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https://www.readbyqxmd.com/read/28328696/enterocolitis-in-a-child-with-hirschsprung-disease
#1
Alexander W D Guillaume, Andrew C Miller, Michael C Nguyen
Hirschsprung disease is a congenital abnormality that can be surgically corrected. However, Hirschsprung-associated enterocolitis can be a life-threatening sequela. Very little has been published in the emergency medicine literature about the risk of enterocolitis and shock in patients with a history of Hirschsprung disease. We describe the case of a 6-month-old male infant with a history of multiple surgeries for Hirschsprung disease who presented to the emergency department with a seemingly benign viral gastrointestinal illness...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28328691/factors-associated-with-discharge-home-after-transfer-to-a-pediatric-emergency-department
#2
Erin R Peebles, Michael R Miller, Tim P Lynch, Janice A Tijssen
OBJECTIVES: The transfer of children from community emergency departments (EDs) to tertiary care pediatric EDs for investigations, interventions, or a second opinion is common. In order to improve health care system efficiency, we must have a better understanding of this population and identify areas for education and capacity building. METHODS: We conducted a retrospective chart review of all patients (aged 0-17 years) who were transferred from community ED to a pediatric ED from November 2013 to November 2014...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28315025/practices-and-attitudes-towards-radiation-risk-disclosure-for-computed-tomography-survey-of-emergency-medicine-residency-program-directors
#3
Jennifer R Marin, Karen E Thomas, Angela M Mills, Joshua S Broder, Kathy Boutis
PURPOSE: The purposes of this study were to evaluate the frequency with which emergency physicians involved in residency leadership disclose potential malignancy risks from computed tomography (CT), assess comfort with these discussions, and evaluate factors influencing risk disclosure. METHODS: We surveyed emergency medicine residency program directors and associate/assistant directors. Primary outcome was the proportion who "almost always" or "most of the time" discussed potential risks...
March 17, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28303693/the-opinions-of-radiographers-nuclear-medicine-technologists-and-radiation-therapists-regarding-technology-in-health-care-a-qualitative-study
#4
Sil Aarts, Forra Cornelis, Yke Zevenboom, Patrick Brokken, Nicole van de Griend, Miriam Spoorenberg, Wendy Ten Bokum, Eveline Wouters
INTRODUCTION: New technology is continuously introduced in health care. The aim of this study was (1) to collect the opinions and experiences of radiographers, nuclear medicine technologists and radiation therapists regarding the technology they use in their profession and (2) to acquire their views regarding the role of technology in their future practice. METHODS: Participants were recruited from five departments in five hospitals in The Netherlands. All radiographers, nuclear medicine therapists and radiation therapists who were working in these departments were invited to participate (n = 252)...
March 2017: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/28302376/emerging-trends-in-antibiotic-resistance-implications-for-emergency-medicine
#5
Ali Pourmand, Maryann Mazer-Amirshahi, Gregory Jasani, Larissa May
BACKGROUND: Many bacteria are demonstrating increasing levels of resistance to commonly used antibiotics. While this has implications for the healthcare system as a whole, many patients infected with these resistant organisms will initially present to the emergency department (ED). The purpose of this review is to provide a summary of current trends in infections caused by the most clinically relevant resistant organisms encountered in emergency medicine. METHODS: Bacteria were selected based on the Centers for Disease Control and Prevention's National Action Plan for Combating Antibiotic Resistant Bacteria, and PubMed database...
March 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28301267/hypotonic-hyporesponsive-episodes-after-administration-of-hexavalent-dtp-based-combination-vaccine-a-description-of-12-cases
#6
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/28301213/academic-radiologist-subspecialty-identification-using-a-novel-claims-based-classification-system
#7
Andrew B Rosenkrantz, Wenyi Wang, Danny R Hughes, Luke A Ginocchio, David A Rosman, Richard Duszak
OBJECTIVE: The objective of the present study is to assess the feasibility of a novel claims-based classification system for payer identification of academic radiologist subspecialties. MATERIALS AND METHODS: Using a categorization scheme based on the Neiman Imaging Types of Service (NITOS) system, we mapped the Medicare Part B services billed by all radiologists from 2012 to 2014, assigning them to the following subspecialty categories: abdominal imaging, breast imaging, cardiothoracic imaging, musculoskeletal imaging, nuclear medicine, interventional radiology, and neuroradiology...
March 16, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28295894/cost-effectiveness-analysis-appraisal-and-application-an-emergency-medicine-perspective
#8
Michael D April, Brian P Murray
Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policy-makers have any formal training in CEA methodology...
March 10, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#9
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#10
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of best-practice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the U.S. Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286840/comparing-the-quality-and-complications-of-tube-thoracostomy-by-emergency-medicine-and-surgery-residents-a-cohort-study
#11
Parvin Kashani, Sepideh Harati, Ali Shirafkan, Alireza Amirbeigi, Hamid Reza Hatamabadi
INTRODUCTION: Tube thoracostomy complications depend on the operator's skill, patients' general condition and the place in which the procedure is done. The present study aimed to compare the quality and complications of tube thoracostomy carried out by emergency medicine residents (EMRs) and surgery residents (SRs). METHODS: This cohort study was conducted on 18-60 years old trauma patients in need of tube thoracostomy presenting to two academic emergency departments...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286837/rapid-acute-physiology-score-versus-rapid-emergency-medicine-score-in-trauma-outcome-prediction-a-comparative-study
#12
Babak Nakhjavan-Shahraki, Masoud Baikpour, Mahmoud Yousefifard, Zahra Sadat Nikseresht, Samaneh Abiri, Jalaledin Mirzay Razaz, Gholamreza Faridaalaee, Mahboob Pouraghae, Sahar Shirzadegan, Mostafa Hosseini
INTRODUCTION: Rapid acute physiology score (RAPS) and rapid emergency medicine score (REMS) are two physiologic models for measuring injury severity in emergency settings. The present study was designed to compare the two models in outcome prediction of trauma patients presenting to emergency department (ED). METHODS: In this prospective cross-sectional study, the two models of RAPS and REMS were compared regarding prediction of mortality and poor outcome (severe disability based on Glasgow outcome scale) of trauma patients presenting to the EDs of 5 educational hospitals in Iran (Tehran, Tabriz, Urmia, Jahrom and Ilam) from May to October 2016...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286823/protocol-adherence-for-severe-sepsis-and-septic-shock-management-in-the-emergency-department-a-clinical-audit
#13
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/28286821/smartphones-and-medical-applications-in-the-emergency-department-daily-practice
#14
Amirhosein Jahanshir, Ehsan Karimialavijeh, Hojjat Sheikh, Motahar Vahedi, Mehdi Momeni
INTRODUCTION: Medical applications help physicians to make more rapid and evidence based decisions that may provide better patient care. This study aimed to determine the extent to which smart phones and medical applications are integrated in the emergency department daily practice. METHOD: In a cross sectional study, a modified standard questionnaire (Payne et al.) consisting of demographic data and information regarding quality and quantity of smartphone and medical app utilization was sent to emergency-medicine residents and interns twice (two weeks apart), in January 2015...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286528/evaluation-of-a-pilot-project-to-introduce-simulation-based-team-training-to-pediatric-surgery-trauma-room-care
#15
Markus Lehner, Ellen Heimberg, Florian Hoffmann, Oliver Heinzel, Hans-Joachim Kirschner, Martina Heinrich
Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28284769/sustainable-resuscitation-ultrasound-education-in-a-low-resource-environment-the-kumasi-experience
#16
Chelsea A Tafoya, Matthew J Tafoya, Maxwell Osei-Ampofo, Rockefeller A Oteng, Torben K Becker
BACKGROUND: Point-of-care-ultrasound (POCUS) is an increasingly important tool for emergency physicians and has become a standard component of emergency medicine residency training in high-income countries. Cardiopulmonary ultrasound (CPUS) is emerging as an effective way to quickly and accurately assess patients who present to the emergency department with shock and dyspnea. Use of POCUS, including CPUS, is also becoming more prevalent in low- and middle-income countries (LMICs); however, formal ultrasound training for emergency medicine resident physicians in these settings is not widely available...
March 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28279543/emergency-department-holding-orders
#17
Stephen J Traub, M'Hamed Temkit, Soroush Saghafian
BACKGROUND: Holding orders help transition admitted emergency department (ED) patients to hospital beds. OBJECTIVE: To describe the effect of ED holding orders. METHODS: We conducted a single-site retrospective study of ward admissions from the ED to the hospital internal medicine (HIM) service over 2 years. Patients were classified based on whether the ED did (group 1) or did not (group 2) write holding orders; group 1 was subdivided into patients sent to the floor with only ED holding orders (group 1A) vs...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28277413/community-primary-care-provider-preferences-for-emergency-department-follow-up-recommendations-a-regional-study
#18
Marissa A Hendrickson, Eta Obeya, Andrew R Wey, Philippe R Gaillard
BACKGROUND: Children who present to emergency departments (EDs) for care are frequently advised to follow up with their primary care providers (PCPs) after discharge; little is known about whether PCPs agree that follow-up advised by EDs is appropriate for their patients. OBJECTIVES: The aims of this study were to determine PCP preferences for follow-up recommendations given to their pediatric patients at the time of ED visits and to compare these preferences to reported emergency medicine provider (EMP) practice...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28277237/does-rapid-blood-sampling-affect-the-retention-time-of-patients-with-low-acuity-complaints-in-the-emergency-department
#19
Ju Young Lee, Sang Hoon Oh, Kyu Nam Park, Jee Yong Lim, Jung Min Lee, Hyun Suk Park, Han Joon Kim
INTRODUCTION: The objective of this study was to investigate whether rapid blood sampling during triage led to shorter stays in the emergency department for patients with low-acuity complaints. METHODS: A retrospective study was conducted in the emergency department (ED) of a tertiary university hospital in South Korea. A pre- and post-intervention comparison analysis was completed over one-month periods in June and September 2014. Data included triage level of the patient, time from the ED visit to receiving the doctor's orders, result time of complete blood cell count (CBC) and blood chemistry (BC), length of stay (LOS) for all discharged patients who required blood sampling...
October 27, 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/28274542/hypokalemia-in-women-and-methadone-therapy-are-the-strongest-non-cardiologic-factors-associated-with-qt-prolongation-in-an-emergency-department-setting
#20
Keith A Marill, Emily S Miller
BACKGROUND: Our primary objective was to determine the adjusted quantitative associations of clinical predictors with QT prolongation, a defining cause of Torsades de Pointes (TdP). METHODS: A retrospective cohort study was performed on consecutive emergency department patients identified by ECG acquisition date, and heart rate corrected QT (QTc) and QRS durations. QTc was modeled as a function of clinical predictors with multiple linear regression. RESULTS: 1010 patients were included...
February 10, 2017: Journal of Electrocardiology
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