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Emergency medicine department

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https://www.readbyqxmd.com/read/27925145/the-oldest-old-in-the-emergency-department-impact-of-renal-function
#1
T Brünnler, M Drey, G Dirrigl, C Weingart, F Rockmann, C Sieber, U Hoffmann
OBJECTIVES: The ageing population implicates an increasing numbers of older adults attending Emergency Departments (ED). We assessed the effect of estimated glomerular filtration rate as a predictor of clinical outcomes in oldest-old patients ≥ 85 years attending the ED in an university teaching hospital. DESIGN: Within three years, 81831 patient contacts were made in our ED. 7799 (9.5%) were older than 85 years, in whom we analyzed the impact of renal function on various outcome parameters...
2016: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/27917402/academic-institution-pilot-study-shows-far-fewer-diagnoses-of-sinusitis-than-reported-nationally
#2
Sarah R Akkina, Sarah J Novis, Nahid R Keshavarzi, Melissa A Pynnonen
OBJECTIVE: To compare the prevalence of acute sinusitis (AS) and chronic sinusitis (CS) diagnosed by primary care and emergency medicine physicians in our academic institution to national data. STUDY DESIGN: Cross-sectional pilot study of institutional census data and a population-based national sample. The setting was primary care and emergency departments at an academic healthcare institution and community healthcare practices nationally. MATERIALS AND METHODS: We determined the proportion of adults visits at our institution for AS and CS from January 1, 2005, to December 31, 2010...
October 2016: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/27913201/early-mortality-and-associated-factors-among-patients-with-stroke-admitted-to-a-large-teaching-hospital-in-tanzania
#3
Kigocha Okeng'o, Pilly Chillo, William K Gray, Richard W Walker, William Matuja
BACKGROUND: Stroke is a major cause of death worldwide and 85.5% of stroke deaths occur in low- and middle-income countries due to stroke. The aim of this study was to investigate correlates and predictors of 30-day mortality in stroke patients in urban Tanzania. METHODS: A prospective 30-day follow-up study was conducted at the Muhimbili National Hospital, Dar es Salaam, Tanzania. We recruited all patients with stroke seen at the Emergency Medicine Department and medical wards...
November 29, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27912950/a-randomized-placebo-controlled-trial-of-traditional-chinese-medicine-as-an-add-on-therapy-to-oral-montelukast-in-the-treatment-of-mild-persistent-asthma-in-children
#4
Pak-Hong Chan, Ching-Yee To, Eric Yat-Tung Chan, Handong Li, Xiuxia Zhang, Pok-Yu Chow, Po-Ling Liu, Shuk-Yu Leung, Chung-Hong Chan, Ka-Yan Chan, Johnny Yick-Chun Chan, Jonathan Pak-Heng Ng, Daniel Kwok-Keung Ng
OBJECTIVES: Traditional Chinese medicine are commonly used for treatment of asthma. However, there are only very limited data about its efficacy in children. Therefore, we aimed to determine the efficacy of augmented Yu Ping Feng San (aYPFS) as an add-on to oral montelukast compared with montelukast alone for treatment of mild persistent asthma in children. DESIGN: A single centre, placebo-controlled, double-blinded, randomized control trial was carried out. Participants with age 6-18 years who had mild persistent asthma were randomized according to random number list to receive either aYPFS plus montelukast for 24 weeks or placebo plus montelukast for 24 weeks...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27910796/reinforcement-of-emergency-department-reduces-acute-admissions-to-medical-department
#5
Mansoor Ahmed Dawood, Gideon Ertner, Jacob Hansen-Schwartz
INTRODUCTION: The medical decision capacity of emergency departments (ED) may rest within the department itself or depend on external consultation. The stepwise development of the ED at Zealand University Hospital, Køge, was used to analyse the influence of medical organisation in the ED on the hospital admission pattern. METHODS: Data were recorded for the month of September of 2009, 2012 and 2014. These periods corresponded to the establishment of the department in 2009 and the 2012-period before organisational change was initiated in 2013, with a substantial increase in the number of senior physicians directly in charge of clinical decisions and the establishment of a limited bedding capacity...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27907982/learners-perspective-where-and-when-pre-residency-trainees-learn-more-to-achieve-their-core-clinical-competencies
#6
Eusang Ahn, Ducksun Ahn, Young-Mee Lee
PURPOSE: While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. METHODS: A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews...
December 2016: Korean Journal of Medical Education
https://www.readbyqxmd.com/read/27906976/a-laboratory-critical-incident-and-error-reporting-system-for-experimental-biomedicine
#7
Ulrich Dirnagl, Ingo Przesdzing, Claudia Kurreck, Sebastian Major
We here propose the implementation of a simple and effective method to enhance the quality of basic and preclinical academic research: critical incident reporting (CIR). CIR has become a standard in clinical medicine but to our knowledge has never been implemented in the context of academic basic research. We provide a simple, free, open-source software tool for implementing a CIR system in research groups, laboratories, or large institutions (LabCIRS). LabCIRS was developed, tested, and implemented in our multidisciplinary and multiprofessional neuroscience research department...
December 2016: PLoS Biology
https://www.readbyqxmd.com/read/27905006/guidelines-on-the-management-of-atrial-fibrillation-in-the-emergency-department-a-critical-appraisal
#8
Giorgio Costantino, Gian Marco Podda, Lorenzo Falsetti, Primiano Iannone, Ana Lages, Alberto M Marra, Maristella Masala, Olaug Marie Reiakvam, Florentia Savva, Jan Schovanek, Sjoerd van Bree, Inês João da Silva Chora, Graziella Privitera, Silvio Ragozzino, Matthias von Rotz, Lycke Woittiez, Christopher Davidson, Nicola Montano
Several guidelines often exist on the same topic, sometimes offering divergent recommendations. For the clinician, it can be difficult to understand the reasons for this divergence and how to select the right recommendations. The aim of this study is to compare different guidelines on the management of atrial fibrillation (AF), and provide practical and affordable advice on its management in the acute setting. A PubMed search was performed in May 2014 to identify the three most recent and cited published guidelines on AF...
November 30, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#9
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27904259/profile-and-outcome-of-sudden-cardiac-arrests-in-the-emergency-department-of-a-tertiary-care-hospital-in-south-india
#10
Gautham Raja Pandian, Suma Mary Thampi, Nilanchal Chakraborty, Deepthi Kattula, Paul Prabhakar Abhilash Kundavaram
BACKGROUND: Sudden cardiac arrest (SCA) requiring cardiopulmonary resuscitation (CPR) is one of the common emergencies encountered in the emergency department (ED) of any hospital. Although several studies have reported the predictors of CPR outcome in general, there are limited data from the EDs in India. MATERIALS AND METHODS: This retrospective study included all patients above 18 years with SCA who were resuscitated in the ED of a tertiary care hospital with an annual census of 60,000 patients between August 2014 and July 2015...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27900531/accidental-cannabis-poisoning-in-the-elderly
#11
Anja Zupan Mežnar, Miran Brvar, Gregor Kralj, Dragan Kovačič
There are two main varieties of Cannabis sativa plant, namely, hemp which is cultivated for fiber and seeds and contains low amounts of psychoactive cannabinoids and the other which is cultivated for the drug cannabis or marijuana. Increasing popularity of hemp food products and alleged beneficial effects of cannabinoids in the drug variety of cannabis might lead to confusion in the lay population and unintentional ingestion of marijuana, as described in this case report. During a workshop on the use of hemp for medicinal purposes, there was a degustation of various hemp food products including also cookies that were brought by one of the attendees...
November 29, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27894630/finding-factors-associated-with-post-emergency-department-morbidity-and-mortality-in-elderly-patients-analyzing-a-case-control-study-answers-to-the-july-2016-annals-of-emergency-medicine-journal-club
#12
Nupur Garg, Tyler W Barrett, David L Schriger
No abstract text is available yet for this article.
December 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27893295/medical-directors-of-breastfeeding-programs-at-academic-medical-centers-duties-and-challenges
#13
Casey B Rosen-Carole
INTRODUCTION: An emerging trend in Academic Medical Centers (AMCs) is to coordinate breastfeeding care, research, and trainee education through "medical director" positions. Little is known about their duties, supports, and challenges. OBJECTIVE: To determine the duties and challenges of directors of breastfeeding medicine in AMCs. METHODS: A survey was distributed four times over a 3-month period to three listservs with a total of 860 members...
November 28, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/27890780/a-clinical-score-to-predict-appendicitis-in-older-male-children
#14
Anupam B Kharbanda, Michael C Monuteaux, Richard G Bachur, Nanette C Dudley, Lalit Bajaj, Michelle D Stevenson, Charles G Macias, Manoj K Mittal, Jonathan E Bennett, Kelly Sinclair, Peter S Dayan
OBJECTIVE: To develop a clinical score to predict appendicitis among older, male children who present to the emergency department (ED) with suspected appendicitis. METHODS: Patients with suspected appendicitis were prospectively recruited at 9 pediatric EDs. A total 2,625 patients enrolled; a subset of 961 males, age 8-18 were analyzed in this secondary analysis. Outcomes determined by pathology, operative reports and follow-up calls. Clinical and laboratory predictors with < 10% missing data and Kappa > 0...
November 24, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27890300/evaluating-clinical-care-in-the-prehospital-setting-is-rapid-emergency-medicine-score-the-missing-metric-of-ems
#15
Scott M Alter, Allison Infinger, Doug Swanson, Jonathan R Studnek
INTRODUCTION: The Rapid Emergency Medicine Score (REMS) was developed to predict emergency department patient mortality. Our objective was to utilize REMS to assess initial patient acuity and evaluate clinical change during prehospital care. METHODS: All non-cardiac arrest emergency transports from April 1, 2013 to March 31, 2014 were analyzed from a single EMS agency. Using age, pulse rate, mean arterial pressure, respiratory rate, oxygen saturation, and Glasgow Coma Scale, initial and final REMS were calculated...
October 25, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27889359/elevated-liver-enzymes-emergency-department-focused-management
#16
Eric Sulava, Samuel Bergin, Brit Long, Alex Koyfman
BACKGROUND: Liver function test (LFT) abnormalities are a common problem faced by emergency physicians. This has become more common with the introduction of laboratory panels and automated routine laboratory testing. Fortunately, not all patients with irregularities in liver enzymes possess underlying pathology. This emergency medicine focused review provides a discussion of the various biochemical tests, their underlying biological basis, and an algorithmic approach to the interpretation of abnormalities...
November 23, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27888601/key-issues-in-the-infected-patient-care-in-the-emergency-department
#17
F Chiarella, J González-Del Castillo, F J Candel, E J García-Lamberechts, M J Núñez-Orantos, F J Martín-Sánchez
OBJECTIVE: To develop a set of recommendations, by consensus of Emergency Medicine experts, on key aspects related to the care of adult patients with acute infection attended in Spanish emergency departments (ED). METHODS: The study was divided into three phases: 1) To design a questionnaire by a coordinating group; 2) To conduct a survey in ED physicians in order to know their opinion on the issues raised by the coordinating group; 3) To develop a number of recommendations based on the responses to the questionnaire and their subsequent discussion...
December 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27887758/blind-nasal-intubation-revisited-no-longer-a-blind-technique
#18
Prakash K Dubey, Preksha Dubey, Niranjan Kumar, Gautam Bhardwaj, Neeraj Kumar
BACKGROUND: Advancements in airway management have made the practice of blind nasal intubation obsolete. We report on successful blind nasal intubation performed with the help of capnography and real-time ultrasonography in two patients with tempormandibular joint ankylosis. CASE REPORT: Blind nasal intubation was performed in a 12-year-old patient and a 17-year old patient under general anesthesia with spontaneous respiration. Capnography was used as an aid during insertion and dynamic ultrasonography was performed to guide and confirm proper tracheal tube placement...
November 22, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27886161/cardiac-ct-in-the-emergency-department-in-the-era-of-highly-sensitive-troponins-is-there-still-a-role
#19
Admir Dedic, Koen Nieman, Udo Hoffmann, Maros Ferencik
INTRODUCTION: Physicians practicing cardiovascular medicine are every day confronted with patients presenting with symptoms suggestive of an acute coronary syndrome (ACS). Over the years, there have been substantial technical advances, such as the introduction of new non-invasive imaging techniques and the introduction of new highly sensitive cardiac biomarkers. EVIDENCE ACQUISITION AND SYNTHESIS: Physicians have adopted these new assets and have become more experienced with them thus improving medical care...
November 25, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27884844/medication-reconciliation-as-a-medication-safety-initiative-in-ethiopia-a-study-protocol
#20
Alemayehu B Mekonnen, Andrew J McLachlan, Jo-Anne E Brien, Desalew Mekonnen, Zenahebezu Abay
INTRODUCTION: Medication related adverse events are common, particularly during transitions of care, and have a significant impact on patient outcomes and healthcare costs. Medication reconciliation (MedRec) is an important initiative to achieve the Quality Use of Medicines, and has been adopted as a standard practice in many developed countries. However, the impact of this strategy is rarely described in Ethiopia. The aims of this study are to explore patient safety culture, and to develop, implement and evaluate a theory informed MedRec intervention, with the aim of minimising the incidence of medication errors during hospital admission...
November 24, 2016: BMJ Open
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