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Emergency room boarding

Kumara V Nibhanipudi
OBJECTIVE: To determine the incidence of urinary tract infections (UTIs) in infants and children (4 months to 6 years of age) with febrile diarrhea, as outpatients. METHODS: This was a prospective institutional review board-approved study. patients (between 4 months and 6 years of age) were enrolled in the study who presented to the pediatric emergency room with a complaint of fever (rectal temperature 101°F or more) and diarrhea (watery stools >3 in number)...
2016: Global Pediatric Health
Scott P Krall, Jose Guardiola, Peter B Richman
BACKGROUND: Emergency Department (ED) service evaluations are typically based on surveys of discharged patients. Physicians/administrators benefit from data that quantifies system-based factors that adversely impact the experience of those who represent the survey cohort. OBJECTIVE: While investigators have established that admitted patient boarding impacts overall ED throughput times, we sought to specifically quantify the relationship between throughput times for patients admitted (EDLOS) versus discharged home from the ED (DCLOS)...
September 2016: American Journal of Emergency Medicine
Liane M McAuliffe, Joshua Ness, Erin Morine, Rushad Juyia, Deborah Light, Hamish Kerr
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
Peter G Noel, Anthony J Fischetti, George E Moore, Alexandre B Le Roux
Off-site consultations by board-certified veterinary radiologists benefit residents and emergency clinicians by providing immediate feedback and potentially improving patient outcome. Smartphone devices and compressed images transmitted by email or text greatly facilitate availability of these off-site consultations. Criticism of a smartphone interface for off-site consultation is mostly directed at image degradation relative to the standard radiographic viewing room and monitors. The purpose of this retrospective, cross-sectional, methods comparison study was to compare the accuracy of abdominal radiographs in two imaging interfaces (Joint Photographic Experts Group, off-site, smartphone vs...
September 2016: Veterinary Radiology & Ultrasound
Mohamed Khalifa, Ibrahim Zabani
Emergency Room (ER) performance has been a timely topic for both healthcare practitioners and researchers. King Faisal Specialist Hospital and Research Center, Saudi Arabia worked on developing a comprehensive set of KPIs to monitor, evaluate and improve the performance of the ER. A combined approach using quantitative and qualitative methods was used to collect and analyze the data. 34 KPIs were developed and sorted into the three components of the ER patient flow model; input, throughput and output. Input indicators included number and acuity of ER patients, patients leaving without being seen and revisit rates...
2016: Studies in Health Technology and Informatics
Elizabeth Bishop Gausden, Matthew R Garner, Stephen J Warner, Ashley Levack, Andrew M Nellestein, Tiffany Tedore, Eva Flores, Dean G Lorich
INTRODUCTION: There is a high incidence of blood transfusion following hip fractures in elderly patients. Tranexamic acid (TXA) has proven efficacy in decreasing blood loss in general trauma patients as well as patients undergoing elective orthopaedic surgery. A randomised controlled trial will measure the effect of TXA in a population of patients undergoing hip fracture surgery. METHODS: This is a double-blinded, randomised placebo-controlled trial. Patients admitted through the emergency room that are diagnosed with an intertrochanteric or femoral neck fracture will be eligible for enrolment and randomised to either treatment with 1 g of intravenous TXA or intravenous saline at the time of skin incision...
2016: BMJ Open
Ayman Ads, Frederic Auerbach, Kelly Ryan, Abdel R El-Ganzouri
We report the successful use of the Air-Q laryngeal airway (Air-Q LA) as a ventilatory device and a conduit for tracheal intubation to rescue the airway in a patient with difficult airway and tracheal stenosis. This is the first case report of the device to secure the airway after two episodes of hypoxemia in the operating room and intensive care unit. Consent for submission of this case report was obtained from our institution's human studies institutional review board given that the patient died a few months after his discharge from the hospital before his personal consent could be obtained and before preparation of this report...
August 2016: Journal of Clinical Anesthesia
Samuel E Ford, Joshua C Patt, Brian P Scannell
OBJECTIVES: To design and implement a month-long, low-cost, comprehensive surgical skills curriculum built to address the needs of orthopedic surgery interns with high satisfaction among both interns and faculty. DESIGN: The study design was retrospective and descriptive. SETTING: The study was conducted at tertiary care referral center with a medium sized orthopedic residency surgery program (5 residents/year). PARTICIPANTS: Totally 5 orthopedic surgery residents and 16 orthopedic surgery faculty participated...
July 2016: Journal of Surgical Education
Denis Dorozhkin, Arun Nemani, Kurt Roberts, Woojin Ahn, Tansel Halic, Saurabh Dargar, Jinling Wang, Caroline G L Cao, Ganesh Sankaranarayanan, Suvranu De
BACKGROUND: Natural orifice translumenal endoscopic surgery (NOTES) is an emerging surgical paradigm, where peritoneal access is achieved through one of the natural orifices of the body. It is being reported as a safe and feasible surgical technique with significantly reduced external scarring. Virtual Translumenal Endoscopic Surgical Trainer (VTEST™) is the first virtual reality simulator for the NOTES. The VTEST™ simulator was developed to train surgeons in the hybrid transvaginal NOTES cholecystectomy procedure...
April 29, 2016: Surgical Endoscopy
Jonathan Robert Nichol, Rongwei Fu, Keith French, Jami Momberger, Daniel A Handel
BACKGROUND: Emergency departments (EDs) are seeing an increase in the importance of patient satisfaction scores, yet little is known about their association with patient and operational characteristics. OBJECTIVES: This study aimed to identify patient and operational characteristics associated with patient satisfaction scores. METHODS: This was a retrospective analysis of data from Press Ganey patient satisfaction surveys of pediatric patients (<18 years) and their families, discharged from the ED of a single, academic, pediatric ED from December 2009 to May 2013...
March 2016: Pediatric Emergency Care
P Wuthisuthimethawee
BACKGROUND: Trauma team activation (TTA) criteria were first implemented in the Emergency Department (ED) of Songklanagarind Hospital in 2009 to treat severe trauma patients. PURPOSE: To determine the efficacy of the TTA criteria on the acute trauma care process in the ED and the 28-day mortality rate. METHODS: A 1-year prospective cohort study was conducted at the ED. Trauma patients who were 18 years old and over who met the TTA criteria were enrolled...
February 15, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Iva Petkovska, Diego R Martin, Matthew F Covington, Shannon Urbina, Eugene Duke, Z John Daye, Lori A Stolz, Samuel M Keim, James R Costello, Surya Chundru, Hina Arif-Tiwari, Dorothy Gilbertson-Dahdal, Lynn Gries, Bobby Kalb
PURPOSE: To determine the accuracy of unenhanced magnetic resonance (MR) imaging in the detection of acute appendicitis in patients younger than 50 years who present to the emergency department with right lower quadrant (RLQ) pain. MATERIALS AND METHODS: The institutional review board approved this retrospective study of 403 patients from August 1, 2012, to July 30, 2014, and waived the informed consent requirement. A cross-department strategy was instituted to use MR imaging as the primary diagnostic modality in patients aged 3-49 years who presented to the emergency department with RLQ pain...
May 2016: Radiology
Varun Gupta, Julian Winocour, Hanyuan Shi, R Bruce Shack, James C Grotting, K Kye Higdon
BACKGROUND: Facelift (rhytidectomy) is a prominent technique for facial rejuvenation with 126 713 performed in the United States in 2014. Current literature on facelift complications is inconclusive and derives from retrospective studies. OBJECTIVES: This study reports the incidence and risk factors of major complications following facelift in a large, prospective, multi-center database. It compares complications of facelifts done alone or in combination with other cosmetic surgical procedures...
January 2016: Aesthetic Surgery Journal
Eiji Mitate, Kensuke Kubota, Kenji Ueki, Rumi Inoue, Ryosuke Inoue, Kenta Momii, Hiroshi Sugimori, Yoshihiko Maehara, Seiji Nakamura
Communication is a serious problem for patients with ventilator-dependent tetraplegia. A 73-year-old man was presented at the emergency room in cardiopulmonary arrest after falling from a height of 2 m. After successful resuscitation, fractures of the cervical spine and cervical spinal cord injury were found. Due to paralysis of the respiratory muscles, a mechanical ventilator with a tracheostomy tube was required. First, a cuffed tracheostomy tube and a speaking tracheostomy tube were inserted, and humidified oxygen was introduced via the suction line...
2015: Case Reports in Emergency Medicine
Cora Peterson, Likang Xu, Curtis Florence, Scott D Grosse, Joseph L Annest
BACKGROUND: US hospital discharge datasets typically report facility charges (ie, room and board), excluding professional fees (ie, attending physicians' charges). OBJECTIVES: We aimed to estimate professional fee ratios (PFR) by year and clinical diagnosis for use in cost analyses based on hospital discharge data. SUBJECTS: The subjects consisted of a retrospective cohort of Truven Health MarketScan 2004-2012 inpatient admissions (n=23,594,605) and treat-and-release emergency department (ED) visits (n=70,771,576)...
October 2015: Medical Care
Kenneth R Koedinger, Sidney D'Mello, Elizabeth A McLaughlin, Zachary A Pardos, Carolyn P Rosé
An emerging field of educational data mining (EDM) is building on and contributing to a wide variety of disciplines through analysis of data coming from various educational technologies. EDM researchers are addressing questions of cognition, metacognition, motivation, affect, language, social discourse, etc. using data from intelligent tutoring systems, massive open online courses, educational games and simulations, and discussion forums. The data include detailed action and timing logs of student interactions in user interfaces such as graded responses to questions or essays, steps in rich problem solving environments, games or simulations, discussion forum posts, or chat dialogs...
July 2015: Wiley Interdisciplinary Reviews. Cognitive Science
M Everett, S Massand, W Davis, B Burkey, P M Glat
OBJECTIVE: Despite extensive research into the treatment of partial-thickness burns, to date there has not been the emergence of a preeminent modality. This pilot study, the first such study to be performed in a burn unit in the US, was designed to evaluate the efficacy and outcomes of the application of copolymer dressing (Suprathel; PolyMedics Innovations Corporation, Stuttgart, Germany) for both superficial and deeper partial-thickness burns. METHOD: The copolymer dressing was used as a primary wound dressing to treat superficial and deep partial-thickness burns (average 5% total body surface area) in paediatric patients...
July 2015: Journal of Wound Care
Abdullah Alabousi, Michael N Patlas, Niv Sne, Douglas S Katz
PURPOSE: The purpose of our study was to validate the hypothesis that eliminating the use of oral contrast for multidetector computed tomography (MDCT) would not affect the detection of acute abdominal abnormalities in emergency room patients. METHODS: We conducted a retrospective study to assess the effect of discontinuing oral contrast use for MDCT scans of the abdomen and pelvis for patients presenting with acute abdominal pain and body mass index (BMI) >25...
November 2015: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
Paul S Appelbaum
"Boarding" involuntary psychiatric patients in medical emergency rooms is common in many parts of the United States. The practice, driven by a shortage of alternative resources, including limited inpatient capacity, can result in patients' being held for days without treatment or a hospital room, often in busy corridors or treatment rooms. A recent challenge to this practice led the Washington Supreme Court to declare it illegal and resulted in the appropriation of substantial funding to create new psychiatric beds...
July 2015: Psychiatric Services: a Journal of the American Psychiatric Association
Bennett Futterman
The origin of the Papal Benediction Sign has been a source of controversy for many generations of medical students. The question has been whether the Papal Benediction Sign posture is the result of an injury to the median nerve or to the ulnar nerve. The increasingly popular use of online "chat rooms" and the vast quantities of information available on the internet has led to an increasing level of confusion. Looking in major anatomy texts, anatomy and board review books as well as numerous internet sites the answer remains unresolved...
September 2015: Clinical Anatomy
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