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physician assistant emergency medicine

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https://www.readbyqxmd.com/read/29407013/contemporary-emergency-department-management-of-patients-with-chest-pain-a-concise-review-and-guide-for-the-high-sensitivity-troponin-era
#1
REVIEW
James E Andruchow, Peter A Kavsak, Andrew D McRae
This article synthesizes current best evidence for the evaluation of patients with suspected acute coronary syndrome (ACS) using high-sensitivity troponin assays, enabling physicians to effectively incorporate them into practice. Unlike conventional assays, high-sensitivity assays can precisely measure blood cardiac troponin concentrations in the vast majority of healthy individuals, facilitating the creation of rapid diagnostic algorithms. Very low troponin concentrations on presentation accurately rule out acute myocardial infarction (AMI) and enable the discharge of approximately 20% of patients after a single test, whereas an additional 30%-40% of patients can be safely discharged after short-interval serial sampling in as little as 1 or 2 hours...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29377711/the-period-prevalence-of-mind-and-body-practice-use-by-adult-emergency-department-patients
#2
Ashleigh J Sellar, David McD Taylor, Nicholas D Ross, Hayley H Chen, Luke D Plant, Daniel McLean, Paul Berlingeri, Rex Gavan, Tracey J Weiland, Jonathan C Knott
OBJECTIVES: Mind and Body Practice (MBP) use (e.g., chiropractic, acupuncture, meditation) among Emergency Department (ED) patients is largely unknown. We aimed to determine the period prevalence, nature of MBP use, and perceptions of MBP among adult ED patients. DESIGN AND SETTING: We undertook a cross-sectional survey of a convenience sample of patients presenting to three EDs between February and June 2016. SUBJECTS: Patients were eligible for inclusion if they were aged 18 years or more and had presented for medical treatment...
January 29, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29334996/italian-guidelines-on-the-assessment-and-management-of-pediatric-head-injury-in-the-emergency-department
#3
REVIEW
Liviana Da Dalt, Niccolo' Parri, Angela Amigoni, Agostino Nocerino, Francesca Selmin, Renzo Manara, Paola Perretta, Maria Paola Vardeu, Silvia Bressan
OBJECTIVE: We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury. METHODS: These guidelines were commissioned by the Italian Society of Pediatric Emergency Medicine and include a systematic review and analysis of the literature published since 2005...
January 15, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29286282/an-assessment-of-emotional-intelligence-in-emergency-medicine-resident-physicians
#4
Dimitrios Papanagnou, Kathryn Linder, Anuj Shah, Kory Scott London, Shruti Chandra, Robin Naples
Objectives: To define the emotional intelligence (EI) profile of emergency medicine (EM) residents, and identify resident EI strengths and weaknesses. Methods: First-, second-, and third-year residents (post-graduate years [PGY] 1, 2, and 3, respectively) of Thomas Jefferson University Hospital's EM Program completed the Emotional Quotient Inventory (EQ-i 2.0), a validated instrument offered by Multi-Health Systems. Reported scores included total mean EI, 5 composite scores, and 15 subscales of EI...
December 27, 2017: International Journal of Medical Education
https://www.readbyqxmd.com/read/29237400/accuracy-of-acute-burns-diagnosis-made-using-smartphones-and-tablets-a-questionnaire-based-study-among-medical-experts
#5
Lisa Blom, Constance Boissin, Nikki Allorto, Lee Wallis, Marie Hasselberg, Lucie Laflamme
BACKGROUND: Remote assistance for burns by medical experts can support nurses and general physicians in emergency care with diagnostic and management advice. Previous studies indicate a high diagnostic accuracy based on images viewed on a computer screen, but whether image-based analysis by experts using handheld devices is accurate remains to be determined. METHOD: A review of patient data from eight emergency centres in the Western Cape, South Africa, revealed 10 typical cases of burns commonly seen in children and adults...
December 13, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29169340/situational-analysis-of-antibiotic-use-and-resistance-in-ghana-policy-and-regulation
#6
Saviour Kwame Yevutsey, Kwame Ohene Buabeng, Moses Aikins, Berko Panyin Anto, Richard B Biritwum, Niels Frimodt-Møller, Martha Gyansa-Lutterodt
BACKGROUND: Antibiotics have played an essential role in decreasing morbidity and mortality from infectious diseases. However, indiscriminate use and unrestricted access is contributing to the emergence of bacterial resistance. This paper reports on a situational analysis of antimicrobial use and resistance in Ghana, with focus on policy and regulation. METHODS: Relevant policy documents, reports, regulations and enactments were reviewed. PubMed and Google search engines were used to extract relevant published papers...
November 23, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29159797/correlation-of-opioid-mortality-with-prescriptions-and-social-determinants-a-cross-sectional-study-of-medicare-enrollees
#7
Christos A Grigoras, Styliani Karanika, Elpida Velmahos, Michail Alevizakos, Myrto-Eleni Flokas, Christos Kaspiris-Rousellis, Ioannis-Nektarios Evaggelidis, Panagiotis Artelaris, Constantinos I Siettos, Eleftherios Mylonakis
BACKGROUND: The opioid epidemic is an escalating health crisis. We evaluated the impact of opioid prescription rates and socioeconomic determinants on opioid mortality rates, and identified potential differences in prescription patterns by categories of practitioners. METHODS: We combined the 2013 and 2014 Medicare Part D data and quantified the opioid prescription rate in a county level cross-sectional study with data from 2710 counties, 468,614 unique prescribers and 46,665,037 beneficiaries...
November 20, 2017: Drugs
https://www.readbyqxmd.com/read/29103917/physician-specialty-and-radiologist-characteristics-associated-with-higher-medicare-patient-complexity
#8
Andrew B Rosenkrantz, Wenyi Wang, Arvind Vijayasarathi, Richard Duszak
RATIONALE AND OBJECTIVES: Meaningfully measuring physician outcomes and resource utilization requires appropriate patient risk adjustment. We aimed to assess Medicare patient complexity by physician specialty and to further identify radiologist characteristics associated with higher patient complexity. MATERIALS AND METHODS: The average beneficiary Hierarchical Condition Category (HCC) risk scores (Medicare's preferred measure of clinical complexity) were identified for all physicians using 2014 Medicare claims data...
November 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29095380/clinical-experience-in-a-community-setting-during-pediatric-emergency-medicine-fellowship-training
#9
Ronald F Marchese, Payal K Gala, Jeffrey A Seiden, Richard Scarfone, Robert A Belfer, Jill Posner
OBJECTIVES: The aim of this study is to explore current community emergency department (ED) experiences available to pediatric emergency medicine (PEM) trainees and estimate the proportion of graduates taking positions that involve working in a community ED setting. METHODS: We conducted an e-mail-based survey among PEM fellowship directors and assistant directors. RESULTS: There were 55 program director respondents (74% response rate). Thirty-one percent of the surveyed PEM fellowship programs provide training exposure to a community ED setting...
October 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29079067/clinical-mimics-an-emergency-medicine-focused-review-of-cellulitis-mimics
#10
Garrett Blumberg, Brit Long, Alex Koyfman
BACKGROUND: Cellulitis is a common clinical condition with low rates of morbidity and mortality if treated appropriately. Mimics of cellulitis presenting with erythema, edema, warmth, and pain can be associated with grave morbidity and mortality if misdiagnosed. OBJECTIVE: This review investigates the signs and symptoms of cellulitis, mimics of cellulitis, and an approach to the management of both cellulitis and its mimics. DISCUSSION: The current emergency medicine definition of cellulitis includes erythema, induration, warmth, and swelling...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29064937/a-history-of-us-army-pas
#11
Robyn L Chalupa, W Sanders Marble
The US military has a long tradition of using physician assistants (PAs). The Army began using PAs in 1971 in an effort to supplement the physicians and surgeons in the medical corps. As their numbers grew, PAs gradually replaced general medical officers assigned to battalions. Later, specialty positions developed in aviation medicine, orthopedics, and emergency medicine. The need for a PA serving as an adviser in the major commands slowly developed at all levels of leadership. In 2015, the Army removed limitations on female PAs assigned to combat units...
November 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29049005/beliefs-attitudes-and-activities-of-healthcare-personnel-about-influenza-and-pneumococcal-vaccines
#12
Fatma Çiftci, Elif Şen, Nalan Demir, Orçun Çiftci, Serhat Erol, Oya Kayacan
OBJECTIVES: Vaccination of healthcare personnel (HCP) is an effective measure for preventing the spread of influenza among at-risk patients. This study was conducted to determine influenza vaccination rates and activities among HCP working at a tertiary healthcare setting. METHODS: This study included 470 HCP (85 physicians, 134 nurses, 53 healthcare assistants, 44 paramedics, 47 medical secretaries, and 107 auxillary staff members) working at the emergency, cardiology, chest diseases, and internal medicine departments with the largest volume of patients with vaccination indication of two large university hospitals with similar medical practices and work environment...
January 2, 2018: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28956888/the-9-item-physician-documentation-quality-instrument-pdqi-9-score-is-not-useful-in-evaluating-emr-scribe-note-quality-in-emergency-medicine
#13
Katherine J Walker, Andrew Wang, William Dunlop, Hamish Rodda, Michael Ben-Meir, Margaret Staples
BACKGROUND: Scribes are assisting Emergency Physicians by writing their electronic clinical notes at the bedside during consultations. They increase physician productivity and improve their working conditions. The quality of Emergency scribe notes is unevaluated and important to determine. OBJECTIVE: The primary objective of the study was to determine if the quality of Emergency Department scribe notes was equivalent to physician only notes, using the Physician Documentation Quality Instrument, Nine-item tool (PDQI-9)...
September 26, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28953294/job-satisfaction-among-academic-family-physicians
#14
Denny Fe Agana, Maribeth Porter, Robert Hatch, Daniel Rubin, Peter Carek
BACKGROUND AND OBJECTIVES: Family physicians report some of the highest rates of burnout among their physician peers. Over the past few years, this rate has increased and work-life balance has decreased. In academic medicine, many report lack of career satisfaction and have considered leaving academia. Our aim was to explore the factors that contribute to job satisfaction and burnout in faculty members in a family medicine department. METHODS: Six academic family medicine clinics were invited to participate in this qualitative study...
September 2017: Family Medicine
https://www.readbyqxmd.com/read/28915258/rapid-emergency-medicine-score-a-novel-prognostic-tool-for-predicting-the-outcomes-of-adult-patients-with-hepatic-portal-venous-gas-in-the-emergency-department
#15
MULTICENTER STUDY
Chen-June Seak, David Hung-Tsang Yen, Chip-Jin Ng, Yon-Cheong Wong, Kuang-Hung Hsu, Joanna Chen-Yeen Seak, Hsien-Yi Chen, Chen-Ken Seak
OBJECTIVE: This study aims to evaluate the performance of Rapid Emergency Medicine Score (REMS), Rapid Acute Physiology Score (RAPS), and Modified Early Warning Score (MEWS) in ascertaining the severity of illness and predicting the mortality of adult hepatic portal venous gas (HPVG) patients presenting to the emergency department (ED). This will assist emergency physicians (EPs) in risk stratification. METHODS: Data for 66 adult HPVG patients who visited the EDs of 2 research hospitals between October 1999 and April 2016 were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28914285/hospital-medicine-point-of-care-ultrasound-credentialing-an-example-protocol
#16
Benji K Mathews, Michael Zwank
Though the use of point-of-care ultrasound (POCUS) has increased over the last decade, formal hospital credentialing for POCUS may still be a challenge for hospitalists. This document details the Hospital Medicine Department Ultrasound Credentialing Policy from Regions Hospital, which is part of the HealthPartners organization in Saint Paul, Minnesota. National organizations from internal medicine and hospital medicine (HM) have not published recommended guidelines for POCUS credentialing. Revised guidelines for POCUS have been published by the American College of Emergency Physicians, though these are not likely intended to guide hospitalists when working with credentialing committees and medical boards...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28835267/workplace-violence-in-a-tertiary-care-israeli-hospital-a-systematic-analysis-of-the-types-of-violence-the-perpetrators-and-hospital-departments
#17
Sigal Shafran-Tikva, Revital Zelker, Zvi Stern, David Chinitz
BACKGROUND: Worldwide, there is a widespread and disturbing pattern of violence towards healthcare workers. However, violent occurrences in Israeli hospitals have often been unrecognized and underreported. Moreover, most studies have not sufficiently differentiated among the different types of violence. To examine the different types of violence experienced by nurses and physicians, the types of perpetrators and the specialty fields involved. METHODS: A quantitative questionnaire was used to assess the incidence of a "basket" of violent behaviors, divided into eight types of violent manifestations...
August 23, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28829517/assessing-the-impact-of-the-extended-release-long-acting-opioid-an-algesics-risk-evaluation-and-mitigation-strategies-on-opioid-prescrip-tion-volume
#18
Victoria Divino, Soledad Cepeda, Paul Coplan, Jean-Yves Maziere, Yingli Yuan, Rolin L Wade
OBJECTIVE: The Food and Drug Administration approved the extended-release/long-acting (ER/LA) opioid analgesics risk evaluation and mitigation strategies (REMS) in July 2012 to educate healthcare providers and patients about safe and appropriate opioid analgesic use. The authors evaluated the impact of the REMS on ER/LA opioid analgesic utilization, overall and stratified by patient characteristics and prescriber type associated with greater expected need for analgesia. DESIGN: Retrospective repeated cross-sectional study...
May 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28822610/evaluation-of-fever-in-the-emergency-department
#19
REVIEW
Sarah DeWitt, Summer A Chavez, Jack Perkins, Brit Long, Alex Koyfman
BACKGROUND: Fever is one of the most common complaints in the emergency department (ED) and is more complex than generally appreciated. The broad differential diagnosis of fever includes numerous infectious and non-infectious etiologies. An essential skill in emergency medicine is recognizing the pitfalls in fever evaluation. OBJECTIVE OF REVIEW: This review provides an overview of the complaint of fever in the ED to assist the emergency physician with a structured approach to evaluation...
November 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28662832/vascular-causes-of-syncope-an-emergency-medicine-review
#20
REVIEW
Brit Long, Alex Koyfman
BACKGROUND: Syncope is a common emergency department (ED) complaint, accounting for 2% of visits annually. A wide variety of etiologies can result in syncope, and vascular causes may be deadly. OBJECTIVE: This review evaluates vascular causes of syncope and their evaluation and management in the ED. DISCUSSION: Syncope is defined by a brief loss of consciousness with loss of postural tone and complete, spontaneous recovery without medical intervention...
September 2017: Journal of Emergency Medicine
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