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Emergency Department Safety

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https://www.readbyqxmd.com/read/28934186/opioid-overdose-outbreak-west-virginia-august-2016
#1
Joel Massey, Michael Kilkenny, Samantha Batdorf, Sarah K Sanders, Debra Ellison, John Halpin, R Matthew Gladden, Danae Bixler, Loretta Haddy, Rahul Gupta
On August 15, 2016, the Mayor's Office of Drug Control Policy in Huntington, West Virginia, notified the Cabell-Huntington Health Department (CHHD) of multiple calls regarding opioid overdose received by the emergency medical system (EMS) during 3 p.m.-8 p.m. that day. A public health investigation and response conducted by the West Virginia Bureau for Public Health (BPH) and CHHD identified 20 opioid overdose cases within a 53-hour period in Cabell County; all cases included emergency department (ED) encounters...
September 22, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28930950/increased-mortality-in-trauma-patients-who-develop-postintubation-hypotension
#2
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Postintubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada, between 2000 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28929478/defining-a-risk-informed-framework-for-whole-of-government-lessons-learned-a-canadian-perspective
#3
Shaye K Friesen, Shelley Kelsey, J A Jim Legere
Lessons learned play an important role in emergency management (EM) and organizational agility. Virtually all aspects of EM can derive benefit from a lessons learned program. From major security events to exercises, exploiting and applying lessons learned and "best practices" is critical to organizational resilience and adaptiveness. A robust lessons learned process and methodology provides an evidence base with which to inform decisions, guide plans, strengthen mitigation strategies, and assist in developing tools for operations...
July 2017: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/28929477/superstorm-sandy-emergency-management-staff-perceptions-of-impact-and-recommendations-for-future-preparedness-new-york-state
#4
Adam Yanson, Asante Shipp Hilts, Stephanie Mack, Millicent Eidson, Trang Nguyen, Guthrie Birkhead
OBJECTIVE: This study collected and summarized feedback from staff at the New York State (NYS) Office of Emergency Management (OEM) and three county OEMs within NYS to understand lessons learned from the 2012 Superstorm Sandy. DESIGN: Cross-sectional qualitative and quantitative analysis. SUBJECTS, PARTICIPANTS: One staff person from each identified critical role from the state and county OEMs who were still employed in the roles identified...
July 2017: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#5
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVE: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28924304/nedocs-vs-subjective-evaluation-%C3%A2-is-the-health-personnel-of-the-emergency-department-aware-of-its-overcrowding
#6
Mauricio Garcia-Romero, Claudia Geraldine Rita-Gáfaro, Jairo Quintero-Manzano, Anderson Bermon Angarita
INTRODUCTION: An emergency department (ED) is considered to be "overcrowded" when the number of patients exceeds its treatment capacity and it does not have the conditions to meet the needs of the next patient to be treated. This study evaluates overcrowding in the emergency department of a hospital in Colombia. OBJECTIVE: To compare the objective NEDOCS scale with a subjective evaluation by ED health staff in order to evaluate the differences between the two. METHODS: The NEDOCS scale was applied and a subjective overcrowding survey was administered to the medical staff and the charge nurse on duty 6 times per day (6:00 a...
June 30, 2017: Colombia Médica: CM
https://www.readbyqxmd.com/read/28917136/nursing-students-socialisation-into-practical-skills
#7
Mona Ewertsson, Sangeeta Bagga-Gupta, Karin Blomberg
Socialisation is a significant factor that shapes nursing students' learning in clinical settings. Little is known about the ways in which students learn practical skills during their clinical practice and how they are socialised into these skills. This knowledge is important for creating an optimal environment for ensuring a high standard of care and patient safety. This study aims to address this knowledge gap. An ethnographic approach was used. Data were collected by participant observations during nursing students' clinical practice in an emergency department at a university hospital in Sweden, and during informal conversations with students and their preceptors...
September 5, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28914750/live-attenuated-influenza-vaccination-prior-to-age-3-years-and-subsequent-development-of-asthma-a-14-year-follow-up-study
#8
Roger P Baxter, Ned Lewis, Bruce Fireman, John Hansen, Nicola P Klein, Justin R Ortiz
BACKGROUND: Live-attenuated influenza vaccines (LAIVs) are not licensed in children <2 years because of a wheezing safety signal that has not been fully elucidated. In 2000, the Kaiser Permanente Vaccine Study Center conducted a placebo controlled randomized clinical trial (RCT) of LAIV in children. As many of these children were still enrolled in Kaiser Permanente in 2014, we could assess the possible long-term association between LAIV and subsequent asthma diagnosis. METHODS: We identified all children who were originally enrolled into the LAIV RCT at < 3 years of age...
September 12, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28914680/outcomes-in-patients-treated-with-a-novel-simple-method-for-hemostasis-of-dermal-avulsion-injuries
#9
Sean Taylor Dowling, Brian Wai Lin
OBJECTIVE: A recently described technique proposes a simple method to achieve permanent hemostasis of distal fingertip dermal avulsion injuries. It is simple to learn and easy to perform with readily available materials found in most emergency departments. However, long-term outcomes for patients treated with this technique have not yet been evaluated. A primary objective of the current article is to provide safety data for the technique using an off-label product indication. SETTING: Emergency department of Kaiser Permanente Medical Center, San Francisco, California...
October 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28913974/impact-of-ladder-related-falls-on-the-emergency-department-and-recommendations-for-ladder-safety
#10
C J Cabilan, Kirsten Vallmuur, Rob Eley, Chantelle Judge, Sarah Cochrane, Connie Reed, Jessica Riordan, Kym Roberts, Ogilvie Thom, Gabriella Wood
OBJECTIVES: To describe the characteristics of patients who presented to the ED from a ladder-related fall and their injuries, highlight the impact of ladder-related falls on the ED, identify contributing factors of ladder falls and draw recommendations to improve ladder safety. METHODS: A prospective observational study was conducted in two EDs. Patients' demographics and ED services used were obtained from medical records. A 53-item questionnaire was used to gather information about the type of ladder used, ladder activity, circumstances of the fall, contributing factors and future recommendations...
September 14, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28905296/potentially-preventable-medical-hospitalizations-and-emergency-department-visits-by-the-behavioral-health-population
#11
Eric M Schmidt, Simone Behar, Alinne Barrera, Matthew Cordova, Leonard Beckum
This study investigated geographic variation in potentially preventable medical outcomes that might be used to monitor access to high-quality medical care in the behavioral health population. Analyzing public and non-public data sources from California on adults admitted between 2009 and 2011 to all non-federal licensed medical inpatient (N = 6,603,146) or emergency department units (N = 21,011,958) revealed that 33.6% of nearly 1 million potentially preventable hospitalizations and 9.8% of 1.5 million potentially preventable emergency department visits were made by people with mental or substance use disorder diagnoses...
September 13, 2017: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/28901005/delivery-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#12
REVIEW
Agustín Ciapponi, Simon Lewin, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Elizabeth Paulsen, Gabriel Rada, Charles S Wiysonge, Gabriel Bastías, Lilian Dudley, Signe Flottorp, Marie-Pierre Gagnon, Sebastian Garcia Marti, Claire Glenton, Charles I Okwundu, Blanca Peñaloza, Fatima Suleman, Andrew D Oxman
BACKGROUND: Delivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28894771/baseline-characteristics-of-fall-from-height-victims-presenting-to-emergency-department-a-brief-report
#13
Hamidreza Hatamabadi, Ali Arhami Dolatabadi, Batoul Atighinasab, Saeed Safari
INTRODUCTION: Trauma due to accidents or fall from height is a major cause of disability and mortality. The present study was designed aiming to evaluate the baseline characteristics of fall from height victims presenting to emergency department (ED). METHODS: This prospective cross-sectional study evaluates the baseline characteristics of fall from height cases presenting to EDs of three educational Hospitals, Tehran, Iran, during one year. Data were analyzed using SPSS 21 and presented using descriptive statistics...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28886611/-mass-casualty-incident-special-features-of-threatening-situations
#14
Björn Hossfeld, Thomas Wurmb, Florent Josse, Matthias Helm
Terrorist attacks or amok runs may cause "threatening situations" for emergency medical services (EMS), fire fighters and physicians. Cooperation with the police is of paramount importance. In order to minimize the risk to rescue personnel and affected persons, emergency medical care has to follow tactical principles. So, the strategy in such "threatening situations" is "Stop the bleeding and clear the scene". The police define three areas of danger: unsafe, partly safe and secure. Medical care in these areas follows the concept of Tactical Combat Casualty Care...
September 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28885427/safety-of-medical-abortion-provided-through-telemedicine-compared-with-in-person
#15
Daniel Grossman, Kate Grindlay
OBJECTIVE: To compare the proportion of medical abortions with a clinically significant adverse event among telemedicine and in-person patients at a clinic system in Iowa during the first 7 years of the service. METHODS: We conducted a retrospective cohort study. We analyzed data on clinically significant adverse events (hospital admission, surgery, blood transfusion, emergency department treatment, and death) for all medical abortions performed by telemedicine or in person at a clinic system in Iowa between July 1, 2008, and June 30, 2015...
September 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28882749/the-consequences-of-violence-against-nurses-working-in-the-emergency-department-a-qualitative-study
#16
H Hassankhani, N Parizad, J Gacki-Smith, A Rahmani, E Mohammadi
BACKGROUND: Workplace violence (WPV) in healthcare organizations can lead to serious consequences that negatively affect nurses' lives and patient care. There is limited research on the deeper, underlying consequences of WPV for emergency nurses, particularly among emergency nurses in Iran. METHODS: A qualitative exploratory design was utilized. Semi-structured interviews were conducted with sixteen nurses working in emergency departments in five hospitals in west and east Azerbaijan of Iran...
September 4, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28881007/delayed-antibiotic-prescriptions-for-respiratory-infections
#17
REVIEW
Geoffrey Kp Spurling, Chris B Del Mar, Liz Dooley, Ruth Foxlee, Rebecca Farley
BACKGROUND: Concerns exist regarding antibiotic prescribing for respiratory tract infections (RTIs) owing to adverse reactions, cost, and antibacterial resistance. One proposed strategy to reduce antibiotic prescribing is to provide prescriptions, but to advise delay in antibiotic use with the expectation that symptoms will resolve first. This is an update of a Cochrane Review originally published in 2007, and updated in 2010 and 2013. OBJECTIVES: To evaluate the effects on clinical outcomes, antibiotic use, antibiotic resistance, and patient satisfaction of advising a delayed prescription of antibiotics in respiratory tract infections...
September 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28875864/pulmonary-embolism-with-cardiac-arrest-a-stemi-patient-s-unexpected-course
#18
Zoë Piggott, Tomislav Jelic
We describe the successful use and complications of bolus-dose alteplase to treat strongly suspected pulmonary embolism (PE) with cardiac arrest in a patient initially presenting as ST-elevation myocardial infarcation (MI). Case description is followed by a review of the indications, safety, and dosing of systemic thrombolytic therapy for high-risk PE in the emergency department (ED). Diagnostic and therapeutic approach to PE in critically ill patients is also considered, including the potential utility of point-of-care ultrasound (PoCUS) in the ED...
September 6, 2017: CJEM
https://www.readbyqxmd.com/read/28870249/improving-emergency-department-radiology-transportation-time-a-successful-implementation-of-lean-methodology
#19
Eveline A Hitti, Ghada R El-Eid, Hani Tamim, Rana Saleh, Miriam Saliba, Lena Naffaa
BACKGROUND: Emergency Department overcrowding has become a global problem and a growing safety and quality concern. Radiology and laboratory turnaround time, ED boarding and increased ED visits are some of the factors that contribute to ED overcrowding. Lean methods have been used in the ED to address multiple flow challenges from improving door-to-doctor time to reducing length of stay. The objective of this study is to determine the effectiveness of using Lean management methods on improving Emergency Department transportation times for plain radiography...
September 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28869100/findings-from-a-rivaroxaban-program-for-acute-venous-thromboembolism-upon-emergency-department-discharge-with-focus-on-utility-of-commercially-available-dose-pack
#20
Aileen Chu, Jill Limberg
OBJECTIVE: To evaluate the impact of a rivaroxaban discharge initiative on the efficacy and safety of acute venous thromboembolism treatment in emergency department patients. PRACTICE INNOVATION: Patients discharged on rivaroxaban from the emergency department were provided extensive counseling along with a commercially-available medication dose pack by the ED pharmacist. Patients were contacted by phone until they had obtained outpatient follow-up and remained adherent to anticoagulation beyond the initial first month of treatment...
August 2, 2017: American Journal of Emergency Medicine
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