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Emergency Department Safety

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https://www.readbyqxmd.com/read/27923422/first-responders-and-prehospital-care-for-road-traffic-injuries-in-malawi
#1
Linda Chokotho, Wakisa Mulwafu, Isaac Singini, Yasin Njalale, Limbika Maliwichi-Senganimalunje, Kathryn H Jacobsen
: Introduction Road traffic collisions are a common cause of injuries and injury-related deaths in sub-Saharan Africa (SSA). Basic prehospital care can be the difference between life and death for injured drivers, passengers, and pedestrians. Problem This study examined the challenges associated with current first response practices in Malawi. METHODS: In April 2014, focus groups were conducted in two areas of Malawi: Karonga (in the Northern Region) and Blantyre (in the Southern Region; both are along the M1 highway), and a qualitative synthesis approach was used to identify themes...
December 7, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27923390/the-rapid-ctca-trial-rapid-assessment-of-potential-ischaemic-heart-disease-with-ctca-a-multicentre-parallel-group-randomised-trial-to-compare-early-computerised-tomography-coronary-angiography-versus-standard-care-in-patients-presenting-with-suspected-or-confirmed
#2
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27923293/working-together-to-improve-patient-safety
#3
Jennifer Morrissey
One of our core aims at the Royal Belfast Hospital for Sick Children (RBHSC) emergency department (ED) is to ensure patient safety within financial and resource constraints.
December 7, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27919874/diltiazem-versus-metoprolol-for-rate-control-in-atrial-fibrillation-with-rapid-ventricular-response-in-the-emergency-department
#4
Michelle C Hines, Brent N Reed, Vijay Ivaturi, Laura J Bontempo, Michael C Bond, Bryan D Hayes
PURPOSE: The impact of patient-specific factors on the choice of β-blocker versus calcium channel blocker therapy for rate control in emergency department (ED) patients treated for atrial fibrillation (AF) was investigated. METHODS: A retrospective cohort study was conducted to evaluate the influence of demographics, prior medication use, hemodynamic and clinical characteristics, and other variables on selection of first-line therapy for AF among patients admitted to the ED of an academic medical center over a 22-month period (October 2012-July 2014) who received i...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27919173/carbon-monoxide-poisoning-during-camping-in-korea
#5
Youn-Jung Kim, Chang Hwan Sohn, Bum Jin Oh, Kyoung Soo Lim, Won Young Kim
OBJECTIVE: The aim of this study was to evaluate the epidemiology and characteristics of unintentional carbon monoxide (CO) poisoning during camping in Korea. METHODS: We performed a retrospective observational study on patients with unintentional camping-related CO poisoning who were admitted to the emergency department (ED) from 1 January 2010 to 31 December 2014. News reports about incidents of camping-related CO poisoning were collected using news search engines...
December 5, 2016: Inhalation Toxicology
https://www.readbyqxmd.com/read/27917728/comparing-catheter-associated-urinary-tract-infection-prevention-programs-between-veterans-affairs-nursing-homes-and-non-veterans-affairs-nursing-homes
#6
Lona Mody, M Todd Greene, Sanjay Saint, Jennifer Meddings, Barbara W Trautner, Heidi L Wald, Christopher Crnich, Jane Banaszak-Holl, Sara E McNamara, Beth J King, Robert Hogikyan, Barbara S Edson, Sarah L Krein
OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire...
December 5, 2016: Infection Control and Hospital Epidemiology
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
#7
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
#8
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/27908594/rucaparib-in-relapsed-platinum-sensitive-high-grade-ovarian-carcinoma-ariel2-part-1-an-international-multicentre-open-label-phase-2-trial
#9
Elizabeth M Swisher, Kevin K Lin, Amit M Oza, Clare L Scott, Heidi Giordano, James Sun, Gottfried E Konecny, Robert L Coleman, Anna V Tinker, David M O'Malley, Rebecca S Kristeleit, Ling Ma, Katherine M Bell-McGuinn, James D Brenton, Janiel M Cragun, Ana Oaknin, Isabelle Ray-Coquard, Maria I Harrell, Elaina Mann, Scott H Kaufmann, Anne Floquet, Alexandra Leary, Thomas C Harding, Sandra Goble, Lara Maloney, Jeff Isaacson, Andrew R Allen, Lindsey Rolfe, Roman Yelensky, Mitch Raponi, Iain A McNeish
BACKGROUND: Poly(ADP-ribose) polymerase (PARP) inhibitors have activity in ovarian carcinomas with homologous recombination deficiency. Along with BRCA1 and BRCA2 (BRCA) mutations genomic loss of heterozygosity (LOH) might also represent homologous recombination deficiency. In ARIEL2, we assessed the ability of tumour genomic LOH, quantified with a next-generation sequencing assay, to predict response to rucaparib, an oral PARP inhibitor. METHODS: ARIEL2 is an international, multicentre, two-part, phase 2, open-label study done at 49 hospitals and cancer centres in Australia, Canada, France, Spain, the UK, and the USA...
November 28, 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27907936/early-treatment-for-neonatal-abstinence-syndrome-a-palliative-approach
#10
Jennifer Hudson, Rachel Mayo, Lori Dickes, Liwei Chen, Windsor Westbrook Sherrill, Julie Summey, Bradley Dalton, Kindal Dankovich
Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted...
December 1, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27901291/success-rate-of-pneumatic-reduction-of-intussusception-with-and-without-sedation
#11
Oren Feldman, Giora Weiser, Mona Hanna, Ori Devir, Uri Balla, David W Johnson, Eran Kozer, Itai Shavit
BACKGROUND: Pneumatic reduction of ileocolic intussusception is often performed without sedation. The aim of this study was to evaluate the success rate of pneumatic reduction of intussusception with and without sedation. METHODS: We conducted a retrospective cohort study in Israel in two tertiary care centers using a similar protocol for pneumatic reduction of intussusception. In one center, patients had pneumatic reduction of intussusception under propofol-based sedation, while in the other, patients had pneumatic reduction of intussusception without any sedation...
November 30, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27896323/intra-articular-lidocaine-versus-intravenous-sedative-and-analgesic-for-reduction-of-anterior-shoulder-dislocation
#12
Parvin Kashani, Fatemeh Asayesh Zarchi, Hamid Reza Hatamabadi, Abbas Afshar, Marzieh Amiri
OBJECTIVE: This prospective clinical trial was performed to compare the safety and efficiency of intra-articular lidocaine (IAL) versus intravenous sedative and analgesic (IVSA) in reduction of anterior shoulder dislocation. MATERIALS AND METHODS: Patients with anterior shoulder dislocation were randomly divided into 2 groups to receive IAL and IVSA. One group patients received an intravenous dose of 0.05 mg/kg midazolam and 1 μg/kg fentanyl, while the other group received 20 mL intra-articular lidocaine (1%)...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27893129/us-emergency-department-visits-for-outpatient-adverse-drug-events-2013-2014
#13
Nadine Shehab, Maribeth C Lovegrove, Andrew I Geller, Kathleen O Rose, Nina J Weidle, Daniel S Budnitz
Importance: The Patient Protection and Affordable Care Act of 2010 brought attention to adverse drug events in national patient safety efforts. Updated, detailed, nationally representative data describing adverse drug events can help focus these efforts. Objective: To describe the characteristics of emergency department (ED) visits for adverse drug events in the United States in 2013-2014 and describe changes in ED visits for adverse drug events since 2005-2006...
November 22, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27890310/same-day-total-hip-arthroplasty-performed-at-an-ambulatory-surgical-center-90-day-complication-rate-on-549-patients
#14
Gregg R Klein, Jason M Posner, Harlan B Levine, Mark A Hartzband
BACKGROUND: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied. METHODS: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed. All patients were discharged to home on the day of surgery...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27889367/use-or-abuse-a-qualitative-study-of-emergency-physicians-views-on-use-of-observation-stays-at-three-hospitals-in-the-united-states-and-england
#15
Graham P Martin, Brad Wright, Azeemuddin Ahmed, Jay Banerjee, Suzanne Mason, Damian Roland
STUDY OBJECTIVE: Accumulating evidence has shown increasing use of observation stays for patients presenting to emergency departments and requiring diagnostic evaluation or time-limited treatment plans, but critics suggest that this expansion arises from hospitals' concerns to maximize revenue and shifts costs to patients. Perspectives of physicians making decisions to admit, observe, or discharge have been absent from the debate. We examine the views of emergency physicians in the United States and England on observation stays, and what influences their decisions to use observation services...
November 23, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27889366/intranasal-lidocaine-in-acute-treatment-of-migraine-a-randomized-controlled-trial
#16
Nazire Avcu, Nurettin Özgür Doğan, Murat Pekdemir, Elif Yaka, Serkan Yılmaz, Cansu Alyeşil, Latif Erdem Akalın
STUDY OBJECTIVE: The study aims to evaluate the efficacy and safety of intranasal lidocaine administration for migraine treatment. METHODS: This single-center, double-blind, randomized, controlled trial was conducted in a tertiary care emergency department. Included patients met the migraine criteria of the International Headache Society. Patients were randomized to intranasal lidocaine or saline solution; all participants received 10 mg of intravenous metoclopramide...
November 23, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27885414/clinical-implementation-of-an-emergency-department-coronary-computed-tomographic-angiography-protocol-for-triage-of-patients-with-suspected-acute-coronary-syndrome
#17
Brian B Ghoshhajra, Richard A P Takx, Pedro V Staziaki, Harshna Vadvala, Phillip Kim, Tomas G Neilan, Nandini M Meyersohn, Daniel Bittner, Sumbal A Janjua, Thomas Mayrhofer, Jeffrey L Greenwald, Quyhn A Truong, Suhny Abbara, David F M Brown, James L Januzzi, Sanjeev Francis, John T Nagurney, Udo Hoffmann
OBJECTIVES: To evaluate the efficiency and safety of emergency department (ED) coronary computed tomography angiography (CTA) during a 3-year clinical experience. METHODS: Single-center registry of coronary CTA in consecutive ED patients with suspicion of acute coronary syndrome (ACS). The primary outcome was efficiency of coronary CTA defined as the length of hospitalization. Secondary endpoints of safety were defined as the rate of downstream testing, normalcy rates of invasive coronary angiography (ICA), absence of missed ACS, and major adverse cardiac events (MACE) during follow-up, and index radiation exposure...
November 24, 2016: European Radiology
https://www.readbyqxmd.com/read/27884844/medication-reconciliation-as-a-medication-safety-initiative-in-ethiopia-a-study-protocol
#18
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
https://www.readbyqxmd.com/read/27882775/association-between-availability-of-care-providers-and-healthcare-utilizations-among-adults-with-asthma
#19
Minchul Kim, Carl V Asche, William Tillis, Jinma Ren
BACKGROUND: Limited accessibility to providers may delay appropriate control of asthma exacerbations. The objective of our study is to estimate the contributors to the hospital/emergency department (ED) visits among adults with asthma focusing on the availability of healthcare providers. METHODS: We conducted a pooled cross-sectional analysis using the 2011-2013 Asthma Call-Back Survey linked with 2012-2016 Area Health Resource Files. We employed multivariable logistic regression with dichotomous outcomes of hospitalization and ED visits...
December 2, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27873299/using-the-manchester-triage-system-for-refusing-nonurgent-patients-in-the-emergency-department-a-30-day-outcome-study
#20
Roger Daglius Dias, Izabel Cristina Rios, Carlos Luis Benites Canhada, Maria Dolores Galinanes Otero Fernandes, Leila Suemi Harima Letaif, Eloisa Bonfá, Maria Beatriz Moliterno Perondi
OBJECTIVE: To evaluate the long-term outcomes and satisfaction of nonurgent patients who seek care in the emergency department (ED) and are diverted to primary health services (PHS). METHODS: Data were collected from 264 nonurgent patients diverted from the ED of a tertiary public university hospital in São Paulo, Brazil. The nonurgent patient definition was performed by Manchester triage system version II (MTS-II) associated to medical interview in the triage service...
September 2016: Journal of Emergency Management: JEM
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