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Emergency Department Safety

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https://www.readbyqxmd.com/read/28086819/efficacy-safety-and-effectiveness-of-licensed-rotavirus-vaccines-a-systematic-review-and-meta-analysis-for-latin-america-and-the-caribbean
#1
Raúl F Velázquez, Alexandre C Linhares, Sergio Muñoz, Pamela Seron, Pedro Lorca, Rodrigo DeAntonio, Eduardo Ortega-Barria
BACKGROUND: RotaTeq™ (RV5; Merck & Co. Inc., USA) and Rotarix™ (RV1, GlaxoSmithKline, Belgium) vaccines, developed to prevent rotavirus diarrhea in children under five years old, were both introduced into national immunization programs in 2006. As many countries in Latin America and the Caribbean have included either RV5 or RV1 in their routine childhood vaccination programs, we conducted a systematic review and meta-analysis to analyze efficacy, safety and effectiveness data from the region...
January 13, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28073650/the-utilisation-of-one-district-hospital-emergency-department-by-people-with-parkinson-s-disease
#2
Marion Harris, Margaret Fry
BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disorder in Australia and the economic burden is more than $8.3 billion a year and predicted to escalate. However, little is known of the trends and characteristics of people with Parkinson's disease presenting to emergency departments (ED). METHOD: The study design was a 12 month retrospective medical record audit. The study was conducted in one metropolitan 300 bed district hospital in an outer suburb of Sydney...
January 7, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28073611/propofol-versus-midazolam-for-procedural-sedation-in-the-emergency-department-a-study-on-efficacy-and-safety
#3
Heleen Lameijer, Ytje T Sikkema, Albert Pol, Maike G E Bosch, Femke Beije, Rieneke Feenstra, Bas W J Bens, Ewoud Ter Avest
BACKGROUND: Procedural sedation for painful procedures in the emergency department (ED) can be accomplished with various pharmacological agents. The choice of the sedative used is highly dependent on procedure- and patient characteristics and on personal- or local preferences. METHODS: We conducted a multicenter retrospective cohort study of procedural sedations performed in the EDs of 5 hospitals in the Netherlands over a 4year period to evaluate the efficacy- (success rate of the intended procedure) and safety (incidence of sedation (adverse) events) of propofol sedations compared to midazolam sedations...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28039294/process-mapping-evaluation-of-medication-reconciliation-in-academic-teaching-hospitals-a-critical-step-in-quality-improvement
#4
Anne Holbrook, James M Bowen, Harsit Patel, Chris O'Brien, John J You, Roshan Tahavori, Jeff Doleweerd, Tim Berezny, Dan Perri, Carmine Nieuwstraten, Sue Troyan, Ameen Patel
BACKGROUND: Medication reconciliation (MedRec) has been a mandated or recommended activity in Canada, the USA and the UK for nearly 10 years. Accreditation bodies in North America will soon require MedRec for every admission, transfer and discharge of every patient. Studies of MedRec have revealed unintentional discrepancies in prescriptions but no clear evidence that clinically important outcomes are improved, leading to widely variable practices. Our objective was to apply process mapping methodology to MedRec to clarify current processes and resource usage, identify potential efficiencies and gaps in care, and make recommendations for improvement in the light of current literature evidence of effectiveness...
December 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/28033243/prognostic-values-of-4-risk-scores-in-chinese-patients-with-chest-pain-prospective-2-centre-cohort-study
#5
Xiao-Hui Chen, Hui-Lin Jiang, Yun-Mei Li, Cangel Pui Yee Chan, Jun-Rong Mo, Chao-Wei Tian, Pei-Yi Lin, Colin A Graham, Timothy H Rainer
Four risk scores for stratifying patients with chest pain presenting to emergency departments (EDs) (namely Thrombolysis in myocardial infarction [TIMI], Global registry for acute coronary events [GRACE], Banach and HEART) have been developed in Western settings but have never been compared and validated in Chinese patients. We aimed to find out to the number of MACE within 7 days, 30 days, and 6 months after initial ED presentation, and also to compare the prognostic performance of these scores in Chinese patients with suspected cardiac chest pain (CCP) to predict 7-day, 30-day, and 6-month major adverse cardiac events (MACE)...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28032307/intravenous-enalaprilat-for-treatment-of-acute-hypertensive-heart-failure-in-the-emergency-department
#6
Syed Imran Ayaz, Craig M Sharkey, Gregory M Kwiatkowski, Suprat Saely Wilson, Reba S John, Rosa Tolomello, Arushi Mahajan, Scott Millis, Phillip D Levy
BACKGROUND: Afterload reduction with bolus enalaprilat is used by some for management of acute hypertensive heart failure (HF) but existing data on the safety and effectiveness of this practice are limited. The purpose of this study was to evaluate the clinical effects of bolus enalaprilat when administered to patients with acute hypertensive heart failure. FINDINGS: We performed an IRB-approved retrospective cohort study of patients who presented to the emergency department of a large urban academic hospital...
December 2016: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28032265/using-continuous-quantitative-capnography-for-emergency-department-procedural-sedation-a-systematic-review-and-cost-effectiveness-analysis
#7
Nicholas Matthew Mohr, Andrew Stoltze, Azeemuddin Ahmed, Elizabeth Kiscaden, Dan Shane
End-tidal CO2 has been advocated to improve safety of emergency department (ED) procedural sedation by decreasing hypoxia and catastrophic outcomes. This study aimed to estimate the cost-effectiveness of routine use of continuous waveform quantitative end-tidal CO2 monitoring for ED procedural sedation in prevention of catastrophic events. Markov modeling was used to perform cost-effectiveness analysis to estimate societal costs per prevented catastrophic event (death or hypoxic brain injury) during routine ED procedural sedation...
December 28, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28025766/safety-of-cardioversion-in-atrial-fibrillation-lasting-less-than-48%C3%A2-h-without-post-procedural-anticoagulation-in-patients-at-low-cardioembolic-risk
#8
Andrea Tampieri, Valentina Cipriano, Fabrizio Mucci, Anna Maria Rusconi, Tiziano Lenzi, Patrizia Cenni
Currently, there is no unified consensus on short-term anticoagulation after cardioversion of atrial fibrillation lasting less than 48 h in low-cardioembolic-risk patients. The aim of this study is to evaluate the rate of transient ischemic attacks, stroke and death in this subset of patients after cardioversion without post-procedural anticoagulation. In a prospective observational study, patients with recent-onset AF undergoing cardioversion attempts in the Emergency Department were evaluated over the past 3 years...
December 26, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28009805/wargame-simulation-theory-and-evaluation-method-for-emergency-evacuation-of-residents-from-urban-waterlogging-disaster-area
#9
Peng Chen, Jiquan Zhang, Yingyue Sun, Xiaojing Liu
Urban waterlogging seriously threatens the safety of urban residents and properties. Wargame simulation research on resident emergency evacuation from waterlogged areas can determine the effectiveness of emergency response plans for high risk events at low cost. Based on wargame theory and emergency evacuation plans, we used a wargame exercise method, incorporating qualitative and quantitative aspects, to build an urban waterlogging disaster emergency shelter using a wargame exercise and evaluation model. The simulation was empirically tested in Daoli District of Harbin...
December 21, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28009694/can-emergency-department-hospital-discharge-and-death-data-be-used-to-monitor-burden-of-drug-overdose-in-rhode-island
#10
Yongwen Jiang, James V McDonald, Jennifer Koziol, Meghan McCormick, Samara Viner-Brown, Nicole Alexander-Scott
CONTEXT: Drug overdoses are a growing public health problem in the United States. Rhode Island is also confronted with a serious epidemic of drug overdose deaths and ranks sixth worst in the United States for age-adjusted drug overdose death rate. OBJECTIVE: To monitor trends of drug overdose-related emergency department (ED) visits, hospitalizations, and deaths and classify the drug overdoses by demographics, discharge status, intent, and specific drug involved to plan for health care resource allocation, mental health services, drug abuse treatment, prevention, and policies...
December 22, 2016: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28007971/paediatric-emergency-department-based-carbon-monoxide-detector-intervention-a-randomised-trial
#11
Lara B McKenzie, Kristin J Roberts, Roxanne M Kaercher, Christy L Collins, R Dawn Comstock, Soledad Fernandez, Mahmoud Abdel-Rasoul, Marcel J Casavant, Leslie Mihalov
BACKGROUND: Although non-fire-related carbon monoxide (CO) poisoning is almost entirely preventable, over 400 people die and 20 000 people are injured each year in the USA from unintentional CO poisoning. Thus, there is a critical need for evidence-based interventions for preventing CO poisoning and increasing the proper use and installation of CO detectors. METHODS: A randomised, controlled trial (Project CODE, a Carbon Monoxide Detector Education intervention) with 2-week and 6-month follow-up home observations was conducted in 299 parents of children aged ≤18 years recruited in the emergency department of a level 1 paediatric trauma centre...
December 22, 2016: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28007362/best-clinical-practice-controversies-in-outpatient-management-of-acute-pulmonary-embolism
#12
Brit Long, Alex Koyfman
BACKGROUND: Pulmonary embolism (PE) is a common condition managed in the emergency department (ED), with a wide range of morbidity and mortality. Patients are classically admitted for treatment and monitoring of anticoagulation. OBJECTIVE: We sought to evaluate the controversy concerning outpatient therapy for patients with acute PE and investigate the feasibility, safety, and efficacy of outpatient management. DISCUSSION: Patients with venous thromboembolism have historically been admitted for treatment and monitoring for concern of worsening disease or side effects of anticoagulation (bleeding)...
December 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28005123/addressing-the-opioid-epidemic-with-multimodal-pain-management
#13
Michael A Kelly
The opioid epidemic has become a national public health and safety problem affecting both adults and adolescents. There is little doubt that this epidemic is rooted in the need for pain control after surgery and that orthopedic surgeons have in part contributed to opioid overprescription. Indeed, opioid abuse, misuse, and diversion are associated with increased hospitalizations, emergency department visits, and associated health care costs. In addition, postoperative exposure to opioids correlates with long-term use and abuse...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28003301/safety-and-feasibility-of-sublingual-microcirculation-assessment-in-the-emergency-department-for-civilian-and-military-patients-with-traumatic-haemorrhagic-shock-a-prospective-cohort-study
#14
David N Naumann, Clare Mellis, Iain M Smith, Jasna Mamuza, Imogen Skene, Tim Harris, Mark J Midwinter, Sam D Hutchings
OBJECTIVES: Sublingual microcirculatory monitoring for traumatic haemorrhagic shock (THS) may predict clinical outcomes better than traditional blood pressure and cardiac output, but is not usually performed until the patient reaches the intensive care unit (ICU), missing earlier data of potential importance. This pilot study assessed for the first time the feasibility and safety of sublingual video-microscopy for THS in the emergency department (ED), and whether it yields useable data for analysis...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27998624/warfarin-initiation-atrial-fibrillation-and-kidney-function-%C3%A2-comparative-effectiveness-and-safety-of%C3%A2-warfarin%C3%A2-in%C3%A2-older%C3%A2-adults%C3%A2-with-newly-diagnosed-atrial%C3%A2-fibrillation
#15
Min Jun, Matthew T James, Zhihai Ma, Jianguo Zhang, Marcello Tonelli, Finlay A McAlister, Braden J Manns, Pietro Ravani, Robert R Quinn, Natasha Wiebe, Vlado Perkovic, Stephen B Wilton, Wolfgang C Winkelmayer, Brenda R Hemmelgarn
BACKGROUND: The effectiveness and safety of warfarin use among patients with atrial fibrillation (AF) and reduced kidney function are uncertain. STUDY DESIGN: Community-based retrospective cohort study (May 1, 2003, to March 31, 2012) using province-wide laboratory and administrative data in Alberta, Canada. SETTING & PARTICIPANTS: 14,892 adults 66 years or older with new AF and a measurement of kidney function. Long-term dialysis patients or kidney transplant recipients were excluded...
December 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27994915/intravenous-colistin-use-for-multidrug-resistant-gram-negative-infections-in-pediatric-patients
#16
Ayşe Karaaslan, Eren Çağan, Eda Kepenekli Kadayifci, Serkan Atıcı, Gülşen Akkoç, Nurhayat Yakut, Sevliya Öcal Demir, Ahmet Soysal, Mustafa Bakır
BACKGROUND: The emergence of infections due to multidrug-resistant Gram-negative bacilli (MDR-GNB) has led to the resurrection of colistin use. The data on colistin use and drug-related adverse effects in children are scarce. AIMS: In this study, we aimed to evaluate the clinical efficacy and safety of colistin use in critically ill pediatric patients. STUDY DESIGN: This study has a retrospective study design. METHODS: Sixty-one critically ill children were identified through the department's patient files archive during the period from January 2011 to November 2014...
November 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27993309/improving-the-safety-of-rapid-sequence-intubation-in-the-emergency-department
#17
EDITORIAL
John C Sakles
No abstract text is available yet for this article.
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27977002/supporting-heart-failure-patient-transitions-from-acute-to-community-care-with-home-telemonitoring-technology-a-protocol-for-a-provincial-randomized-controlled-trial-tec4home
#18
(no author information available yet)
BACKGROUND: Seniors with chronic diseases such as heart failure have complex care needs. They are vulnerable to their condition deteriorating and, without timely intervention, may require multiple emergency department visits and/or repeated hospitalizations. Upon discharge, the transition from the emergency department to home can be a vulnerable time for recovering patients with disruptions in the continuity of care. Remote monitoring of heart failure patients using home telemonitoring, coupled with clear communication protocols between health care professionals, can be effective in increasing the safety and quality of care for seniors with heart failure discharged from the emergency department...
December 18, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27976450/studying-the-safety-and-performance-of-rapid-sequence-intubation-data-collection-method-matters
#19
Andrea S Rinderknecht, Jenna R Dyas, Benjamin T Kerrey, Gary L Geis, Mona H Ho, Matthew R Mittiga
OBJECTIVE: We sought to describe and compare chart and video review as data collection sources for the study of Emergency Department (ED) Rapid Sequence Intubation (RSI). METHODS: This retrospective cohort study compares the availability and content of key RSI outcome and process data from two sources: chart and video data from 12 months of pediatric ED RSI. Key outcomes included adverse effects (oxyhemoglobin desaturation, physiologic changes, inadequate paralysis, vomiting), process components (number of laryngoscopy attempts, end-tidal CO2 detection), and timing data (duration of pre-oxygenation and laryngoscopy attempts)...
December 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27974330/post-exposure-prophylaxis-guidelines-for-children-and-adolescents-potentially-exposed-to-hiv
#20
REVIEW
Alasdair Bamford, Gareth Tudor-Williams, Caroline Foster
UK guidelines for HIV post-exposure prophylaxis (PEP) in adults have recently been updated. Indications for PEP have been modified and there has been a change in the recommended antiretroviral therapy for adults to a combination of raltegravir with tenofovir and emtricitabine (Truvada). Raltegravir and tenofovir are now available in paediatric formulations and offer improved safety and tolerability over previously recommended ritonavir-boosted lopinavir with zidovudine. This guideline provides recommendations for those caring for children potentially exposed to HIV and other bloodborne viruses in primary care, emergency departments, secondary care and specialist paediatric HIV centres...
January 2017: Archives of Disease in Childhood
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