in low-, intermediate- or high-incidence countries. Adherence to infection control measures (administrative controls, environmental controls, and personal respiratory protection) is essential to reduce risk of disease transmission between suspected tuberculosis patients and health care workers, but for different reasons, both objective and subjective, adherence is low...
January 2017: MEDICC Review
https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#19
Michael W Hubble, Clark Tyson
Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28210321/telemedicine-in-chronic-obstructive-pulmonary-disease
#20
Nicolino Ambrosino, Guido Vagheggini, Stefano Mazzoleni, Michele Vitacca
Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. The legal problems associated with telemedicine are still controversial. Economic advantages for healthcare systems, though potentially high, are still poorly investigated. A European Respiratory Society Task Force has defined indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of COPD patients including those undergoing home mechanical ventilation...
December 2016: Breathe
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