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Office emergencies

Minerva Kyei-Onanjiri, Mary Carolan-Olah, John Koku Awoonor-Williams, Terence V McCann
BACKGROUND: Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies...
March 15, 2018: BMC Health Services Research
Shiva Kalidindi, Thomas A Lacy
Emergencies do occur in pediatric primary care offices. The American Academy of Pediatrics Committee on Pediatric Emergency Medicine recommends that primary care offices perform a self-assessment of office readiness for emergencies. Primary care offices should develop an emergency response plan to recognize, stabilize, and transfer sick children. They should also ensure their offices have the essential equipment, supplies, and medications readily available in case of emergencies. Primary care offices can prepare and practice for office emergencies through "mock codes" and by maintaining certification in basic and advanced life support courses...
March 1, 2018: Pediatric Annals
Gretchen Hackett, Jodi Brady, Robert P Olympia
Students presenting with syncope and/or seizure occur occasionally in the school setting. Several studies have shown that seizures as well as respiratory distress are the most common medical emergencies that prompt school nurses and staff to contact emergency medical services (EMS) to transport students to the closest emergency department (Knight 1999, Olympia 2005). It is important to develop a differential diagnosis for syncope, to initiate stabilization of the student with life-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow-up at their primary health care provider's office, or directly to the closest emergency department via EMS)...
March 1, 2018: NASN School Nurse
Deepa P Rao, Steven McFaull, Wendy Thompson, Gayatri C Jayaraman
INTRODUCTION: With growing awareness about traumatic brain injuries (TBI), there is limited information about population level patterns of TBI care in Canada. METHODS: We examined data from the Canadian Community Health Survey (years 2004, 2009, and 2014) among all respondents ages 12 years and older. TBI management characteristics examined included access to care within 48 hours of injury, point of care, hospital admission, and follow-up. RESULTS: We observed that many Canadians sought care within 48 hours of their injury, with no changes over time...
March 2018: Health Promotion and Chronic Disease Prevention in Canada
Maxine D Fisher, Ancilla W Fernandes, Temitope O Olufade, Paul J Miller, Mark S Walker, Moon Fenton
PURPOSE: The goal of this study was to describe patient characteristics, health resource utilization (HRU), and costs associated with treating recurrent or refractory head and neck cancer (HNC) among patients with disease progression in the community oncology setting. METHODS: This retrospective observational study was conducted by using data from the Vector Oncology Data Warehouse. Patients had been diagnosed with locally advanced or metastatic (stage III-IVc) HNC between January 1, 2007, and October 1, 2015...
March 9, 2018: Clinical Therapeutics
Jane H Brice, Matthew A Psioda, Renee Johnson, Amy Oakley, Julianne M Cyr, Christopher S Cowden, Richard Uribe
BACKGROUND: Accessing the emergency medical services system via 9-1-1 operators is an effective way for patients to seek urgent health care; however, technological advances and telecommunication practices inundate the 9-1-1 and emergency services infrastructure with unintentional calls that delay response efforts to legitimate medical emergencies. OBJECTIVE: To determine whether the change in university-wide dial-out prefix from "9" to "7" reduced unnecessary calls to a 9-1-1 call center...
March 9, 2018: Prehospital Emergency Care
Teresa To, Laura Y Feldman, Jingqin Zhu, Andrea S Gershon
During pregnancy, women with asthma may be at higher risk of exacerbation. The objective of this study was to determine whether women with asthma in Ontario, Canada have increased health services utilization (HSU) during pregnancy.Rates of asthma-specific, asthma-related and non-pregnancy-related HSU were calculated in a population-based cohort of pregnant women with asthma. Poisson regression with repeated measures was used to determine adjusted rate ratios and 95% confidence intervals of HSU during and one year after pregnancy, compared to the year before pregnancy...
March 8, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Andrew C Faust, Emily Guy, Nidhu Baby, Anthony Ortegon
BACKGROUND: Methemoglobinemia is a well-recognized adverse drug reaction related to the use of certain local anesthetic agents. The mainstay of treatment for methemoglobinemia is i.v. methylene blue, along with provision of supplemental oxygen; however, methylene blue is listed as a category X teratogen. This poses an issue should methemoglobinemia develop during pregnancy. CASE REPORT: A 35-year-old, 20-week and 5-day gravid female was transferred from an outpatient oral surgeon's office for hypoxia...
March 5, 2018: Journal of Emergency Medicine
Jack Morrison, Giles Watts, Glyn Hobbs, Nick Dawnay
Field based forensic tests commonly provide information on the presence and identity of biological stains and can also support the identification of species. Such information can support downstream processing of forensic samples and generate rapid intelligence. These approaches have traditionally used chemical and immunological techniques to elicit the result but some are known to suffer from a lack of specificity and sensitivity. The last 10 years has seen the development of field-based genetic profiling systems, with specific focus on moving the mainstay of forensic genetic analysis, namely STR profiling, out of the laboratory and into the hands of the non-laboratory user...
February 21, 2018: Forensic Science International
M E Ogunsanya, S O Nduaguba, C M Brown
Objectives The objective of this paper is to describe the annual direct medical expenditures for cutaneous lupus erythematosus (CLE) patients, and to estimate the incremental health care expenditures and utilization associated with depression among adults with CLE, while controlling for covariates. Methods Using the 2014 Medical Expenditure Panel Survey (MEPS), we compared CLE patients with and without depression to determine differences in: (a) health care utilization-inpatient, outpatient, office-based and emergency room (ER) visits, and prescriptions filled; and (b) expenditures-total costs, inpatient, outpatient, office-based, ER, and prescription medication costs, and other costs using demography-adjusted and comorbidity-adjusted multivariate models (age, gender, race/ethnicity, marital status, education, perception of health status, poverty category, smoking status, and Charlson Comorbidity Index)...
January 1, 2018: Lupus
Sabrina Roy, Fred H Hochberg, Pamela S Jones
This article aims to document the growth in extracellular vesicle (EV) research. Here, we report the growth in EV-related studies, patents, and grants as well as emerging companies with major intent on exosomes. Four different databases were utilized for electronic searches of published literature: two general databases - Scopus/Elsevier and Web of Science (WoS), as well as two specialized US government databases - the USA Patent and Trademark Office and National Institutes of Health (NIH) of the Department of Health and Human Services...
2018: Journal of Extracellular Vesicles
Chris O Ifediora, Gary D Rogers
RATIONALE, AIMS AND OBJECTIVES: This study explores the postconsultation follow-up behaviours of patients who used the Australian after-hours house-call (AHHC) medical services. These behaviours provide insights into the nature of the continuity of care (CoC) in the industry and are a measure quality in AHHC service delivery. Understanding the patterns of these CoCs and their predictors will enable stakeholders in the industry, both locally and globally, plan and implement higher quality services...
March 2, 2018: Journal of Evaluation in Clinical Practice
Satya Surbhi, Ilana Graetz, Jim Y Wan, Justin Gatwood, James E Bailey
BACKGROUND: Nonadherence to essential chronic medications has been identified as a potential driver of high health care costs in superutilizers of inpatient services. Few studies, however, have documented the levels of nonadherence and factors associated with nonadherence in this high-cost, vulnerable population. OBJECTIVE: To examine the factors associated with nonadherence to essential chronic medications, with special emphasis on mental illness and use of opioid medications...
March 2018: Journal of Managed Care & Specialty Pharmacy
Pinkal S Patel, Karen Y Chung, Leila Kasrai
BACKGROUND: There is an emerging interest in global surgery. The Lancet Commission on Global Surgery recognizes the important role that nongovernmental organizations (NGOs) play in the delivery of cleft lip and/or palate (CLP) surgical care. To better address the unmet burden of surgical disease, the commissioners propose the use of a centralized registry to maximize coordination of global surgical volunteerism efforts. This study aims to create a comprehensive database of CLP organizations...
February 26, 2018: Journal of Craniofacial Surgery
Jeremiah M Kinsman, Kathy Robinson
OBJECTIVE: Previous research conducted in November 2013 found there were a limited number of states and territories in the United States (US) that authorize emergency medical technicians (EMTs) and emergency medical responders (EMRs) to administer opioid antagonists. Given the continued increase in the number of opioid-related overdoses and deaths, many states have changed their policies to authorize EMTs and EMRs to administer opioid antagonists. The goal of this study is to provide an updated description of policy on EMS licensure levels' authority to administer opioid antagonists for all 50 US states, the District of Columbia (DC), and the Commonwealth of Puerto Rico (PR)...
February 27, 2018: Prehospital Emergency Care
Jamie K Jones
OBJECTIVE: The purpose of this study was to explore the meaning and uses of the office space among licensed clinical social workers in private practice. BACKGROUND: Previous research suggests the importance of the office space in clinical practice in regard to therapeutic alliance, client behavior, and the well-being of the therapist. However, therapist offices contain much variation in design. This study looked further into specifically how the therapy room is important through the perspective of the licensed clinical social workers in order to identify common themes...
January 1, 2018: HERD
Mark C Navin, Andrea T Kozak, Emily C Clark
BACKGROUND: In 2015, Michigan implemented an education requirement for parents who requested nonmedical exemptions from school or daycare immunization mandates. Michigan required parents to receive education from public health staff, unlike other states, whose vaccine education requirements could be completed online or at physicians' offices. METHODS AND FINDINGS: Results of focus group interviews with 39 of Michigan's vaccine waiver educators, conducted during 2016 and 2017, were analyzed to identify themes describing educators' experiences of waiver education...
February 20, 2018: Vaccine
Per Venge
The early and accurate discrimination between bacterial and viral causes of acute infections is the key to a better use of antibiotics and will help slow down the fast-growing resistance to commonly used antibiotics. This discrimination is in the vast majority of cases possible to achieve by blood assay of the biomarker human neutrophil lipocalin (HNL), which we showed to be uniquely increased in patients suffering from bacterial infections. In serum, sensitivities and specificities of >90% are achieved in both adults and children...
February 23, 2018: Upsala Journal of Medical Sciences
Casey M Hay, Joseph L Kelley, Robert P Edwards, Kathleen M Pombier, John T Comerci
Super-utilizers account for many emergency department visits (EDV) and hospitalizations. Among Medicare/Medicaid patients, 5% to 10% account for >50% of spending. Little is known about super-utilization in gynecologic oncology. Charts of 64 gynecologic oncology patients with ≥3 EDV and/or admissions over 12 months were reviewed retrospectively. Cancer type distribution was 47% ovarian, 23% cervical, 23% endometrial, and 6% vulvar. Treatment at index visit was 61% chemotherapy, 16% no treatment, 8% recent surgery, and 6% radiation...
February 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Heather V Nelson-Brantley, Debra J Ford, Karen L Miller, Kristin A Stegenga, Robert H Lee, Marjorie J Bott
OBJECTIVE: The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led change to become the 1st to achieve Magnet®. BACKGROUND: Approximately 21% of the US population lives in rural areas served by CAHs. Rural nurse executives are particularly challenged with limited resources. METHODS: Staff nurses, nurse managers, interprofessional care providers, the chief nursing officer, and board of directors (n = 27) were interviewed...
March 2018: Journal of Nursing Administration
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