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Emergency department fast track

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https://www.readbyqxmd.com/read/27712833/-acute-cardiac-disease-in-the-emergency-department-fast-track-approach-for-outpatient-management
#1
X Marcaggi, L Belle
No abstract text is available yet for this article.
October 3, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27693165/-fast-track-chest-pain-pathway-in-emergency-department
#2
O Nallet, N Ketata, N Ferrier, X Marcaggi
Acute chest pain is a common reason of consultation in the emergency department. The difficulty lies in discriminating patients with acute coronary syndrome or other life-threatening conditions from those non-cardiovascular, non-life-threatening chest pain. Only 15 to 25 % of patients with acute chest pain actually have acute coronary syndrome. Algorithms using high sensitivity troponin at admission and a second assessment 1 or 3hours later are validated to "rule in" or "rule out" the diagnosis of non ST-elevation myocardial infarction...
September 29, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27692752/-optimization-of-the-management-of-acute-heart-failure-new-concept-of-fast-track
#3
S Andrieu, B Jouve, M Pansieri
The acute heart failure generates a very important number of hospitalizations for a high cost. A recent reflection on optimizing its management is ongoing, based on the fastest management in the emergency department, with a distinction between which patient should remain and who returns at home, and under what conditions, allowing to limit the number of hospitalizations. It will require a reorganization of emergency department and updating of decision algorithms and new guidelines of care.
September 28, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27677560/comparison-of-emergency-department-wait-times-in-adults-with-sickle-cell-disease-versus-other-painful-etiologies
#4
Dianne Pulte, Paris B Lovett, David Axelrod, Albert Crawford, John McAna, Rhea Powell
Sickle cell disease is characterized by intermittent painful crises often requiring treatment in the emergency department (ED). Past examinations of time-to-provider (TTP) in the ED for patients with sickle cell disease demonstrated that these patients may have longer TTP than other patients. Here, we examine TTP for patients presenting for emergency care at a single institution, comparing patients with sickle cell disease to both the general population and to those with other painful conditions, with examination of both institutional and patient factors that might affect wait times...
September 28, 2016: Hemoglobin
https://www.readbyqxmd.com/read/27538991/an-innovative-fast-track-solution-for-food-bolus-impaction-due-to-jackhammer-esophagus-in-an-emergency-department-the-nitro-push-blind-technique-case-report
#5
Luigi Marano, Alessandro Cecchi, Federica Chiodo, Francesco Gullo, Pasquale Fiorillo, Luca Roncetti, Mattia Longaroni, Gianluca Proietti Silvestri, Silvano Lolli, Giorgio Nicolic, Alberto Patriti
BACKGROUND: In the medical literature are described only few clinical cases of esophageal food bolus impaction due to esophageal motility disorders. Moreover, the management of this condition is highly variable with no evidence in the literature to strongly support a clear defined intervention. CASE PRESENTATION: In this paper we describe for the first time a case of 53-year-old male with food bolus impaction due to Jackhammer esophagus referred to emergency department...
2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27286295/identifying-areas-for-improvement-in-the-hiv-screening-process-of-a-high-prevalence-emergency-department
#6
Jason Zucker, David Cennimo, Gregory Sugalski, Shobha Swaminthan
Since 1993, the Centers for Disease Control recommendations for HIV testing were extended to include persons obtaining care in the emergency department (ED). Situated in Newark, New Jersey, the University Hospital (UH) ED serves a community with a greater than 2% HIV prevalence, and a recent study showed a UH ED HIV seroprevalence of 6.5%, of which 33% were unknown diagnoses. Electronic records for patients seen in the UH ED from October 1st, 2014, to February 28th, 2015, were obtained. Information was collected on demographics, ED diagnosis, triage time, and HIV testing...
June 2016: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/27068846/prospective-30-day-outcome-evaluation-of-a-fast-track-protocol-for-23-hour-ambulatory-primary-and-revisional-laparoscopic-roux-en-y-gastric-bypass-in-820-consecutive-unselected-patients
#7
Ioannis Raftopoulos, Andreas Giannakou, Elana Davidson
BACKGROUND: Results from validated national databases suggest that a 1-day length of stay (LOS) is not only unattainable in more than 20% of primary laparoscopic Roux-en-Y gastric bypass (LRYGB) operations, but it is also associated with an increased 30-day mortality risk. There are no published data regarding the feasibility and safety of 1-day LOS after revisional LRYGB. STUDY DESIGN: We reviewed 1 surgeon's experience after implementation of a 1-day fast-track protocol (FTP) in 784 primary and 36 revisional consecutive LRYGB patients...
June 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/26940235/the-association-between-vital-signs-and-mortality-in-a-retrospective-cohort-study-of-an-unselected-emergency-department-population
#8
Malin Ljunggren, Maaret Castrén, Martin Nordberg, Lisa Kurland
BACKGROUND: Vital signs are widely used in emergency departments. Previous studies on the association between vital signs and mortality in emergency departments have been restricted to selected patient populations. We aimed to study the association of vital signs and age with 1-day mortality in patients visiting the emergency department. METHODS: This retrospective cohort included patients visiting the emergency department for adults at Södersjukhuset, Sweden from 4/1/2012 to 4/30/2013...
March 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/26931195/admission-of-elderly-medical-patients-to-fast-track-or-standard-hospitalisation-protocol-for-a-randomised-trial
#9
Camilla Strøm, Lars Simon Rasmussen, Søren Wistisen Rasmussen, Kim Hvid Benn Madsen, Henrik Ancher Ancher Sørensen, Thomas Andersen Schmidt
INTRODUCTION: Emergency department-based short stay units (SSUs) are increasingly being introduced to provide accelerated care. The effects of treatment in SSUs for elderly medical patients are not well-studied. METHODS: The ELDER trial is a single-blinded, randomised parallel trial with 1:1 allocation between hospitalisation in an SSU (intervention) and the Department of Internal Medicine (standard care). The study is conducted at Holbaek Hospital, Denmark. Elderly patients are screened for inclusion if an emergency physician assesses that treatment in an SSU is possible...
March 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/26817430/nurse-practitioners-in-the-emergency-department-barriers-and-facilitators-for-role-implementation
#10
Catherine M Doetzel, James A Rankin, Karen L Then
Emergency department (ED) wait times, length of stay, and overcrowding are common issues in developed health care systems in many countries. These ED issues are multifactorial in nature and require further evaluation in an attempt to provide consistent, adequate health care to each patient. Authors in countries, such as Australia and the United Kingdom, have attempted to address the concerns of increasing wait times, length of stay, and overcrowding by establishing nurse practitioners (NPs) into the ED who practice in domains traditionally dominated by physicians...
January 2016: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/26169889/ultra-sensitive-copeptin-and-cardiac-troponin-in-diagnosing-non-st-segment-elevation-acute-coronary-syndromes-the-copacs-study
#11
Fabrizio Ricci, Rosa Di Scala, Cristiano Massacesi, Marta Di Nicola, Gianni Cremonese, Doranna De Pace, Serena Rossi, Irma Griffo, Ivana Cataldo, Stefano Martinotti, Domenico Rotondo, Allan S Jaffe, Marco Zimarino, Raffaele De Caterina
OBJECTIVES: We tested the noninferiority of a fast-track rule-out protocol for the diagnosis of non-ST-segment elevation myocardial infarction vs noncoronary chest pain based on the single-sampling combined assessment of medium-sensitivity cardiac troponin I and ultra-sensitive copeptin compared with the serial assessment of medium-sensitivity cardiac troponin I. METHODS: Ultra-sensitive copeptin and medium-sensitivity cardiac troponin I levels were measured at presentation in 196 consecutive patients admitted to the emergency department for acute nontraumatic chest pain within 6 hours from symptoms onset and without ST-segment elevation on a 12-lead electrocardiogram...
January 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/26142258/transient-ischemic-attack-fast-track-and-long-term-stroke-risk-role-of-diffusion-weighted-magnetic-resonance-imaging
#12
Sabrina Anticoli, Francesca Romana Pezzella, Claudio Pozzessere, Luca Gallelli, Maria Cristina Bravi, Valeria Caso, Antonio Siniscalchi
BACKGROUND: Acute ischemic lesions on diffusion-weighted magnetic resonance imaging (DWI-MRI) are reliable predictors of recurrent stroke at 90 days. However, to date, limited information on transient ischemic attack (TIA) patients with positive DWI lesions for stroke risk from 1 to 5 years is available. In this study, we evaluated the role of positive DWI lesions and vascular risk factors on stroke, cardiovascular death, and mortality at 90 days (T0), 1 year (T1), and 5 years (T2). Moreover, we also evaluated the association between stroke risk and the presence of DWI lesions...
September 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/26087756/strategies-and-solutions-to-alleviate-access-block-and-overcrowding-in-emergency-departments
#13
REVIEW
Stewart S W Chan, N K Cheung, Colin A Graham, Timothy H Rainer
OBJECTIVES: Access block refers to the delay caused for patients in gaining access to in-patient beds after being admitted. It is almost always associated with emergency department overcrowding. This study aimed to identify evidence-based strategies that can be followed in emergency departments and hospital settings to alleviate the problem of access block and emergency department overcrowding; and to explore the applicability of these solutions in Hong Kong. DATA SOURCES: A systematic literature review was performed by searching the following databases: CINAHL, Cochrane Database of Systematic Reviews, EMBASE, MEDLINE (OVID), NHS Evidence, Scopus, and PubMed...
August 2015: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/26063177/a-daytime-fast-track-improves-throughput-in-a-single-physician-coverage-emergency-department
#14
Julie Copeland, Andrew Gray
OBJECTIVES: Fast tracks are one approach to reduce emergency department (ED) crowding. No studies have assessed the use of fast tracks in smaller hospitals with single physician coverage. Our study objective was to determine if implementation of an ED fast track in a single physician coverage setting would improve wait times for low-acuity patients without negatively impacting those of higher acuity. METHODS: A daytime fast track opened in 2010 at Strathroy Middlesex General Hospital, a southwestern Ontario community hospital...
November 2015: CJEM
https://www.readbyqxmd.com/read/26014365/consensus-statement-on-advancing-research-in-emergency-department-operations-and-its-impact-on-patient-care
#15
Maame Yaa A B Yiadom, Michael J Ward, Anna Marie Chang, Jesse M Pines, Nick Jouriles, Donald M Yealy
The consensus conference on "Advancing Research in Emergency Department (ED) Operations and Its Impact on Patient Care," hosted by The ED Operations Study Group (EDOSG), convened to craft a framework for future investigations in this important but understudied area. The EDOSG is a research consortium dedicated to promoting evidence-based clinical practice in emergency medicine. The consensus process format was a modified version of the NIH Model for Consensus Conference Development. Recommendations provide an action plan for how to improve ED operations study design, create a facilitating research environment, identify data measures of value for process and outcomes research, and disseminate new knowledge in this area...
June 2015: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/25976905/assessment-of-a-structured-management-pathway-for-patients-referred-to-the-emergency-department-for-syncope-results-in-a-tertiary-hospital
#16
Andrea Ungar, Francesca Tesi, Valentina Maddalena Chisciotti, Giuseppe Pepe, Simone Vanni, Stefano Grifoni, Daniela Balzi, Martina Rafanelli, Niccolò Marchionni, Michele Brignole
AIMS: High hospitalization rates (39-58% in the literature) of patients admitted to Emergency Department (ED) for transient loss of consciousness (T-LOC) suspected for syncope are still an unresolved issue. The presence of an Observation Unit has reduced hospital admissions and the duration of hospitalization in controlled studies, and a Syncope Unit (SU) in the hospital may reduce hospitalization and increase the number of diagnoses in patients with T-LOC. We assessed the effect of a structured organization on hospitalization rate and outcome...
March 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/25842428/-paediatric-emergencies-example-of-the-management-of-winter-epidemics
#17
Jean-Christophe Mercier, Xavier Bellettre, Émilie Lejay, Marie Desmarest, Luigi Titomanlio
Every year, epidemics of viral bronchiolitis and gastroenteritis occur with a significant increase in the number of visits (by a factor 1.8) and hospitalisations that can over-exceed bed capacity leading to transfer sick children to other hospitals. This kind of hospital 'crisis' is not limited to paediatrics, big cities or western nations. It is a worldwide worrying problem. Because our hospital sits in the Northern districts of Paris where a large community of m.ncants lives in poverty, our number of visits is high (mean 250 per day), and winter epidemics further jeopardise the difficult equilibrium achieved between quality management and waiting times...
January 2015: La Revue du Praticien
https://www.readbyqxmd.com/read/25781378/developing-emergency-department-physician-shift-schedules-optimized-to-meet-patient-demand
#18
David W Savage, Douglas G Woolford, Bruce Weaver, David Wood
OBJECTIVES: 1) To assess temporal patterns in historical patient arrival rates in an emergency department (ED) to determine the appropriate number of shift schedules in an acute care area and a fast-track clinic and 2) to determine whether physician scheduling can be improved by aligning physician productivity with patient arrivals using an optimization planning model. METHODS: Historical data were statistically analyzed to determine whether the number of patients arriving at the ED varied by weekday, weekend, or holiday weekend...
January 2015: CJEM
https://www.readbyqxmd.com/read/25671005/effect-of-an-emergency-department-fast-track-on-press-ganey-patient-satisfaction-scores
#19
Calvin E Hwang, Grant S Lipman, Marlena Kane
INTRODUCTION: Mandated patient surveys have become an integral part of Medicare remuneration, putting hundreds of millions of dollars in funding at risk. The Centers for Medicare & Medicaid Services (CMS) recently announced a patient experience survey for the emergency department (ED). Development of an ED Fast Track, where lower acuity patients are rapidly seen, has been shown to improve many of the metrics that CMS examines. This is the first study examining if ED Fast Track implementation affects Press-Ganey scores of patient satisfaction...
January 2015: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25493117/using-lean-based-systems-engineering-to-increase-capacity-in-the-emergency-department
#20
Benjamin A White, Yuchiao Chang, Beth G Grabowski, David F M Brown
INTRODUCTION: While emergency department (ED) crowding has myriad causes and negative downstream effects, applying systems engineering science and targeting throughput remains a potential solution to increase functional capacity. However, the most effective techniques for broad application in the ED remain unclear. We examined the hypothesis that Lean-based reorganization of Fast Track process flow would improve length of stay (LOS), percent of patients discharged within one hour, and room use, without added expense...
November 2014: Western Journal of Emergency Medicine
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