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Pre-Hospital Emergency Medicine

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https://www.readbyqxmd.com/read/29115370/-febrile-syndromes-in-the-traveler-returning-from-tropical-regions-admitted-in-a-monographic-unit
#1
N Moya Notario, M Hernández-Cabrera, C Carranza-Rodríguez, E Pisos-Álamo, N Jaén-Sánchez, J L Pérez-Arellano
OBJECTIVE: The aim was to analyse those syndromes with fever in travellers who return from tropical regions evaluated at our Department of Infectology and Tropical Medicine. Clarifying these conditions intends to reach earlier diagnoses and, perhaps, to avoid the emergence and spread of imported diseases, as well as to establish appropriate preventive measures. METHODS: An observational descriptive transversal study was performed, selecting those patients who returned from tropical regions with fever, amongst all travellers evaluated in our department between 1998 and 2013...
November 8, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29113010/comparison-of-four-methods-of-endotracheal-tube-passage-in-simulated-airways-there-is-room-for-improved-techniques
#2
Kirsten Kingma, Ross Hofmeyr, Irene Suilan Zeng, Christin Coomarasamy, Andrew Brainard
OBJECTIVE: Endotracheal intubation requires laryngoscopy followed by passage of the endotracheal tube (ETT). Tube passage can be difficult, but there is little evidence to support which adjunct for tube passage is most effective. METHODS: The four tube passage adjuncts tested were the naked ETT, stylet ETT, railroaded bougie and preloaded bougie. Participants completed pre- and post-test surveys identifying demographics, experience and method preference. After instruction, participants completed eight intubations on manikins with 'easy' and 'difficult' airways...
November 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29105736/stroke-identification-by-criteria-based-dispatch-a-register-based-study
#3
E N Ellensen, H Naess, T Wisborg, S Hunskaar, E Zakariassen
BACKGROUND: Rapid and precise dispatch of resources is a key element in pre-hospital emergency medicine. Emergency medical communication centres (EMCCs) dispatch resources based on protocols and guidelines, balancing the acute need of the individual and the resource allocation of the pre-hospital emergency medical system. The aim of this study was to determine the validity of stroke identification by the Norwegian dispatch guidelines. METHOD AND MATERIAL: This was a register-based study where patients suspected for stroke were compared to those with the final diagnosis of stroke as an indicator group for the guideline validation...
November 5, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29074070/comparison-of-intubation-devices-in-level-c-personal-protective-equipment-a-cadaveric-study
#4
R Scott Taylor, Matthew Pitzer, Grayson Goldman, Augusta Czysz, Thomas Simunich, John Ashurst
BACKGROUND: With the advancement of chemical, biological and nuclear warfare and the reemergence of infectious diseases, the possibility of intubating in personal protective equipment has become increasingly more real to the emergency physician. Human cadaveric models have been found to simulate real world conditions better than mannequins. The aim of the study was to determine the first pass success rate and average time to successful intubation while wearing Personal Protective Equipment (PPE)...
October 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29070085/the-south-dakota-model-health-care-professions-student-disaster-preparedness-and-deployment-training
#5
Matt P Owens, Cheri Buffington, Michael P Frost, Randall J Waldner
OBJECTIVE: The Association of American Medical Colleges recommended an increase in medical education for public health emergencies, bioterrorism, and weapons of mass destruction in 2003. The University of South Dakota Sanford School of Medicine (USD SSOM) implemented a 1-day training event to provide disaster preparedness training and deployment organization for health professions students called Disaster Training Day (DTD). METHODS: Hospital staff and emergency medical services personnel provided the lecture portion of DTD using Core Disaster Life Support (CDLS; National Disaster Life Support Foundation) as the framework...
October 26, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28941075/patient-perspectives-on-priorities-for-emergency-medicine-research-the-perspex-study
#6
Stuart Vb McLay, David McCutcheon, Glenn Arendts, Stephen Pj Macdonald, Daniel M Fatovich
OBJECTIVES: To determine the priorities for emergency medicine research of patients currently in an ED and to compare their priorities with those of ACEM researchers. METHODS: A survey of current patients in the EDs of Royal Perth Hospital and Armadale Health Service. Patients gave their reason for presentation, suggested three important research priorities for emergency medicine and ranked their top 5 choices from a pre-specified list published by the ACEM researchers...
September 21, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28932302/predictive-value-of-tracheal-rapid-ultrasound-exam-performed-in-the-emergency-department-for-verification-of-tracheal-intubation
#7
Babak Masoumi, Reza Azizkhani, Gilava Hedayati Emam, Morteza Asgarzadeh, Behrouz Zargar Kharazi
BACKGROUND: Verification of the correct placement of the endotracheal tube (ETT) has been one of the most challenging issues of airway management in the field of emergency medicine. Early detection of oesophagal intubation through a reliable method is important for emergency physicians. AIM: The aim of this study was to assess the diagnostic accuracy of tracheal rapid ultrasound exam (TRUE) to assess endotracheal tube misplacement during emergency intubation. METHODS: This was an observational prospective study performed in the emergency department of the major tertiary referral hospital in the city...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
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
#8
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/28919404/emergency-in-the-clinic-a-simulation-curriculum-to-improve-outpatient-safety
#9
Eve Espey, Gillian Baty, John Rask, Michelle Chungtuyco, Brenda Pereda, Lawrence Leeman
BACKGROUND: Emergency response skills are essential when events such as seizure, anaphylaxis, or hemorrhage occur in the outpatient setting. Because services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. OBJECTIVE: The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy...
September 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28886784/development-of-a-new-infusion-protocol-for-austere-trauma-resuscitations
#10
Stewart A Stancil
Intravenous fluid therapy for hemorrhagic shock has undergone enormous changes since it was first conducted almost 200 years ago. In the past 40 years especially, practices have dramatically changed with regards to fluid resuscitation. In pre-hospital, combat, austere, and rural emergency medicine the stakes are especially high to deliver an effective and logical resuscitation fluid strategy to a patient that is suffering from hemorrhagic shock. This article follows a prior article published in July 2014. It highlights the development of new cutting edge intravenous therapy regimens that maximize hemodynamic outcomes that can be effected by those providers that care for injured patients without the benefit of ample resources...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28874007/new-horizons-in-comprehensive-geriatric-assessment
#11
S G Parker, A McLeod, P McCue, K Phelps, M Bardsley, H C Roberts, S P Conroy
In this article, we discuss the emergence of new models for delivery of comprehensive geriatric assessment (CGA) in the acute hospital setting. CGA is the core technology of Geriatric Medicine and for hospital inpatients it improves key outcomes such as survival, time spent at home and institutionalisation. Traditionally It is delivered by specialised multidisciplinary teams, often in dedicated wards, but in recent years has begun to be taken up and developed quite early in the admission process (at the 'front door'), across traditional ward boundaries and in specialty settings such as surgical and pre-operative care, and oncology...
September 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28800938/using-hospital-use-trends-to-improve-transitional-care
#12
Joe Feinglass, Celeste A Mallama, Angela Rogers, Caroline Teter, Courtney Hurt, Christine Schaeffer
BACKGROUND: This study evaluates the Northwestern Medicine Group Transitional Care clinic (NMG-TC), which transitions patients from an urban hospital to primary care at partner community clinics. We evaluate change over the 55 month study period in emergency department, observation or inpatient use within 90 days of an initial NMG-TC visit. METHODS: Electronic health records were used to determine patient demographic, insurance and clinical characteristics, including inflation-adjusted total hospital charges in the 90 days prior and the 90 days after an initial NMG-TC visit...
August 8, 2017: Healthcare
https://www.readbyqxmd.com/read/28796559/improvements-in-patient-and-health-system-outcomes-using-an-integrated-oncology-and-palliative-medicine-approach-on-a-solid-tumor-inpatient-service
#13
Richard F Riedel, Kim Slusser, Steve Power, Christopher A Jones, Thomas W LeBlanc, Arif H Kamal, Devi Desai, Deborah Allen, Yinxi Yu, Steven Wolf, Anthony N Galanos
PURPOSE: Early palliative care (PC) improves outcomes for outpatients with advanced cancer. Its effect on hospitalized patients with cancer is unknown. Herein, we report on the influence of a novel, fully integrated inpatient medical oncology and PC partnership at a tertiary medical center during its first year of implementation. METHODS: We conducted a retrospective, longitudinal, pre- and postintervention cohort study at Duke University Hospital. Pre- and postintervention cohorts were defined as all patients admitted to the solid tumor inpatient service from September 1, 2009, to June 30, 2010, and September 1, 2011 to June 30, 2012, respectively...
September 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28726526/integrated-care-coordination-by-an-interprofessional-team-reduces-emergency-department-visits-and-hospitalisations-at-an-academic-health-centre
#14
Anne H Gaglioti, Patrick Barlow, Kate DuChene Thoma, George R Bergus
People with chronic behavioural and physical health conditions have higher healthcare costs and mortality rates than patients with chronic physical conditions alone. As a result, there has been promotion of integrated care for this group. It is important to train primary care residents to practice in integrated models of care with interprofessional teams and to evaluate the effectiveness of integrated care models to promote high-quality care for this at-risk group. We implemented an integrated, interprofessional care management programme for adults with chronic mental and physical health needs as part of a curriculum for family medicine and family medicine psychiatry residents...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28713660/a-cross-sectional-pharmacoepidemiological-study-of-the-utilization-pattern-of-pre-anesthetic-medications-in-major-surgical-procedures-in-a-tertiary-care-hospital
#15
Madhuri Kulkarni, Anant Patil
OBJECTIVE : A study of the utilization pattern of pre-anesthetic medications in major surgical procedures. MATERIAL AND METHODS : A cross-sectional, pharmacoepidemiological study was conducted among patients undergoing surgical procedures in routine or emergency conditions under general anesthesia. The utilization of pre-anesthetic medicines in all patients was reported. RESULTS: A total of 110 patients (mean age - 42.36 years; 57.27% males) were enrolled...
June 13, 2017: Curēus
https://www.readbyqxmd.com/read/28655343/cardiopulmonary-arrest-in-primary-care-clinics-more-holes-than-cheese-a-survey-of-the-knowledge-and-attitudes-of-primary-care-physicians-regarding-resuscitation
#16
Sharon Einav, Oren Wacht, Nechama Kaufman, Eliezer Alkalay
BACKGROUND: Patients experiencing pre-arrest symptoms may first refer to their primary care physician. The study's aim was to determine the likelihood that a patient undergoing out-of-hospital cardiac arrest will receive appropriate resuscitation efforts in a primary care clinic in a country with a directive that clinics maintain resuscitation equipment and physicians undergo periodic resuscitation training. METHODS: An anonymous, 23-question online cross-sectional survey was created and administered to primary care physicians working in community clinics (10/1/2015-5/3/2015)...
June 10, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28616160/cardiopulmonary-arrest-in-primary-care-clinics-more-holes-than-cheese-a-survey-of-the-knowledge-and-attitudes-of-primary-care-physicians-regarding-resuscitation
#17
Sharon Einav, Oren Wacht, Nechama Kaufman, Eliezer Alkalay
BACKGROUND: Patients experiencing pre-arrest symptoms may first refer to their primary care physician. The study's aim was to determine the likelihood that a patient undergoing out-of-hospital cardiac arrest will receive appropriate resuscitation efforts in a primary care clinic in a country with a directive that clinics maintain resuscitation equipment and physicians undergo periodic resuscitation training. METHODS: An anonymous, 23-question online cross-sectional survey was created and administered to primary care physicians working in community clinics (10/1/2015-5/3/2015)...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28587264/being-in-the-chemotherapy-suite-versus-being-in-the-oncology-ward-an-analytical-view-of-two-hospital-sites-occupied-by-people-experiencing-cancer
#18
Catherine Hughes, Kate van Heugten, Sally Keeling, Francisc Szekely
How do people with cancer occupy places within the health system during their journey through palliative care? The answer to this question was explored by the authors as part of a wider ethnographic study of eight people's journeys from referral to palliative care services to the end of life. This article reports on findings that have emerged from ongoing analysis that has been completed in the years proceeding data collection. An ethnographic research design was used to collect data about the participants and their family members over a three-year period...
June 5, 2017: Cancers
https://www.readbyqxmd.com/read/28569281/a-qualitative-study-of-determinants-of-patient-behaviour-leading-to-an-infection-related-hospital-admission
#19
A P Tonna, A E Weidmann, R B Laing, I Tonna, G M Macartney, V Paudyal, D Stewart
Objectives To describe and understand the determinants of patients' behaviours surrounding admission to hospital for an acute infective episode Method Patients admitted to the infection or acute medicine admission units of a major Scottish teaching hospital and commenced on antibiotic therapy after admission were included. Semi-structured face-to-face interviews were conducted using a pre-piloted interview schedule guide that focused on gathering information about patient behaviours and experiences prior to admission to hospital with an acute infection...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28550970/thoracotomy-in-the-emergency-department-for-resuscitation-of-the-mortally-injured
#20
J Christopher DiGiacomo, L D George Angus
PURPOSE: Emergency department resuscitative thoracotomy is an intervention of last resort for the acutely dying victim of trauma. In light of improvements in pre-hospital emergency systems, improved operative strategies for survival such as damage control and improvements in critical care medicine, the most extreme of resuscitation efforts should be re-evaluated for the potential survivor, with success properly defined as the return of vital signs which allow transport of the patient to the operating room...
June 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
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