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Pre-hospital emergency care

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https://www.readbyqxmd.com/read/28228341/doctors-and-nurses-perceptions-of-military-pre-hospital-emergency-care-when-training-becomes-reality
#1
REVIEW
Sten-Ove Andersson, Lars Lundberg, Anders Jonsson, Pia Tingström, Madeleine Abrandt Dahlgren
The aim of this study was to identify physicians' and nurses' perceptions of military pre-hospital emergency care before and after an international mission. A qualitative empirical study with a phenomenographic approach was used. The results after pre-deployment training can be categorised as (1) learning about military medicine and (2) taking care of the casualty. The results after an international mission can be categorised as (1) collaborating with others, (2) providing general health care and (3) improving competence in military medicine...
February 19, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28228314/pre-hospital-acute-coronary-syndrome-care-in-kerala-india-a-qualitative-analysis
#2
Amisha Patel, P P Mohanan, Dorairaj Prabhakaran, Mark D Huffman
OBJECTIVE: Ischemic heart disease is the leading cause of death in India. Many of these deaths are due to acute coronary syndromes (ACS), which require prompt symptom recognition, care-seeking behavior, and transport to a treatment facility in the critical pre-hospital period. In India, little is known about pre-hospital management of individuals with ACS. We aim to understand the facilitators, barriers, and context of optimal pre-hospital ACS care to provide opportunities to reduce pre-hospital delays and improve acute cardiovascular care...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28225375/impact-of-a-child-life-and-music-therapy-procedural-support-intervention-on-parental-perception-of-their-child-s-distress-during-intravenous-placement
#3
Gabriela S Ortiz, Todd OʼConnor, Jessa Carey, Adam Vella, Audrey Paul, Diane Rode, Alan Weinberg
OBJECTIVES: Child life specialists and music therapists have a unique and integral role in providing psychosocial care to pediatric patients and families. These professionals are trained to provide clinical interventions that support coping and adjustment and reduce the risk of psychological trauma related to hospital visits and health care encounters. The researchers devised a multimodal approach using a combined child life and music therapy intervention to address procedure-related distress in patients receiving intravenous (IV) placement in the pediatric emergency department...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224346/dedication-increases-productivity-an-analysis-of-the-implementation-of-a-dedicated-medical-team-in-the-emergency-department
#4
Pedro Ramos, José Artur Paiva
BACKGROUND: In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28219136/-an-epidemiological-investigation-of-pediatric-patients-under-14-with-large-area-burns-a-multicenter-study
#5
W F Cheng, D X Zhao, Z A Shen, H Y Zhang, J J Tu, Z Q Yuan, P Duan, G D Song
Objective: To investigate and evaluate the epidemiological characteristics of patients under 14 with large area burns in China. Methods: Data of pediatric patients aged 0-14yr with ≥30% total body surface area (TBSA) burned admitted into 106 burn centers in the mainland of China in 2014 were retrieved. The children were divided into three age groups: 0-3, 4-6 and 7-14 years according to the age. Information of age, gender, time of burn injury, causes of burns, admission time, prehospital emergency care of burn wound, burn area, inhalation injuries, the case fatality rate and length of hospital stay were collected for analysis...
February 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28217595/impact-of-pre-hospital-care-on-the-outcome-of-children-arriving-with-agonal-breathing-to-a-pediatric-emergency-service-in-south-india
#6
Debasis Das Adhikari, Krishna Mahathi, Urmi Ghosh, Indira Agarwal, Anila Chacko, Ebor Jacob, Kala Ebenezer
BACKGROUND: Data on the prehospital interventions received by critically ill children at arrival to Paediatric Emergency Services (PES) is limited in developing countries. This study aims to describe the pre-hospital care scenario, transport and their impact on outcome in non-traumatic, acutely ill children presenting in PES with agonal breathing. METHODS: Prospective observational study done on children aged below 15 years arriving in PES with agonal breathing due to non-trauma related causes...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28210351/cross-continuum-tool-is-associated-with-reduced-utilization-and-cost-for-frequent-high-need-users
#7
Lauran Hardin, Adam Kilian, Leslie Muller, Kevin Callison, Michael Olgren
INTRODUCTION: High-need, high-cost (HNHC) patients can over-use acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to increased U.S. healthcare cost. Our objective was to reduce healthcare cost and improve outcomes by optimizing the system of care. We targeted HNHC patients and identified root causes of frequent healthcare utilization. We developed a cross-continuum intervention process and a succinct tool called a Complex Care Map (CCM)© that addresses fragmentation in the system and links providers to a comprehensive individualized analysis of the patient story and causes for frequent access to health services...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209449/maxillofacial-and-concomitant-serious-injuries-an-eight-year-single-center-experience
#8
Fausto Fama, Marco Cicciu, Alessandro Sindoni, Enrico Nastro-Siniscalchi, Roberto Falzea, Gabriele Cervino, Francesca Polito, Francesco De Ponte, Maria Gioffre-Florio
PURPOSE: Maxillofacial injuries are frequently associated with multiple trauma and can determine functional and aesthetic bad outcomes. The severity of maxillofacial injuries may be considerable and can divert clinicians' attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department (ED) of the University Hospital of Messina (North-East Sicily, Italy) for maxillofacial traumas...
January 20, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28202076/developing-quality-indicators-for-physician-staffed-emergency-medical-services-a-consensus-process
#9
Helge Haugland, Marius Rehn, Pål Klepstad, Andreas Krüger
BACKGROUND: There is increasing interest for quality measurement in health care services; pre-hospital emergency medical services (EMS) included. However, attempts of measuring the quality of physician-staffed EMS (P-EMS) are scarce. The aim of this study was to develop a set of quality indicators for international P-EMS to allow quality improvement initiatives. METHODS: A four-step modified nominal group technique process (expert panel method) was used. RESULTS: The expert panel reached consensus on 26 quality indicators for P-EMS...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28184955/-tranexamic-acid-in-the-german-emergency-medical-service-a%C3%A2-national-survey
#10
V Zickenrott, I Greb, A Henkelmann, F Balzer, S Casu, L Kaufner, C von Heymann, K Zacharowski, C F Weber
BACKGROUND: Trauma-induced coagulopathy, one of the leading causes of trauma-related death, is detected in about one of four trauma patients upon hospital admission. The current European Management of Major Bleeding and Coagulopathy Following Trauma guidelines, published in 2013, recommend that tranexamic acid (TXA) be administered as early as possible to inhibit hyperfibrinolysis (grade of recommendation (GoR 1A)). Furthermore, it is suggested that protocols for the management of patients with bleeding or showing signs of bleeding include the administration of the first dose of TXA at the site of injury or during transportation to hospital (GoR 2C)...
February 9, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28170398/emergency-obstetric-care-in-a-rural-district-of-burundi-what-are-the-surgical-needs
#11
E De Plecker, R Zachariah, A M V Kumar, M Trelles, S Caluwaerts, W van den Boogaard, J Manirampa, K Tayler-Smith, M Manzi, K Nanan-N'zeth, B Duchenne, B Ndelema, W Etienne, P Alders, R Veerman, R Van den Bergh
OBJECTIVES: In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC), we assessed the a) characteristics of women at risk of, or with an obstetric complication and their types b) the number and type of obstetric surgical procedures and anaesthesia performed c) human resource cadres who performed surgery and anaesthesia and d) hospital exit outcomes. METHODS: A retrospective analysis of EmOC data (2011 and 2012). RESULTS: A total of 6084 women were referred for EmOC of whom 2534(42%) underwent a major surgical procedure while 1345(22%) required a minor procedure (36% women did not require any surgical procedure)...
2017: PloS One
https://www.readbyqxmd.com/read/28169135/case-study-and-case-based-research-in-emergency-nursing-and-care-theoretical-foundations-and-practical-application-in-paramedic-pre-hospital-clinical-judgment-and-decision-making-of-patients-with-mental-illness
#12
Ramon Z Shaban, Julie Considine, Margaret Fry, Kate Curtis
Generating knowledge through quality research is fundamental to the advancement of professional practice in emergency nursing and care. There are multiple paradigms, designs and methods available to researchers to respond to challenges in clinical practice. Systematic reviews, randomised control trials and other forms of experimental research are deemed the gold standard of evidence, but there are comparatively few such trials in emergency care. In some instances it is not possible or appropriate to undertake experimental research...
February 3, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28164367/the-association-of-admission-hyperglycaemia-and-adverse-clinical-outcome-in-medical-emergencies-the-multinational-prospective-observational-triage-study
#13
A Kutz, T Struja, P Hausfater, D Amin, A Amin, S Haubitz, M Bernard, A Huber, B Mueller, P Schuetz
AIMS: The clinical relevance of hyperglycaemia in an emergency department population remains incompletely understood. We investigated the association between admission blood glucose levels and adverse clinical outcomes in a large emergency department cohort. METHODS: We prospectively enrolled 7132 adult medical patients seeking emergency department care in three tertiary care hospitals in Switzerland, France and the USA. We used adjusted multivariable logistic regression models to examine the association between admission blood glucose levels and 30-day mortality, as well as adverse clinical course stratified by pre-existing diabetes and principal medical diagnoses...
February 6, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28160237/management-of-patients-presenting-with-haemoptysis-to-a-tertiary-care-italian-emergency-department-the-florence-haemoptysis-score-flhasc
#14
Simone Vanni, Simone Bianchi, Sofia Bigiarini, Claudia Casula, Marco Brogi, Stefano Orsi, Manlio Acquafresca, Lorenzo Corbetta, Stefano Grifoni
We analysed the clinical features and diagnostic workup of patients presenting with haemoptysis to an Italian teaching hospital to derive an easy-to-use clinical score to guide risk stratification and initial management in the emergency department (ED). We retrospectively reviewed clinical records of consecutive patients with haemoptysis over 1 year. A pre-specified set of variables, including demographic data, vital signs, type of expectorate (pure blood vs. blood-streaked sputum), comorbidities, and diagnostic tests and treatments was originally registered...
February 3, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28156587/palliative-outpatient-hot-clinic-rapid-access-for-oncology-patients-visiting-emergency-department-in-a-tertiary-hospital-in-singapore-a-1-year-experience
#15
Mervyn Yong Hwang Koh, Jia Fang Lee
: 137 Background: Oncology patients often present with symptoms at Emergency Department (ED). While most patients require admission for further management, some patients can be discharged from ED with outpatient follow-up. However, most patients were given 4 to 6 week appointment. In the light of this service gap, our department collaborated with ED to facilitate rapid access to Palliative Outpatient Hot Clinic (POHC) within 3 working days from ED visit in 2015. METHODS: We performed a retrospective review of all patients seen in the ED who satisfied the referral criteria to POHC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28153014/towards-best-practice-in-acute-stroke-care-in-ghana-a-survey-of-hospital-services
#16
Leonard Baatiema, Michael Otim, George Mnatzaganian, Ama De-Graft Aikins, Judith Coombes, Shawn Somerset
BACKGROUND: Stroke and other non-communicable diseases are important emerging public health concerns in sub-Saharan Africa where stroke-related mortality and morbidity are higher compared to other parts of the world. Despite the availability of evidence-based acute stroke interventions globally, uptake in low-middle income countries (LMIC) such as Ghana is uncertain. This study aimed to identify and evaluate available acute stroke services in Ghana and the extent to which these services align with global best practice...
February 2, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28152936/improving-transitions-of-care-through-implementation-of-a-standardized-handoff-at-a-comprehensive-cancer-center
#17
Mohamed Ait Aiss, Helene P Phu, Lakeisha R Day, Varkey Abraham, Karen Chen, Mejia Rodrigo, Shehla Razvi, Carmen E Gonzalez, Norman Brito-Dellan, Srinivas Banala, David Rubio, Nicole Vaughan-Adams, Debra S Ruiz, Tan Jens, Charles F Levenback, Michael M Frumovitz, Behrouz Zand, Carmelita P Escalante
: 242 Background: Communication failures cause two-thirds of sentinel events in hospitals. These adverse occurrences are often both fatal and preventable. Consequently, improving the quality of handoffs has been identified by multiple accreditation constituents as a top priority patient safety goal. This project was part of an institutional initiative to standardize handoffs among physicians, trainees, and midlevel providers. METHODS: Four subgroups were identified as pilot areas: Gynecologic Oncology (Gyn Onc) fellows to nocturnalists, Surgical Oncology fellows, Pediatric Oncology residents and fellows, and Emergency Center attending staff to inpatient hospitalists...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152800/acute-hospitalizations-in-cancer-patients-treated-with-definitive-radiotherapy-a-retrospective-cohort-study-with-implications-for-an-urgent-care-clinic
#18
Peter Edward Gabriel, Daniel Owen, Melody Ju Xu, Charles B Simone, John Peter Plastaras, John Paul Christodouleas, Wei-Ting Hwang, Neha Vapiwala
: 312 Background: Reasons for hospitalizations in patients undergoing curative-intent radiotherapy (RT) have not been well characterized previously. Implementation of urgent cancer care clinics could decrease rates of hospitalization, but the reasons for acute visits must be better understood. This retrospective cohort study investigates emergency department (ED) visits or admissions in patients treated with definitive RT. METHODS: Under an IRB-approved protocol, the cohort was defined as all consecutive patients >=18 yo who began RT (RTSTART) between 7/1/11 and 12/31/13 for nonmetastatic disease with curative intent...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28151526/-pre-hospital-management-of-patients-with-chest-pain-and-or-dyspnoea-of-cardiac-origin
#19
Farzin Beygui, Maaret Castren, Natale Daniele Brunetti, Fernando Rosell-Ortiz, Michael Christ, Uwe Zeymer, Kurt Huber, Fredrik Folke, Leif Svensson, Hector Bueno, Arnoud Van't Hof, Nikolaos Nikolaou, Lutz Nibbe, Sandrine Charpentier, Eva Swahn, Marco Tubaro, Patrick Goldstein
Chest pain and acute dyspnoea are frequent causes of emergency medical services activation. The pre-hospital management of these conditions is heterogeneous across different regions of the world and Europe, as a consequence of the variety of emergency medical services and absence of specific practical guidelines. This position paper focuses on the practical aspects of the pre-hospital treatment on board and transfer of patients taken in charge by emergency medical services for chest pain and dyspnoea of suspected cardiac aetiology after the initial assessment and diagnostic work-up...
2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28145035/the-epidemiology-of-long-stay-patients-in-a-university-teaching-hospital
#20
Kim O'Sullivan, Johan Martensson, Raymond Robbins, K J Farley, Doug Johnson, Daryl Jones
BACKGROUND: Patients admitted to acute care hospitals may have multiple co-morbidities, and a small proportion may stay a protracted period. AIMS: To assess the proportion of hospital patients who are long stay (≥14 days), evaluate associations with baseline variables and subsequent in-patient morbidity and mortality. METHODS: Retrospective observational study of patients aged ≥ 18 years staying in hospital for at least 24 hr between 1-7-2013 and 30-6-2014...
February 1, 2017: Internal Medicine Journal
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