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ED Administration

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https://www.readbyqxmd.com/read/29783863/phase-1-randomized-parallel-group-double-blind-placebo-controlled-trial-to-evaluate-the-effects-of-erenumab-amg-334-and-concomitant-sumatriptan-on-blood-pressure-in-healthy-volunteers
#1
Jan de Hoon, Anne Van Hecken, Corinne Vandermeulen, Marissa Herbots, Yumi Kubo, Ed Lee, Osa Eisele, Gabriel Vargas, Kristin Gabriel
Objectives The aim of this study was to assess the effects of concomitant administration of erenumab and sumatriptan on resting blood pressure, pharmacokinetics, safety, and tolerability in healthy subjects. Methods In this phase 1, parallel-group, one-way crossover, double-blind, placebo-controlled study, healthy adult subjects were randomized (1:2) to receive either intravenous placebo and subcutaneous sumatriptan 12 mg (i.e. two 6-mg injections separated by 1 hour) or intravenous erenumab 140 mg and subcutaneous sumatriptan 12 mg...
January 1, 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29776826/recognition-of-sympathetic-crashing-acute-pulmonary-edema-scape-and-use-of-high-dose-nitroglycerin-infusion
#2
Samantha Paone, Leigha Clarkson, Billy Sin, Sheena Punnapuzha
Sympathetic Crashing Acute Pulmonary Edema (SCAPE), or flash pulmonary edema, is the extreme end of the acute pulmonary edema spectrum. A sympathetic surge occurs as a result of decreased systemic perfusion resulting in further increases in afterload, causing the patient to decompensate. Patients can decompensate quickly, therefore patients require rapid interventions. The use of high-dose nitroglycerin (HDN) has been a topic of interest as it is believed to achieve preload and afterload reduction. However, its use continues to be controversial due to concerns of drug induced hypotension, syncope or paresthesia...
May 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29769154/performance-of-the-french-version-of-the-4at-for-screening-the-elderly-for-delirium-in-the-emergency-department
#3
Anne-Julie Gagné, Philippe Voyer, Valérie Boucher, Alexandra Nadeau, Pierre-Hugues Carmichael, Mathieu Pelletier, Emilie Gouin, Simon Berthelot, Raoul Daoust, Machelle Wilchesky, Hélène Richard, Isabelle Pelletier, Stephanie Ballard, Antoine Laguë, Marcel Émond
CLINICIAN'S CAPSULE What is known about the topic? Delirium is frequent in older inpatients but often goes undetected. A short tool, the 4 A's Test (4AT), was created and validated for the detection of delirium. What did this study ask? This study compared the performance of the French version of the 4AT (4AT-F) with the Confusion Assessment Method (CAM) for the screening of delirium. What did this study find? The 4AT-F was a fast and reliable screening tool for delirium in the emergency department (ED). Why does this study matter to clinicians? Because of its quick administration time, it allows for systematic screening of patients at risk of delirium and cognitive impairment...
May 17, 2018: CJEM
https://www.readbyqxmd.com/read/29768293/seasonality-of-common-pediatric-infectious-diseases
#4
Susan C Lipsett, Michael C Monuteaux, Andrew M Fine
BACKGROUND/OBJECTIVE: Traditional sources cite seasonal patterns for common infectious diseases, often based on microbiologic data, but little is known about cyclical trends in clinically diagnosed infectious conditions in the emergency department (ED). We leveraged the publicly available Nationwide Emergency Department Sample database to measure the seasonality of the most common pediatric infectious diseases diagnosed in US EDs. METHODS: We searched the Nationwide Emergency Department Sample database to identify infectious diagnoses comprising at least 1% of all diagnosis codes ascribed to patients 21 years and younger in US EDs from 2009 to 2013...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29764909/ohio-pediatric-asthma-repository-opportunities-to-revise-care-practices-to-decrease-time-to-physiologic-readiness-for-discharge
#5
Jeffrey M Simmons, Jocelyn M Biagini Myers, Lisa J Martin, Carolyn M Kercsmar, Christine L Schuler, Valentina V Pilipenko, John W Kroner, Hua He, Stephen R Austin, Huyen-Tran Nguyen, Kristie R Ross, Karen S McCoy, Sherman J Alter, Samantha M Gunkelman, Pierre A Vauthy, Gurjit K Khurana Hershey
BACKGROUND: Large-scale, multisite studies in which researchers evaluate patient- and systems-level factors associated with pediatric asthma exacerbation outcomes are lacking. We sought to investigate patient-level risks and system-level practices related to physiologic readiness for discharge (PRD) in the prospective Ohio Pediatric Asthma Repository. METHODS: Participants were children ages 2 to 17 years admitted to an Ohio Pediatric Asthma Repository hospital for asthma exacerbation...
May 15, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29763535/team-based-pod-system-reduces-lengths-of-stay-for-treat-and-release-patients
#6
Nicholas Gavin, Kathy Peterson
To boost performance on a range of metrics, the 55-bed ED at NYU Lutheran Medical Center in Brooklyn, NY, transitioned to a pod system in August 2016. The approach, which is designed to foster team-based care, involves assigning physicians and nurses to designated geographic areas throughout the day, minimizing the movement of physicians as well as the need for phone communication. When coupled with other changes, including the introduction of point-of- care testing, the pod initiative has enabled the ED to reduce lengths of stay for all treat-and-release patients to less than three hours for the first time in the history of the department, according to administrators...
June 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29761672/emergency-department-administration-of-oxycodone-by-nurses-treating-musculoskeletal-pain-an-observational-prospective
#7
Mansour Khoury, Sigalit Caspi, Ruth Stalnikowics, Elad Peless, Ela Raiizman, Shaden Salameh
BACKGROUND: Acute musculoskeletal pain is one of the most commonly reported symptoms among patients visiting the emergency department (ED). Treatment with over-the-counter pain medications, given by nurses, results in improved pain management and reduces the waiting time to drug administration without significant side effects. Opioid analgesics are extensively used for acute pain in the ED. Compared to morphine, oxycodone has a much more specific pharmacological activity, higher analgesic potential, and more tolerable side effects...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29760856/continuous-intravenous-sub-dissociative-dose-ketamine-infusion-for-managing-pain-in-the-emergency-department
#8
Sergey Motov, Jefferson Drapkin, Antonios Likourezos, Tyler Beals, Ralph Monfort, Christian Fromm, John Marshall
Introduction: Our objective was to describe dosing, duration, and pre- and post-infusion analgesic administration of continuous intravenous sub-dissociative dose ketamine (SDK) infusion for managing a variety of painful conditions in the emergency department (ED). Methods: We conducted a retrospective chart review of patients aged 18 and older presenting to the ED with acute and chronic painful conditions who received continuous SDK infusion in the ED for a period over six years (2010-2016)...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29760847/decreased-nursing-staffing-adversely-affects-emergency-department-throughput-metrics
#9
Zachariah Ramsey, Joseph S Palter, John Hardwick, Jordan Moskoff, Errick L Christian, John Bailitz
Introduction: The effect of nurse staffing on emergency department (ED) efficiency remains a significant area of interest to administrators, physicians, and nurses. We believe that decreased nursing staffing adversely affects key ED throughput metrics. Methods: We conducted a retrospective observational review of our electronic medical record database from 1/1/2015 to 12/31/2015 at a high-volume, urban public hospital. We report nursing hours, door-to-discharge length of stay (LOS) and door-to-admit LOS, and percentage of patients who left without being seen (LWBS)...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759531/biphasic-anaphylaxis-a-review-of-the-literature-and-implications-for-emergency-management
#10
REVIEW
Ali Pourmand, Chelsea Robinson, Wahab Syed, Maryann Mazer-Amirshahi
BACKGROUND: The biphasic reaction is a feared complication of anaphylaxis management in the emergency department (ED). The traditional recommended ED observation time is 4-6 h after complete resolution of symptoms for every anaphylaxis patient. However, there has been great controversy regarding whether this standard of care is evidence-based. METHODS: Articles were selected using a PubMed, MEDLINE search for the keywords "biphasic anaphylaxis", yielding 155 articles...
May 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29755621/the-influence-of-expectation-on-nondeceptive-placebo-and-nocebo-effects
#11
Hua Wei, Lili Zhou, Huijuan Zhang, Jie Chen, Xuejing Lu, Li Hu
Nondeceptive placebo has demonstrated its efficiency in clinical practice. Although the underlying mechanisms are still unclear, nondeceptive placebo effect and nondeceptive nocebo effect may be mediated by expectation. To examine the extent to which expectation influences these effects, the present study compared nondeceptive placebo and nocebo effects with different expectation levels. Seventy-two healthy female participants underwent a standard conditioning procedure to establish placebo and nocebo effects...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/29754866/outpatient-pharmacotherapy-for-neonatal-abstinence-syndrome
#12
Faouzi I Maalouf, William O Cooper, James C Slaughter, Judith Dudley, Stephen W Patrick
OBJECTIVE: To determine differences in lengths of stay, length of therapy, emergency department (ED) utilization, and hospital readmissions between infants with neonatal abstinence syndrome (NAS) treated exclusively with inpatient pharmacotherapy compared with those discharged on outpatient pharmacotherapy. STUDY DESIGN: This retrospective cohort study of infants enrolled in the Tennessee Medicaid program used administrative and vital records data from 2009 to 2011...
May 7, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29754670/knowledge-to-action-rationale-and-design-of-the-patient-centered-care-transitions-in-heart-failure-pact-hf-stepped-wedge-cluster-randomized-trial
#13
Harriette G C Van Spall, Shun Fu Lee, Feng Xie, Dennis T Ko, Lehana Thabane, Quazi Ibrahim, Peter R Mitoff, Michael Heffernan, Manish Maingi, Michael C Tjandrawidjaja, Mohammad I Zia, Mohamed Panju, Richard Perez, Kim D Simek, Liane Porepa, Ian D Graham, R Brian Haynes, Dilys Haughton, Stuart J Connolly
INTRODUCTION: Heart Failure (HF) is a common cause of hospitalization in older adults. The transition from hospital to home is high-risk, and gaps in transitional care can increase the risk of re-hospitalization and death. Combining health care services supported by meta-analyses, we designed the PACT-HF transitional care model. METHODS: Adopting an integrated Knowledge Translation (iKT) approach in which decision-makers and clinicians are partners in research, we implement and test the effectiveness of PACT-HF among patients hospitalized for HF...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29750945/ocular-injury-in-united-states-emergency-departments-seasonality-and-annual-trends-estimated-from-a-nationally-representative-dataset
#14
David A Ramirez, Travis C Porco, Thomas M Lietman, Jeremy D Keenan
PURPOSE: To determine whether ocular trauma occurs more frequently in the summer months. DESIGN: Retrospective, cross-sectional study. METHODS: The Nationwide Emergency Department Sample (NEDS) is a large, publicly available administrative database that provides nationally representative estimates of emergency department (ED) visits in the United States. Billing codes from NEDS from 2006 to 2013 were used to identify all cases of ocular trauma, and the United States decennial census was used to estimate the population at risk for visiting an ED...
May 8, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29747792/hospital-based-emergency-department-visits-with-dental-conditions-impact-of-the-medicaid-reimbursement-fee-for-dental-services-in-new-york-state-2009-2013
#15
Sankeerth Rampa, Fernando A Wilson, Hongmei Wang, Nizar K Wehbi, Lynette Smith, Veerasathpurush Allareddy
OBJECTIVES: Hospital-based emergency department (ED) visits for dental problems have been on the rise. The objectives of this study are to provide estimates of hospital-based ED visits with dental conditions in New York State and to examine the impact of Medicaid reimbursement fee for dental services on the utilization of EDs with dental conditions. METHODS: New York State Emergency Department Database for the year 2009-2013 and Health Resources and Services Administration's Area Health Resource File were used...
June 2018: Journal of Evidence-based Dental Practice
https://www.readbyqxmd.com/read/29742355/the-interaction-between-rural-urban-status-and-dual-use-status-among-veterans-with-heart-failure
#16
Kelly J Hunt, Mulugeta Gebregziahber, Charles J Everett, Paul A Heidenreich, Robert Neal Axon
INTRODUCTION: Dual healthcare system use is associated with higher rates of healthcare utilization, but the influence of rurality on this phenomenon is unclear. This study aimed to determine the extent to which rurality in the USA modifies the likelihood for acute healthcare use among veterans with heart failure (HF). METHODS: Using merged Veterans Affairs (VA), Medicare, and state-level administrative data, a retrospective cohort study of 4985 veterans with HF was performed...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29733099/long-term-opioid-users-with-chronic-noncancer-pain-assessment-of-opioid-abuse-risk-and-relationship-with-healthcare-resource-use
#17
Anna D Coutinho, Kavita Gandhi, Rupali M Fuldeore, Pamela B Landsman-Blumberg, Sanjay Gandhi
OBJECTIVE: Identify opioid abuse risk factors among chronic noncancer pain (CNCP) patients receiving long-term opioid therapy and assess healthcare resource use (HRU) among patients at elevated abuse risk. DESIGN: Data were obtained from an integrated administrative claims database. Classification and Regression Tree (CART) analysis identified risk factors potentially predictive of opioid abuse, which were used to classify the overall population into cohorts defined by levels of abuse risk...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29730093/adverse-events-and-satisfaction-with-use-of-intranasal-midazolam-for-emergency-department-procedures-in-children
#18
Laurie Malia, V Matt Laurich, Jesse J Sturm
PURPOSE: Procedural sedation is commonly performed in the emergency department (ED). Having safe and fast means of providing sedation and anxiolysis to children is important for the child's tolerance of the procedure, parent satisfaction and efficient patient flow in the ED. OBJECTIVE: To evaluate fasting times associated with the administration of intranasal midazolam (INM) and associated complications. Secondary objectives included assessing provider and caregiver satisfaction scores...
April 30, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29724975/long-term-consumption-of-energy-drinks-induces-biochemical-and-ultrastructural-alterations-in-the-heart-muscle
#19
Camelia Munteanu, Corina Rosioru, Corneliu Tarba, Camelia Lang
OBJECTIVE: Energy drinks (EDs) target young and active individuals and they are being marketed as enhancers of energy, concentration, and physical and cognitive performance. Their long-term consumption raises serious health concerns related to cardiovascular events. Here we investigate the effects of long-term Red Bull® consumption and its combination with alcohol on certain biochemical parameters and the ultrastructure of the myocardium. METHODS: Male Wistar rats were categorized into four groups and given different treatments via oral administration...
May 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29719379/comparison-of-tadalafil-pharmacokinetics-after-administration-of-a-new-orodispersible-film-versus-a-film-coated-tablet
#20
Sang-In Park, Su-Hak Heo, Gihwan Kim, Seokhoon Chang, Keon-Hyoung Song, Min-Gul Kim, Eun-Heui Jin, JaeWoo Kim, SeungHwan Lee, Jang Hee Hong
Background: An orodispersible film (ODF) of tadalafil may provide increased convenience for erectile dysfunction (ED) patients as compared to conventional tablet formulations. In this study, we aimed to compare the pharmacokinetic, safety, and tolerability profiles of a newly developed ODF formulation of tadalafil to those of a film-coated tablet (FCT) of tadalafil. Materials and methods: This study was conducted in healthy male subjects using an open-label, randomized sequence, two-period, two-formulation, single-dose, crossover design...
2018: Drug Design, Development and Therapy
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