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Emergency medicine department

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https://www.readbyqxmd.com/read/29783250/-signifuing-resident-of-the-city-poltava-at-the-expense-of-signs-stroke-risk-factors-and-urgent-measures-according-to-medico-social-survey
#1
Anzhelina M Kryvchun, Nataliia V Lytvynenko, Viktoriia A Pinchuk, Galyna Ya Sylenko, Viktoriia M Gladka
OBJECTIVE: Introduction: The problem of cerebrovascular diseases and their most severe form - cerebral stroke is one of the most pressing problems in modern medicine due to the high level of lethality, significant disability of patients. The aim: To assess and increase the sign of residents of the city Poltava at the expense of signs of stroke, its risk factors for emergence and emergency measures for stroke. PATIENTS AND METHODS: Materials and methods: During the annual social event dedicated to the World Stroke Day, on October 27, 2017, a survey of 981 people in Poltava city was conducted by volunteer students and staff of the Department of Nervous Diseases with Neurosurgery and Medical Genetics of "Ukrainian Medical Stomatological Academy"...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#2
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29781108/an-exploratory-study-of-sectra-table-visualization-improves-the-effectiveness-of-emergency-bedside-echocardiography-training
#3
Di Shi, Joseph H Walline, Jihai Liu, Xuezhong Yu, Jun Xu, Priscilla P Song, Huadong Zhu, John M O'Donnell
OBJECTIVES: Echocardiography is an essential tool in emergency medicine, and its training is the most challenging of all types of bedside ultrasound (US) training. This study investigated the effectiveness of the Sectra Table (Sectra AB, Linköping, Sweden), an anatomy visualization and collaboration tool, in improving the quality of echocardiography training for emergency medicine physicians. METHODS: We conducted an exploratory prospective observational study from 2015 to 2017 and enrolled 66 trainees who participated in a 2...
May 21, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29779679/loperamide-abuse-cardiotoxicity-should-loperamide-still-be-an-over-the-counter-medication
#4
Amr Idris, Kenji Kaye
Loperamide is an over-the-counter anti-diarrheal medication that is inexpensive, easily accessible, and widely used. It is generally thought to be safe and effective without the potential for abuse. However, recent discovery of its ability to treat opioid withdrawal symptoms at high doses has led to not only its abuse, but also the need to recognize its cardiotoxicity due to the ability to prolong the QTc interval. We report a case of a 33 year old female with a history of opioid dependence who presented to the emergency department with acute onset shortness of breath and generalized weakness who was subsequently found to be in ventricular tachycardia...
May 18, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29778776/identification-and-medical-utilization-of-incident-cases-of-alcohol-dependence-a-population-based-case-control-study
#5
Chun-Hung Pan, Min-Shan Li, Tien-Wey Yang, Ming-Chyi Huang, Sheng-Shiang Su, Yen-Ni Hung, Chiao-Chicy Chen, Chian-Jue Kuo
BACKGROUND: Patients with alcohol dependence (AD) often seek help from medical professionals due to alcohol-related diseases, but the overall distribution of medical specialties identifying new AD cases is unclear. We investigated how such cases were identified and how medical resources were utilized before the identification of AD in a nationwide cohort. METHODS: We enrolled a population-based cohort (N = 1,000,000) using the National Health Insurance Research Database of Taiwan; 8181 cases with incident AD were retrieved between January 1, 2000, and December 31, 2010...
May 5, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29776701/nonstandard-advance-directives-in-emergency-medicine-what-should-we-do
#6
Kenneth V Iserson
BACKGROUND: Critically ill or injured emergency department or prehospital patients who lack decision-making capacity sometimes present with a non-standard advance directive, such as a "Do Not Resuscitate" tattoo or medallion. Emergency clinicians must immediately address the question of whether to withhold treatment based on what may or may not be a valid patient directive. DISCUSSION: Advance directives have been standardized for a good reason. Emergency department or prehospital healthcare providers must be able to immediately interpret and act on them without needing a legal interpretation...
May 16, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29773359/-psychoactive-substances-use-in-r%C3%A3-union-island-and-mayotte-french-departments-in-indian-ocean
#7
Amélie Daveluy, Françoise Haramburu
INTRODUCTION: The government plan for the fight against drugs and addictive behaviors 2013-2017 includes several actions concerning French overseas territories, in particular to strengthen information on drug addiction. The Interministerial mission for combating drugs and addictive behaviors (MILD&CA) has commissioned the Bordeaux addictovigilance center to strengthen exchanges on addictovigilance with Réunion Island and Mayotte and to make an inventory of problematic drug use in these two French departments of Indian Ocean...
February 27, 2018: Thérapie
https://www.readbyqxmd.com/read/29769484/prevalence-of-non-alcoholic-fatty-liver-disease-and-its-biochemical-predictors-in-patients-with-type-2-diabetes-mellitus
#8
M A Kabir, M Z Uddin, N I Siddiqui, I H Robi, M S Malek, M S Islam, S Rahman, M S Hossain, S K Mahapatra, M J Alam, F Ahmad, M S Alam, M A Islam
Non-alcoholic fatty liver disease (NAFLD) is emerging as the most common chronic liver condition in the Western world and it is commonly associated with type 2 diabetes mellitus (DM). The aim of this study to determine the prevalence of NAFLD and identify the predisposing factors in type 2 DM patients with NAFLD. Total of 258 patients of type 2 DM were included in this observational study in the Department of Medicine, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from 11th May 2013 to 11th November 2013...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29768299/early-variation-of-quick-sequential-organ-failure-assessment-score-to-predict-in-hospital-mortality-in-emergency-department-patients-with-suspected-infection
#9
Lemachatti Najla, Ortega Mar, Penaloza Andrea, Pierrick Le Borgne, Pierre-Géraud Claret, Céline Occelli, Jennifer Truchot, Florence Dumas, Anne-Laure Feral-Pierssens, Héry Andrianjafy, Sebastien Beaune, Youri Yordanov, Pierre Hausfater, Bruno Riou, Ben Bloom, Evguenia Krastinova, Yonathan Freund
BACKGROUND: The quick sequential organ failure assessment (qSOFA) score showed good prognostic performance in patients with suspicion of infection in the emergency department (ED). However, previous studies only assessed the performance of individual values of qSOFA during the ED stay. As this score may vary over short timeframes, the optimal time of measurement, and the prognostic value of its variation are unclear. The objective of the present study was to prospectively assess the prognostic value of the change in qSOFA over the first 3 h (ΔqSOFA=qSOFA at 3 h-qSOFA at inclusion)...
May 15, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29765259/shadowing-emergency-medicine-residents-by-medical-education-specialists-to-provide-feedback-on-non-medical-knowledge-based-acgme-sub-competencies
#10
Anna L Waterbrook, Karen C Spear Ellinwood, T Gail Pritchard, Karen Bertels, Ariel C Johnson, Alice Min, Lisa R Stoneking
Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29761678/ultrasound-of-jugular-veins-for-assessment-of-acute-dyspnea-in-emergency-departments-and-for-the-assessment-of-acute-heart-failure
#11
Batsheva Tzadok, Shay Shapira, Eran Tal-Or
BACKGROUND: When a patient arrives at the emergency department (ED) presenting with symptoms of acute decompensated heart failure (ADHF), it is possible to reach a definitive diagnosis through many different venues, including medical history, physical examination, echocardiography, chest X-ray, and B-type natriuretic peptide (BNP) levels. Point-of-care ultrasound (POCUS) has become a mainstream tool for diagnosis and treatment in the field of emergency medicine, as well as in various other departments in the hospital setting...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29760863/implementation-of-an-emergency-medicine-research-associates-program-sharing-20-years-of-experience
#12
Beau Abar, Vincent DeRienzo, Joseph Glick, Nancy Wood, Manish N Shah, Sandra Schneider, David Adler
Introduction: The use of research associates (RA) programs to facilitate study enrollment in the emergency department was initiated during the mid-1990s. The University of Rochester Medical Center (URMC) was an early adopting site for this model, which has experienced considerable growth and development over the past 20 years. Methods: Our goal was to detail the Emergency Department Research Associates (EDRA) program processes developed at the URMC that has led to our program's sustainability and productivity...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759656/well-being-among-emergency-medicine-resident-physicians-results-from-the-abem-longitudinal-study-of-emergency-medicine-residents
#13
Debra G Perina, Catherine A Marco, Rebecca Smith-Coggins, Terry Kowalenko, Mary M Johnston, Anne Harvey
BACKGROUND: The Longitudinal Study of Emergency Medicine Residents (LSEMR) conducted by the American Board of Emergency Medicine queries a randomized cohort of emergency medicine (EM) residents. It is designed to identify residents' perceptions of their training, sources of stress, well-being level, and career choice satisfaction over time. OBJECTIVES: This study utilizes LSEMR to identify resident well-being levels, career satisfaction, factors producing stress, and whether a specific cohort is more stressed than the overall respondent group...
May 11, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759290/anesthesiology-s-future-with-specialists-in-population-health
#14
REVIEW
Mike Schweitzer
In population health medicine, often it is not primary care, but rather the specialists' care teams that are responsible for the most overall spending for health care. Engaging specialists in population health medicine is a prerequisite to be successful in improving the quality of care by reducing complications, unnecessary utilization, avoidable Emergency Department visits/readmissions, and total cost of care. Creating patient-centric, physician-lead, interdisciplinary care teams to redesign the delivery of care across the continuum of the episode of care (eg, shadow bundle) is a successful approach to commercial or Centers for Medicare and Medicaid Services value-based payments...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29753519/state-of-the-national-emergency-department-workforce-who-provides-care-where
#15
M Kennedy Hall, Kevin Burns, Michael Carius, Mitchel Erickson, Jane Hall, Arjun Venkatesh
STUDY OBJECTIVE: We describe the current US emergency medicine workforce in terms of clinician type and examine rural and urban emergency medicine workforce differences. METHODS: Using the 2014 Medicare Public Use Files, we performed a cross-sectional study of all clinicians receiving reimbursement for evaluation and management (E/M) services (levels 1 to 5) to Medicare fee-for-service Part B beneficiaries in the emergency department. Providers were defined as emergency physicians, nonemergency physicians, or advanced practice providers, corresponding with the Medicare Public Use Files data set...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29753518/application-of-the-canadian-computed-tomography-head-rule-to-patients-with-minimal-head-injury
#16
Kevin Davey, Turandot Saul, Geoffrey Russel, Jonathan Wassermann, Joshua Quaas
STUDY OBJECTIVE: Two clinical decision rules, the Canadian CT Head Rule and the New Orleans Criteria, set the standard to guide clinicians in determining which patients with minor head trauma need computed tomography (CT) imaging. Both rules were derived with patients with minor head injury who had had a loss of consciousness or witnessed disorientation. No evidence exists for evaluating patients and need for CT imaging with minimal head injury; that is, patients who had a head injury but no loss of consciousness or disorientation and therefore would have been excluded from the Canadian CT Head Rule and New Orleans Criteria trials...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29746359/evaluation-of-a-focused-cardiac-ultrasound-protocol-in-a-pediatric-emergency-department
#17
Antonio Riera, Bevin Weeks, Beth L Emerson, Lei Chen
OBJECTIVES: The objective of this study was to evaluate the implementation of a focused cardiac ultrasound (FoCUS) protocol in a pediatric emergency department (PED). METHODS: We conducted a cross-sectional, observational, quality improvement project in a PED of an urban tertiary care children's hospital. A FoCUS protocol was collaboratively developed by pediatric cardiology and pediatric emergency medicine. This included a reference document with definitions, indications, image acquisition guidelines, and interpretation expectations...
May 9, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29742757/evaluation-of-a-novel-system-to-enhance-clinicians-recognition-of-preadmission-adverse-drug-reactions
#18
Joshua C Smith, Qingxia Chen, Joshua C Denny, Dan M Roden, Kevin B Johnson, Randolph A Miller
BACKGROUND:  Often unrecognized by providers, adverse drug reactions (ADRs) diminish patients' quality of life, cause preventable admissions and emergency department visits, and increase health care costs. OBJECTIVE:  This article evaluates whether an automated system, the Adverse Drug Effect Recognizer (ADER), could assist clinicians in detecting and addressing inpatients' ongoing preadmission ADRs. METHODS:  ADER uses natural language processing to extract patients' medications, findings, and past diagnoses from admission notes...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29742331/youth-with-autism-spectrum-disorder-in-the-emergency-department
#19
Sarah Lytle, Andrew Hunt, Sonal Moratschek, Marcie Hall-Mennes, Martha Sajatovic
OBJECTIVE: This comprehensive literature review summarizes reports on emergency department (ED) use by youth with autism spectrum disorder (ASD). DATA SOURCES: We conducted a systematic search of the PubMed, PsycINFO, CINAHL, and EMBASE databases (1985-2016), limited to studies published in English. The following search terms were used: autism, autistic, Asperger, emergency department/room/physician/doctor/treatment/medicine, childhood developmental disorders (pervasive), and emergencies...
May 8, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29738675/the-role-of-technology-and-telemetry-medicine-in-the-initial-management-of-a-st-segment-elevated-myocardial-infarction-in-a-rural-emergency-department
#20
Michael L Hood
CONTEXT: The 12-lead electrocardiogram (ECG) is an integral part of the diagnostic tools available for recognising a patient who is experiencing an ST-segment elevated myocardial infarction (STEMI). Consequently, a great emphasis is placed on the rapid acquisition and expert interpretation of the 12-lead ECG so that the appropriate reperfusion management might be commenced to optimise patient outcomes by preventing further damage to the myocardium. With the advancement of telemetric and diagnostic abilities of the modern ECG machine, the role of frontline rural emergency clinicians is as important as ever...
May 2018: Rural and Remote Health
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