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Emergency room boarding

A A Hyder, S He, W Zafar, M U Mir, J A Razzak
OBJECTIVES: Injuries increasingly contribute to the global burden of disease in low- and middle-income countries. This study presents results from a large-scale surveillance study on injury from several urban emergency departments (EDs) in Pakistan. The objective is to document the burden of injuries that present to the healthcare system in Pakistan and to test the feasibility of an ED-based injury and trauma surveillance system. STUDY DESIGN: Cross-sectional study conducted using active surveillance approach...
April 18, 2017: Public Health
Louise E Vaz, Cindi L Farnstrom, Kimberly K Felder, Judith Guzman-Cottrill, Hannah Rosenberg, Richard C Antonelli
Background.: Outpatient parenteral or prolonged oral antibiotic therapy (OPAT) programs reduce inpatient healthcare costs by shifting care to outpatient settings. Care coordination (CC) is a necessary component to successfully transition patients. Our objective was to assess outcomes of provider time spent on nonreimbursable CC activities in a pediatric OPAT program. Methods.: We used a qualitative feasibility pilot design and modified the Care Coordination Measurement Tool...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
Tariq Rahman, Ralph Page, Christopher Page, Jean-Remy Bonnefoy, Tim Cox, Thomas H Shaffer
Objective pulmonary function (PF) evaluation is essential for the diagnosis, monitoring, and management of many pediatric respiratory diseases as seen in the emergency room, intensive care, and outpatient settings. In this paper, the development and testing of a new noninvasive PF instrument, pneuRIP(TM), which utilizes respiratory inductance plethysmography (RIP) are discussed. The pneuRIP(TM) hardware includes a small circuit board that connects to the RIP bands and measures and wirelessly transmits the band inductance data to any designated wirelessly connected tablet...
March 2017: Journal of Medical Devices
Hal E Crosswell, Terra Dillard, Jennifer Bayne, Tina Redenz, Kyle Duggan, Angela Belew
83 Background: Although cancer centers have focused on optimizing seamless Multidisciplinary Care (MDC) at tumor boards and/or clinics, there has been little published on effective ways to involve supportive services into the management of cancer patients. Historically, supportive services have been initiated when there is an active need rather than in anticipation of that need. As an alternative to pursuing such "crisis management" in our patients, Bon Secours St. Francis Cancer Center (BSSF) initiated Interdisciplinary Care (IDC) Rounds in an effort to anticipate patient needs, enhance quality of life (QoL), and potentially limit avoidable emergency room and hospital admissions...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Denis Dorozhkin, Jaisa Olasky, Daniel B Jones, Steven D Schwaitzberg, Stephanie B Jones, Caroline G L Cao, Marcos Molina, Steven Henriques, Jinling Wang, Jeff Flinn, Suvranu De
BACKGROUND: The Virtual Electrosurgical Skill Trainer is a tool for training surgeons the safe operation of electrosurgery tools in both open and minimally invasive surgery. This training includes a dedicated team-training module that focuses on operating room (OR) fire prevention and response. The module was developed to allow trainees, practicing surgeons, anesthesiologist, and nurses to interact with a virtual OR environment, which includes anesthesia apparatus, electrosurgical equipment, a virtual patient, and a fire extinguisher...
December 30, 2016: Surgical Endoscopy
Lisa J Sundean, E Carol Polifroni
Nurses' knowledge, skills, and expertise uniquely situate them to contribute to health care transformation as equal partners in organizational board governance. The Institute of Medicine, the 10,000 Nurses on Boards Coalition, and a growing number of nurse and health care scholars advocate nurse board leadership; however, nurses are rarely appointed as voting board members. When no room is made for nurses to take a seat at the table, the opportunity is lost to harness the power of nursing knowledge for health care transformation and social justice...
November 2016: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
Joshua Frisby, Vernon Smith, Stephen Traub, Vimla L Patel
Hospital Emergency Departments (EDs) frequently experience crowding. One of the factors that contributes to this crowding is the "door to doctor time", which is the time from a patient's registration to when the patient is first seen by a physician. This is also one of the Meaningful Use (MU) performance measures that emergency departments report to the Center for Medicare and Medicaid Services (CMS). Current documentation methods for this measure are inaccurate due to the imprecision in manual data collection...
January 2017: Journal of Biomedical Informatics
Brian E Lacy, Michael D Crowell, Carole Mathis, David Bauer, Leslie J Heinberg
BACKGROUND AND AIMS: Gastroparesis (GP) patients suffer from recurrent symptoms of nausea, vomiting, early satiety, and abdominal pain. The impact of GP on quality of life (QoL), health care utilization and daily activities is not well understood. MATERIALS AND METHODS: Part 1: 398 adult patients (≥18 y) with documented GP (symptoms >6 mo) were surveyed to assess QoL and pain using the Short Form 36 and McGill pain questionnaires. Part 2: 491 adult GP patients were surveyed to evaluate employment status, work and daily activities, medication use, physician visits, diagnostic testing, emergency room visits, and hospitalizations related to their GP symptoms...
October 21, 2016: Journal of Clinical Gastroenterology
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...
June 21, 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...
December 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
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