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Emergency medicine department

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https://www.readbyqxmd.com/read/28926480/postconcussive-symptoms-over-the-first-14-days-after-mild-traumatic-brain-injury-an-experience-sampling-study
#1
Maria Pacella, Arjun Prabhu, Julia Morley, Stephanie Huang, Brian Suffoletto
OBJECTIVE: This study examined changes in postconcussive symptoms (PCS) over the acute postinjury recovery period, focusing on how daily PCSs differ between mild traumatic brain injury (mTBI) and other injury types. SETTING: An urban emergency department (ED) in Western Pennsylvania. SUBJECTS: A total of 108 adult patients with trauma being discharged from the ED were recruited and grouped by injury type: mild TBI (mTBI; n = 39), head injury without mTBI (HI: n = 16), and non-head-injured trauma controls (TCs: n = 53)...
September 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28925587/lessons-learned-from-the-development-and-parameterization-of-a-computer-simulation-model-to-evaluate-task-modification-for-healthcare-providers
#2
Parastu Kasaie, W David Kelton, Rachel M Ancona, Michael J Ward, Craig M Froehle, Michael S Lyons
Computer simulation is a highly advantageous method for understanding and improving healthcare operations with a wide variety of possible applications. Most computer-simulation studies in emergency medicine have sought to improve allocation of resources to meet demand, or to assess the impact of hospital and other system policies on emergency department (ED) throughput. These models have enabled essential discoveries that can be used to improve the general structure and functioning of EDs. Theoretically, computer simulation could also be used to examine the impact of adding or modifying specific provider tasks...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28922339/incidence-and-risk-factors-of-anaesthesia-related-perioperative-cardiac-arrest-a-6-year-observational-study-from-a-tertiary-care-university-hospital
#3
Andreas Hohn, Jan-Nicolas Machatschek, Jeremy Franklin, Stephan A Padosch
BACKGROUND: In recent decades, the incidences of anaesthesia-related perioperative mortality and adverse outcomes have decreased drastically. However, to date, data on perioperative cardiac arrest and risk factors of perioperative cardiac arrest from European countries are scarce. OBJECTIVES: To determine the incidences of perioperative cardiac arrest and rates of anaesthesia-related and anaesthesia-contributory cardiac arrest. Identification of pre-existing risk factors leading to perioperative cardiac arrest...
September 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28921727/hot-off-the-press-embedded-clinical-decision-support-in-electronic-health-record-decreases-use-of-high-cost-imaging-in-the-emergency-department-embed-study
#4
Corey Heitz, Justin Morgenstern, William K Milne
This longitudinal before/after study of embedded CDRs assessed the effects of clinical decision support on use of common imaging studies. Among high users, rates of CT-brain and CT c-spine were reduced after implementation of embedded clinical decision instruments, while in low users, rates increased. This article summarizes the manuscript and the Skeptics Guide to Emergency Medicine podcast, as well as the ensuing social media/online discussion. This article is protected by copyright. All rights reserved.
September 15, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28919600/modified-blatchford-score-for-risk-stratification-in-adult-patient-with-nonvariceal-upper-gastrointestinal-haemorrhage-and-their-short-term-hospital-outcome
#5
M S Islam, M Z Uddin, M S Ali, M N Islam, M H Rahman, I H Robi, M M Haque, M W Rahman, M A Uddin, F Ahamed, M S Malek, M A Kabir, M S Rahman, A U Khan, F A Doel
Upper gastrointestinal hemorrhage (UGIH) is one of the most common and life-threatening gastrointestinal emergency. There are several risk scores for risk stratification in UGIB patients. The Modified Blatchford score, which relies only on clinical and laboratory parameters, is practical in the emergency setting The Modified Blatchford scoring system also known as Glasgow Blatchford Scoring (GBS) have been developed to stratify risk of non variceal upper gastrointestinal hemorrhage or need of medical or surgical intervention, endoscopic therapy...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28915258/rapid-emergency-medicine-score-a-novel-prognostic-tool-for-predicting-the-outcomes-of-adult-patients-with-hepatic-portal-venous-gas-in-the-emergency-department
#6
Chen-June Seak, David Hung-Tsang Yen, Chip-Jin Ng, Yon-Cheong Wong, Kuang-Hung Hsu, Joanna Chen-Yeen Seak, Hsien-Yi Chen, Chen-Ken Seak
OBJECTIVE: This study aims to evaluate the performance of Rapid Emergency Medicine Score (REMS), Rapid Acute Physiology Score (RAPS), and Modified Early Warning Score (MEWS) in ascertaining the severity of illness and predicting the mortality of adult hepatic portal venous gas (HPVG) patients presenting to the emergency department (ED). This will assist emergency physicians (EPs) in risk stratification. METHODS: Data for 66 adult HPVG patients who visited the EDs of 2 research hospitals between October 1999 and April 2016 were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28914856/-the-russian-consensus-on-the-diagnosis-and-treatment-of-chronic-pancreatitis-enzyme-replacement-therapy
#7
I E Khatkov, I V Maev, D S Bordin, Yu A Kucheryavyi, S R Abdulkhakov, S A Alekseenko, E I Alieva, R B Alikhanov, I G Bakulin, A Yu Baranovsky, E V Beloborodova, E A Belousova, I M Buriev, E V Bystrovskaya, S V Vertyankin, L V Vinokurova, E I Galperin, A V Gorelov, V B Grinevich, M V Danilov, V V Darvin, E A Dubtsova, T G Dyuzheva, V I Egorov, M G Efanov, N V Zakharova, V E Zagainov, V T Ivashkin, R E Izrailov, N V Korochanskaya, E A Kornienko, V L Korobka, N Yu Kokhanenko, M A Livzan, I D Loranskaya, K A Nikolskaya, M F Osipenko, A V Okhlobystin, V D Pasechnikov, E Yu Plotnikova, S I Polyakova, O A Sablin, V I Simanenkov, N I Ursova, V V Tsvirkun, V V Tsukanov, A V Shabunin
Pancreatology Club Professional Medical Community, 1A.S. Loginov Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow; 2A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow; 3Kazan State Medical University, Ministry of Health of Russia, Kazan; 4Kazan (Volga) Federal University, Kazan; 5Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk; 6Morozov City Children's Clinical Hospital, Moscow Healthcare Department, Moscow; 7I...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28914285/hospital-medicine-point-of-care-ultrasound-credentialing-an-example-protocol
#8
Benji K Mathews, Michael Zwank
Though the use of point-of-care ultrasound (POCUS) has increased over the last decade, formal hospital credentialing for POCUS may still be a challenge for hospitalists. This document details the Hospital Medicine Department Ultrasound Credentialing Policy from Regions Hospital, which is part of the HealthPartners organization in Saint Paul, Minnesota. National organizations from internal medicine and hospital medicine (HM) have not published recommended guidelines for POCUS credentialing. Revised guidelines for POCUS have been published by the American College of Emergency Physicians, though these are not likely intended to guide hospitalists when working with credentialing committees and medical boards...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28900071/a-case-of-non-islet-cell-tumor-hypoglycemia-nicth-associated-with-gastrointestinal-stromal-tumor-gist
#9
John M Wilson, Jessica Ginsberg, Karen Cutts, Steve Urban
BACKGROUND Non-islet cell tumor hypoglycemia (NICTH) is a newly recognized, but uncommon, paraneoplastic syndrome that is associated with tumors of mesenchymal origin. We report a case of NICTH associated with a gastrointestinal stromal tumor (GIST). CASE REPORT A 60-year-old man presented to the emergency department of our hospital after being found unconscious in his home. His serum blood glucose on hospital admission was 40 mg/dL. He reported a three-month history of diffuse abdominal pain, fatigue, and blurred vision...
September 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28891235/financial-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#10
REVIEW
Charles S Wiysonge, Elizabeth Paulsen, Simon Lewin, Agustín Ciapponi, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Gabriel Rada, Andrew D Oxman
BACKGROUND: One target of the Sustainable Development Goals is to achieve "universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all". A fundamental concern of governments in striving for this goal is how to finance such a health system. This concern is very relevant for low-income countries. OBJECTIVES: To provide an overview of the evidence from up-to-date systematic reviews about the effects of financial arrangements for health systems in low-income countries...
September 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28889147/acute-coronary-syndrome-risk-prediction-of-rapid-emergency-medicine-scoring-system-in-acute-chest-pain-an-observational-study-of-patients-presenting-with-chest-pain-in-the-emergency-department-in-central-saudi-arabia
#11
Tahir Mehmood, Mohammad S Al Shehrani, Muhammad Ahmad
To assess the diagnostic validity of the rapid emergency medical score (REMS) for the risk stratification of acute coronary syndrome (ACS) from non-cardiogenic chest pain. Methods: An observational cross-sectional study was carried out among patients presenting with chest pain to the Emergency Department of Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia, for 6 months from January to June 2016. All patients, included through non-probability convenience sampling, were assessed using standard protocols for the physiological parameters of the REMS, and ACS was confirmed through electrocardiography, cardiac enzyme testing, and angiography (if needed)...
September 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28888560/unintentional-cannabis-ingestion-in-children-a-systematic-review
#12
John R Richards, Nishelle E Smith, Aimee K Moulin
OBJECTIVE: To analyze published reports of unintentional cannabis ingestions in children to determine presenting signs and symptoms, route of exposure, treatment, and outcome. STUDY DESIGN: PubMed, OpenGrey, and Google Scholar were systematically searched. Articles were selected, reviewed, and graded using Oxford Center for Evidence-Based Medicine guidelines. RESULTS: Of 3316 articles, 44 were included (3582 children age ≤12 years). We found no high quality (Oxford Center for Evidence-Based Medicine level I or II) studies and 10 level III studies documenting lethargy as the most common presenting sign and confirming increasing incidence of unintentional ingestion in states having decriminalized medical and recreational cannabis...
September 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28886611/-mass-casualty-incident-special-features-of-threatening-situations
#13
Björn Hossfeld, Thomas Wurmb, Florent Josse, Matthias Helm
Terrorist attacks or amok runs may cause "threatening situations" for emergency medical services (EMS), fire fighters and physicians. Cooperation with the police is of paramount importance. In order to minimize the risk to rescue personnel and affected persons, emergency medical care has to follow tactical principles. So, the strategy in such "threatening situations" is "Stop the bleeding and clear the scene". The police define three areas of danger: unsafe, partly safe and secure. Medical care in these areas follows the concept of Tactical Combat Casualty Care...
September 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28884282/efficiency-analysis-of-integrated-public-hospital-networks-in-outpatient-internal-medicine
#14
Miguel Angel Ortíz-Barrios, Juan P Escorcia-Caballero, Fabián Sánchez-Sánchez, Fabio De Felice, Antonella Petrillo
Healthcare systems are evolving towards a complex network of interconnected services due to the increasing costs and the increasing expectations for high service levels. It is evidenced in the literature the importance of implementing management techniques and sophisticated methods to improve the efficiency of healthcare systems, especially in emerging economies. This paper proposes an integrated collaboration model between two public hospitals to reach the reduction of weighted average lead time in outpatient internal medicine department...
September 7, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28883195/mapping-equivalence-of-german-emergency-department-medical-record-concepts-with-snomed-ct-after-implementation-with-hl7-cda
#15
Dominik Brammen, Heike Dewenter, Kai U Heitmann, Volker Thiemann, Raphael W Majeed, Felix Walcher, Rainer Röhrig, Sylvia Thun
INTRODUCTION: The German Emergency Department Medical Record (GEDMR) was created by medical domain experts and healthcare providers providing a dataset as well as a form. The trauma module of GEDMR was syntactically standardized using HL7 CDA and semantically standardized using different terminologies including SNOMED CT, LOINC and proprietary coding systems. This study depicts the mapping accuracy with aforementioned syntactical and semantical standards in general and especially the content coverage of SNOMED CT...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28879242/disparities-in-emergency-department-pain-treatment-for-toothache
#16
H H Lee, C W Lewis, C M McKinney
Racial disparities in how pain is treated in the emergency department (ED) for toothache have not been reported. Due to increasing reliance on EDs for dental care, the authors investigated whether race/ethnicity and insurance type are associated with treatment for toothache pain. The authors conducted a nationally representative cross-sectional study of ED toothache visits by adults (19 to 64 y old), using the 2008-2010 National Hospital Ambulatory Medical Care Survey. Multinomial regression models accounted for the complex survey design...
October 2016: JDR Clinical and Translational Research
https://www.readbyqxmd.com/read/28876710/-hospital-pathway-of-complex-patients-in-a-medical-service-of-a-local-hospital
#17
Claire Bardini, Gatete Karege, Anna Christe, Laurent Christin
In the current Swiss medical system, hospital care is provided by both university hospitals and so-called « peripheral » hospitals. While university hospitals offer advanced technology and a wide range of medical specialists, how is care organized within the smaller, less complex structure of a peripheral hospital ? In emergencies, although patients usually go to their local hospital, they should not be exposed to lower quality care. Quality treatment is guaranteed by a well-organized structure, supported by a competent team of general doctors and specialists who have access to advanced technology...
September 6, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28874939/rapid-primary-care-follow-up-from-the-ed-to-reduce-avoidable-hospital-admissions
#18
Amanda S Carmel, Peter Steel, Robert Tanouye, Aleksey Novikov, Sunday Clark, Sanjai Sinha, Judy Tung
INTRODUCTION: Hospital admissions from the emergency department (ED) now account for approximately 50% of all admissions. Some patients admitted from the ED may not require inpatient care if outpatient care could be optimized. However, access to primary care especially immediately after ED discharge is challenging. Studies have not addressed the extent to which hospital admissions from the ED may be averted with access to rapid (next business day) primary care follow-up. We evaluated the impact of an ED-to-rapid-primary-care protocol on avoidance of hospitalizations in a large, urban medical center...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28874937/antimicrobial-therapy-for-pneumonia-in-the-emergency-department-the-impact-of-clinical-pharmacists-on-appropriateness
#19
Brett A Faine, Nicholas Mohr, Jenna Dietrich, Laura Meadow, Kari K Harland, Elizabeth Chrischilles
INTRODUCTION: Pneumonia impacts over four million people annually and is the leading cause of infectious disease-related hospitalization and mortality in the United States. Appropriate empiric antimicrobial therapy decreases hospital length of stay and improves mortality. The objective of our study was to test the hypothesis that the presence of an emergency medicine (EM) clinical pharmacist improves the timing and appropriateness of empiric antimicrobial therapy for community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP)...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28870390/how-do-we-balance-the-long-term-health-of-a-patient-with-the-short-term-risk-to-the-physician
#20
Michael B Weinstock, Amal Mattu, Erik P Hess
BACKGROUND: There is a wide variation in practice patterns among emergency medicine physicians; many factors weigh into the medical decision-making process including the health of the patient as well as short-term risk to the physician. OBJECTIVE: The objective of our discussion is to illustrate specific scenarios where medical decisions are focused on the physician's short-term risk, then to propose an approach to shifting the balance to the patient's long-term health...
September 1, 2017: Journal of Emergency Medicine
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