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https://www.readbyqxmd.com/read/28330460/sepsis-recognition-in-the-emergency-department-impact-on-quality-of-care-and-outcome
#1
Marius Morr, Alexander Lukasz, Eva Rübig, Hermann Pavenstädt, Philipp Kümpers
BACKGROUND: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED). METHODS: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28329477/second-degree-burn-to-mustard-powder
#2
Danielle M Tartar, Victoria R Sharon
Mustard seeds and powder are commonly used inhomeopathic and traditional medicines, in whichthey are believed to have both anti-microbial andanti-inflammatory properties. They are thereforeutilized in the treatment of conditions ranging fromarthritis to respiratory congestion. Herein, we presenta patient with a second degree burn who usedmustard powder in the form of a mustard plasterto treat chest congestion. She experienced seconddegree burn wounds to the lower neck and chest, andrecovery with complete re-epithelialization followingtopical silver sulfadiazine, liberal emollient therapy,and triamcinolone ointment...
January 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28325015/estimating-apnea-hypopnea-index-only-from-an-accelerometer-signal-measured-on-the-chest
#3
Yasunobu Yamauchi, Sawa Fuke, Kanako Nakayama, Jun'ya Takakura, Hitoshi Usuniwa, Keiji Koike, Eriko Ouchi, Nagafumi Doi
Sleep apnea syndrome (SAS) is becoming a public concern in the field of preventive medicine because it causes more deleterious diseases. However, the majority of patients are not diagnosed and an easier-to-use, lower-cost device for screening of SAS is needed compared to the existing multimodal devices. In this study, we developed and tested a method to estimate the apnea-hypopnea index (AHI), which is the measure of severity of SAS, only from an accelerometer signal measured on the chest. Simultaneous recordings of overnight sleep polysomnography and accelerometer signal were conducted for 50 participants...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28323084/integration-of-in-hospital-cardiac-arrest-contextual-curriculum-into-a-basic-life-support-course-a-randomized-controlled-simulation-study
#4
Elizabeth A Hunt, Jordan M Duval-Arnould, Nnenna O Chime, Kareen Jones, Michael Rosen, Merona Hollingsworth, Deborah Aksamit, Marida Twilley, Cheryl Camacho, Daniel P Nogee, Julianna Jung, Kristen Nelson-McMillan, Nicole Shilkofski, Julianne S Perretta
OBJECTIVE: To compare resuscitation performance on simulated in-hospital cardiac arrests after traditional American Heart Association (AHA) Healthcare Provider Basic Life Support course (TradBLS) versus revised course including in-hospital skills (HospBLS). DESIGN: Prospective, randomized, controlled curriculum evaluation. SETTING: Johns Hopkins Medicine Simulation Center. SUBJECTS: One hundred twenty-two first year medical students divided into fifty-nine teams...
March 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28302497/building-community-through-a-pulmcc-twitter-chat-to-advocate-for-pulmonary-critical-care-and-sleep
#5
Christopher L Carroll, Kristi Bruno, Pradeep Ramachandran
BACKGROUND: Social media sites such as Twitter can significantly enhance education and advocacy efforts. In 2013, the American College of Chest Physicians (CHEST) launched a Twitter chat series using the hashtag #pulmcc to educate and advocate for topics related to pulmonary, critical care and sleep medicine. METHOD: To assess the reach of these chats, we analyzed the metrics using Symplur analytics, and compared data from each chat, as well as participant data...
March 13, 2017: Chest
https://www.readbyqxmd.com/read/28295894/cost-effectiveness-analysis-appraisal-and-application-an-emergency-medicine-perspective
#6
Michael D April, Brian P Murray
Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policy-makers have any formal training in CEA methodology...
March 10, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#7
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28290929/advanced-trauma-life-support-time-standards
#8
Andrew B Hall, Felix S Boecker, Joseph M Shipp, Dennis Hanseman
INTRODUCTION: Trauma readiness is critical to military medicine. Without medical centers that include persistent volumes of trauma, simulation has become the means to maintain and practice those skills. To create those simulations, standards for both design and metrics to evaluate practitioners are required. MATERIALS AND METHODS: Forty-four traumas were monitored and times to completion of the various steps of Advanced Trauma Life Support were recorded and tabulated...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286840/comparing-the-quality-and-complications-of-tube-thoracostomy-by-emergency-medicine-and-surgery-residents-a-cohort-study
#9
Parvin Kashani, Sepideh Harati, Ali Shirafkan, Alireza Amirbeigi, Hamid Reza Hatamabadi
INTRODUCTION: Tube thoracostomy complications depend on the operator's skill, patients' general condition and the place in which the procedure is done. The present study aimed to compare the quality and complications of tube thoracostomy carried out by emergency medicine residents (EMRs) and surgery residents (SRs). METHODS: This cohort study was conducted on 18-60 years old trauma patients in need of tube thoracostomy presenting to two academic emergency departments...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286835/role-of-feedback-during-evaluation-in-improving-emergency-medicine-residents-skills-an-experimental-study
#10
Ali Vafaei, Kamran Heidari, Mohammad-Ali Hosseini, Mostafa Alavi-Moghaddam
INTRODUCTION: Evaluation of students' learning in clinical education system is one of the most important and challenging issues that facilities in this field have been facing. The present study aimed to evaluate the role of feedback during evaluation in increasing emergency medicine residents' clinical skills. METHOD: The present experimental study was performed on all second year emergency medicine residents of two educational hospitals, Tehran, Iran, with switching replications design and before-after method...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286826/screening-characteristics-of-bedside-ultrasonography-in-confirming-endotracheal-tube-placement-a-diagnostic-accuracy-study
#11
Hamid Zamani Moghadam, Mohamad Davood Sharifi, Hasan Rajabi, Mojtaba Mousavi Bazaz, Ali Alamdaran, Niazmohammad Jafari, Seyed Amir Masoud Hashemian, Morteza Talebi Deloei
INTRODUCTION: Confirmation of proper endotracheal tube placement is one of the most important and lifesaving issues of tracheal intubation. The present study was aimed to evaluate the accuracy of tracheal ultrasonography by emergency residents in this regard. METHOD: This was a prospective, cross sectional study for evaluating the diagnostic accuracy of ultrasonography in endotracheal tube placement confirmation compared to a combination of 4 clinical confirmation methods of chest and epigastric auscultation, direct laryngoscopy, aspiration of the tube, and pulse oximetry (as reference test)...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28283339/prinzmetal-angina-coronary-vasospasm-associated-with-5-fluorouracil-chemotherapy
#12
Maxim Ben-Yakov, Amal Mattu, William J Brady, Sarah B Dubbs
Several chemotherapeutic agents are known to be cardiotoxic. One of them, 5-fluorouracil (5-FU), has been associated with coronary ischemia and reversible vasospasm. In this report, we describe a 54-year-old man with rectal cancer who developed chest pain during 5-FU infusion. His initial electrocardiogram (ECG), obtained while he was experiencing chest pain, showed hyperacute T waves in the anterolateral leads. Those waves disappeared along with the chest pain after administration of sublingual nitroglycerine...
March 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28282354/diagnostic-evaluation-of-nontraumatic-chest-pain-in-athletes
#13
Byron Moran, Sean Bryan, Ted Farrar, Chris Salud, Gary Visser, Raymond Decuba, Deborah Renelus, Tyler Buckley, Michael Dressing, Nicholas Peterkin, Eric Coris
This article is a clinically relevant review of the existing medical literature relating to the assessment and diagnostic evaluation for athletes complaining of nontraumatic chest pain. The literature was searched using the following databases for the years 1975 forward: Cochrane Database of Systematic Reviews; CINAHL; PubMed (MEDLINE); and SportDiscus. The general search used the keywords chest pain and athletes. The search was revised to include subject headings and subheadings, including chest pain and prevalence and athletes...
March 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/28280896/surgeon-manipulated-live-surgery-video-recording-apparatuses-personal-experience-and-review-of-literature
#14
REVIEW
Emin Kapi
BACKGROUND: Visual recording of surgical procedures is a method that is used quite frequently in practices of plastic surgery. While presentations containing photographs are quite common in education seminars and congresses, video-containing presentations find more favour. For this reason, the presentation of surgical procedures in the form of real-time video display has increased especially recently. Appropriate technical equipment for video recording is not available in most hospitals, so there is a need to set up external apparatus in the operating room...
March 9, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28279620/asystole-during-direct-laryngoscopy-for-vocal-fold-injection-in-a-healthy-patient
#15
Zahrah Taufique, Gregory R Dion, Milan R Amin
OBJECTIVES: This study aims (1) to present a case of asystole during direct laryngoscopy in an otherwise healthy patient at an outpatient surgery center and (2) to review literature on cardiac complications, specifically asystole and bradycardia, during direct laryngoscopy. METHODS: A 67-year-old woman with no prior cardiac history underwent induction with succinylcholine and remifentanil for direct laryngoscopy and vocal fold augmentation. During suspension laryngoscopy, the patient became asystolic, and advanced care life support measures were started...
March 6, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28279271/giants-in-chest-medicine-paul-m-o-byrne-mbbch-fccp
#16
EDITORIAL
Sally E Wenzel
No abstract text is available yet for this article.
March 2017: Chest
https://www.readbyqxmd.com/read/28274529/japanese-herbal-medicine-induced-pneumonitis-a-review-of-73-patients
#17
Yasunori Enomoto Md, Yutaro Nakamura Md PhD, Noriyuki Enomoto Md PhD, Tomoyuki Fujisawa Md PhD, Naoki Inui Md PhD, Takafumi Suda
BACKGROUND: The number of reports concerning Japanese herbal medicine (JHM)-induced pneumonitis has increased. However, comprehensive data are lacking in this regard, and the clinical characteristics of the disease remain unclear. METHODS: A literature review was performed using PubMed and Ichushi-Web-the database of the Japan Medical Abstracts Society-to identify articles published between 1996 and 2015 describing patients with JHM-induced pneumonitis. The final cohort included 73 patients in 59 articles (7 in English; 52 in Japanese)...
March 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28274219/a-household-survey-of-medicine-storage-practices-in-gondar-town-northwestern-ethiopia
#18
Fitsum Sebsibe Teni, Abdrrahman Shemsu Surur, Assefa Belay, Dawit Wondimsigegn, Dessalegn Asmelashe Gelayee, Zewdneh Shewamene, Befikadu Legesse, Eshetie Melese Birru
BACKGROUND: Household surveys are crucial to get accurate information on how medicines are acquired, and used by consumers, as they provide the best evidence in the area. The objective of this study was to document household medicine storage practices in Gondar town, northwestern Ethiopia. METHODS: A cross-sectional household survey was conducted from April 5 to May 6, 2015. In the study, 809 households were surveyed from four sub-cities in the town selected through multistage sampling with 771 included in the final analysis...
March 9, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28270128/the-effect-of-referral-templates-on-out-patient-quality-of-care-in-a-hospital-setting-a-cluster-randomized-controlled-trial
#19
Henrik Wåhlberg, Per Christian Valle, Siri Malm, Øistein Hovde, Ann Ragnhild Broderstad
BACKGROUND: The assessment of quality of care is an integral part of modern medicine. The referral represents the handing over of care from the general practitioner to the specialist. This study aimed to assess whether an improved referral could lead to improved quality of care. METHODS: A cluster randomized trial with the general practitioner surgery as the clustering unit was performed. Fourteen surgeries in the area surrounding the University Hospital of North Norway Harstad were randomized stratified by town versus countryside location...
March 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28259149/focused-cardiac-ultrasound-by-unselected-residents-the-challenges
#20
Vidar Ruddox, Ingvild Billehaug Norum, Thomas Muri Stokke, Thor Edvardsen, Jan Erik Otterstad
BACKGROUND: Focus Cardiac Ultrasound (FoCUS) performed by internal medicine residents on call with 2 h of training can provide a means for ruling out cardiac disease, but with poor sensitivity. The purpose of the present study was to evaluate diagnostic usefulness as well as diagnostic accuracy of FoCUS following 4 h of training. METHODS: All residents on call were given a 4-h training course with an additional one-hour training course after 6 months. They were asked to provide a pre- and post-FoCUS diagnosis, with the final diagnosis at discharge as reference...
March 4, 2017: BMC Medical Imaging
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