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Emergency department observation unit

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https://www.readbyqxmd.com/read/29350674/takotsubo-cardiomyopathy-in-an-ultra-centenarian-woman
#1
Laura Bonfanti, Silvia Buratti, Luigi Vignali, Giuseppe Lippi, Franco Masini, Michele Bianconcini, Gianfranco Cervellin
A 101 years-old woman was admitted to our Emergency Department (ED) for acute dyspnea which onset nearly two hours before presentation. She had been on hydrochlorothyazyde-amiloride therapy due to mild hypertension. No other relevant features were present in the clinical history. The old lady had never been admitted to the hospital, and she was still living alone. A few days before hospital admission, one of the daughters became ill, so that a caregiver was paid for assisting her 12/24. This new circumstance was reluctantly accepted by the old lady...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29347982/emergency-department-hyperoxia-is-associated-with-increased-mortality-in-mechanically-ventilated-patients-a-cohort-study
#2
David Page, Enyo Ablordeppey, Brian T Wessman, Nicholas M Mohr, Stephen Trzeciak, Marin H Kollef, Brian W Roberts, Brian M Fuller
BACKGROUND: Providing supplemental oxygen is fundamental in the management of mechanically ventilated patients. Increasing amounts of data show worse clinical outcomes associated with hyperoxia. However, these previous data in the critically ill have not focused on outcomes associated with brief hyperoxia exposure immediately after endotracheal intubation. Therefore, the objectives of this study were to evaluate the impact of isolated early hyperoxia exposure in the emergency department (ED) on clinical outcomes among mechanically ventilated patients with subsequent normoxia in the intensive care unit (ICU)...
January 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29342203/biological-pathways-underlying-the-association-of-red-cell-distribution-width-and-adverse-clinical-outcome-results-of-a-prospective-cohort-study
#3
Giedre Zurauskaite, Marc Meier, Alaadin Voegeli, Daniel Koch, Sebastian Haubitz, Alexander Kutz, Luca Bernasconi, Andreas Huber, Mario Bargetzi, Beat Mueller, Philipp Schuetz
BACKGROUND: Red cell distribution width (RDW) predicts disease outcome in several patient populations, but its prognostic value in addition to other disease parameters in unselected medical inpatients remains unclear. Our aim was to investigate the association of admission RDW levels and mortality adjusted for several disease pathways in unselected medical patients from a previous multicenter study. METHODS: We included consecutive adult, medical patients at the time point of hospital admission through the emergency department into this observational, cohort study...
2018: PloS One
https://www.readbyqxmd.com/read/29340508/-space-time-and-power-in-hospital-health-care-contributions-based-on-the-ethnography-of-an-obstetric-center
#4
María Guadalupe García, María Laura Recoder, Susana Margulies
This paper presents the results of an ethnographic study of an obstetric center within a hospital of Greater Buenos Aires and an analysis of the spatio-temporal dimension of hospital care. The fieldwork, carried out between 2007 and 2011, followed the everyday dynamics of the hospital and included observation in the obstetrics unit (waiting areas, the obstetric center where births and emergencies receive care, and the ambulatory care, ultrasound, and hospitalization rooms, among others) as well as spaces such as the appointments and statistics offices, the office of social services, the central hall, the pharmacy, and hallway waiting areas...
July 2017: Salud Colectiva
https://www.readbyqxmd.com/read/29336989/are-geriatric-patients-placed-in-an-emergency-department-observation-unit-on-a-chest-pain-pathway-more-likely-than-non-geriatric-patients-to-re-present-to-the-hospital-within-30%C3%A2-days
#5
Christopher C Gruenberg, Alan H Breaud, James H Liu, Patricia M Mitchell, James A Feldman, Kerrie P Nelson, Joseph H Kahn
BACKGROUND: Emergency department observation units (EDOUs) are used frequently for low-risk chest pain evaluations. OBJECTIVE: The purpose of this study was to determine whether geriatric compared to non-geriatric patients evaluated in an EDOU for chest pain have differences in unscheduled 30-day re-presentation, length of stay (LOS), and use of stress testing. METHODS: We conducted an exploratory, retrospective, cohort study at a single academic, urban ED of all adult patients placed in an EDOU chest pain protocol from June 1, 2014 to May 31, 2015...
January 11, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29335822/emergency-department-throughput-an-intervention
#6
Nowreen Haq, Rona Stewart-Corral, Eric Hamrock, Jamie Perin, Waseem Khaliq
Shortening emergency department (ED) boarding time and managing hospital bed capacity by expediting the inpatient discharge process have been challenging for hospitals nationwide. The objective of this study is was to explore the effect of an innovative prospective intervention on hospital workflow, specifically on early inpatient discharges and the ED boarding time. The intervention consisted of a structured nursing "admission discharge transfer" (ADT) protocol receiving new admissions from the ED and helping out floor nursing with early discharges...
January 15, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29332470/a-school-based-neuromuscular-training-program-and-sport-related-injury-incidence-a-prospective-randomized-controlled-clinical-trial
#7
Kim D Barber Foss, Staci Thomas, Jane C Khoury, Gregory D Myer, Timothy E Hewett
CONTEXT:   An estimated 40 million school-aged children (age range = 5-18 years) participate annually in sports in the United States, generating approximately 4 million sport-related injuries and requiring 2.6 million emergency department visits at a cost of nearly $2 billion. OBJECTIVE:   To determine the effects of a school-based neuromuscular training (NMT) program on sport-related injury incidence across 3 sports at the high school and middle school levels, focusing particularly on knee and ankle injuries...
January 13, 2018: Journal of Athletic Training
https://www.readbyqxmd.com/read/29332000/how-good-are-doctors-at-introducing-themselves-hellomynameis
#8
Peter Gillen, Sue Faye Sharifuddin, Muireann O'Sullivan, Alison Gordon, Eva M Doherty
BACKGROUND: This explorative study was triggered by the '#hellomynameis' campaign initiated by Dr Kate Granger in the UK. Our objectives were twofold: first, to measure rates of introduction in an Irish hospital setting by both consultant and non-consultant hospital doctors. Second to establish whether such practices were associated with patient perceptions of the doctor/patient interaction. METHOD: A patient 'exit' survey was undertaken following doctor-patient consultations in both acute (surgical and medical assessment units) and elective settings (outpatient clinics)...
January 13, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29324936/the-impact-of-lung-perfusion-scintigraphy-in-the-emergency-management-of-patients-with-suspected-pulmonary-embolism
#9
Cristina Ferrari, Alessandra Cimino, Giacomo Bianco, Francesca Iuele, Alessandra Di Palo, Margherita Fanelli, Artor Niccoli-Asabella, Giuseppe Rubini
OBJECTIVE: Pulmonary Embolism (PE) is an emergency condition that requires immediate treatment. As the symptoms and the risk factors are nonspecific, PE differential diagnosis is often required. Even if angio-CT is considered the gold standard for PE diagnosis, the frequent allergic condition and/or chronic renal failure of patients make, in most cases, not possible the use of contrast enhancement in emergency with even more increasing use of Lung Perfusion Scintigraphy (LPS), as a simple and fast examination with no preparation/contraindication...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29322848/inpatient-satisfaction-at-different-public-sector-hospitals-of-a-metropolitan-city-in-pakistan-a-comparative-cross-sectional-study
#10
Mehwish Hussain, Rehana Rehman, Zia Ikramuddin, Nava Asad, Ayesha Farooq
OBJECTIVE: To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. METHODS: A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance...
January 11, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29321107/can-i-send-this-patient-with-stroke-home-strategies-managing-transient-ischemic-attack-and-minor-stroke-in-the-emergency-department
#11
Bernard P Chang, Sara Rostanski, Joshua Willey, Benjamin Kummer, Eliza Miller, Mitchell Elkind
BACKGROUND: While transient ischemic attack and minor stroke (TIAMS) are common conditions evaluated in the emergency department (ED), there is controversy regarding the most effective and efficient strategies for managing them in the ED. Some patients are discharged after evaluation in the ED and cared for in the outpatient setting, while others remain in an observation unit without being admitted or discharged, and others experience prolonged and potentially costly inpatient admissions...
January 8, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29319593/effects-of-interruptions-on-triage-process-in-emergency-department-a-prospective-observational-study
#12
Kimberly D Johnson, Gordon L Gillespie, Kimberly Vance
For 130 million people seeking emergency treatment in the United States, incomplete or inaccurate triage examination can result in delays, which could compromise patient outcomes. The purpose of this study was to identify triage interruptions and determine how interruptions affect the triage process. A significant difference was seen in triage duration between interrupted and uninterrupted interviews. Understanding the impact of interruptions on patient outcomes will allow nurses and other health care providers to develop interventions to mitigate the impact...
January 9, 2018: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/29314505/daily-home-bnp-monitoring-in-heart-failure-for-prediction-of-impending-clinical-deterioration-results-from-the-home-hf-study
#13
Kenneth McDonald, Richard Troughton, Ulf Dahlström, Henry Dargie, Henry Krum, Peter van der Meer, Theresa McDonagh, John J Atherton, Ken Kupfer, Richard C San George, Mark Richards, Robert Doughty
BACKGROUND: Serial measurement of natriuretic peptides may guide management in heart failure (HF) patients. In previous trials, natriuretic peptides were infrequently monitored, which may undervalue the benefit of this approach. METHODS AND RESULTS: HOME was an adaptive three-arm randomized clinical study to test whether home monitoring of BNP could reduce HF-related death, hospitalization due to acute decompensated HF (ADHF), and ADHF treated with intravenous diuretics in the emergency department or outpatient setting...
January 4, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29306267/role-of-emergency-department-observation-units-in-the-management-of-patients-with-unexplained-syncope-a-critical-review-and-meta-analysis
#14
REVIEW
Filippo Numeroso, Gianluigi Mossini, Giuseppe Lippi, Gianfranco Cervellin
This meta-analysis aimed to establish the role of standardized emergency department (ED) observation protocols in the management of syncopal patients as an alternative to ordinary admission. A systematic electronic literature search was performed to identify randomized controlled trials or observational studies evaluating syncopal patients managed in ED observation units. Data regarding mean length of stay, rate of etiological diagnosis, admission rate, and incidence of short-term serious outcomes were extracted...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29279631/a-clinical-study-on-the-initial-assessment-of-arterial-lactate-and-base-deficit-as-predictors-of-outcome-in-trauma-patients
#15
Rameshbabu Homanna Javali, Prithvishree Ravindra, Akkamahadevi Patil, Madhu Srinivasarangan, Harshit Mundada, S B Adarsh, S Nisarg
Background: Trauma is a leading cause of mortality in India. Outcomes can be improved by early recognition of hemorrhagic shock and expedited management. At present, we rely on traditional vital signs, which are not sensitive measures. Point of care biochemical markers have been emerging as prognostic markers in trauma, but have not been studied in Indian setting. Aims: This study aims to study the association between arterial lactate and base deficit (BD) at emergency department (ED) admission and 24 h outcome in trauma patients at risk of hemodynamic compromise...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29277163/criterion-validity-and-inter-rater-reliability-of-a-palliative-care-screening-tool-for-patients-admitted-to-an-emergency-department-intensive-care-unit
#16
Sabrina Corrêa da Costa Ribeiro, Ricardo Tavares de Carvalho, Juraci Aparecida Rocha, Roger Daglius Dias
OBJECTIVE: The use of palliative care (PC) screening criteria to trigger PC consultations may optimize the utilization of PC services, improve patient comfort, and reduce invasive and futile end-of-life care. The aim of the present study was to assess the criterion validity and inter-rater reliability of a PC screening tool for patients admitted to an emergency department intensive care unit (ED-ICU). METHOD: Observational retrospective study evaluating PC screening criteria based on the presence of advanced diagnosis and the use of two "surprise questions" (traditional and modified)...
December 26, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29275423/alcohol-screening-in-a-national-referral-hospital-an-observational-study-from-qatar
#17
Ayman El-Menyar, Rafael Consunji, Ahammed Mekkodathil, Ruben Peralta, Hassan Al-Thani
BACKGROUND Alcohol consumption is a high-risk factor for several medical disorders and traffic accidents and poses a burden on outpatient clinics and emergency units. We aimed to assess the pattern of alcohol screening among patients in a multicultural setting in a national referral hospital in an Arab Middle-Eastern country. MATERIAL AND METHODS A retrospective analysis was conducted for patients who were screened with blood alcohol concentration (BAC) in the Emergency Department (ED) in the period from January 2009 to December 2012...
December 24, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29274930/immediate-stress-echocardiography-for-low-risk-chest-pain-patients-in-the-emergency-department-a-prospective-observational-cohort-study
#18
Gregory Jasani, Mia Papas, Avkash J Patel, Neil Jasani, Brian Levine, Yuanyuan Zhang, Erik S Marshall
BACKGROUND: Evaluation and disposition of low-risk chest pain (CP) patients in the emergency department (ED) is time consuming and expensive. Low-risk CP often results in hospital admission to rule out myocardial infarction, which leads to additional costs and delays. OBJECTIVE: Our aim was to assess whether an immediate exercise stress echocardiogram (IESE) in the ED will allow safe, efficient, and cost-effective evaluation and discharge of patients with low-risk CP...
December 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29250027/derivation-of-a-three-biomarker-panel-to-improve-diagnosis-in-patients-with-mild-traumatic-brain-injury
#19
W Frank Peacock, Timothy E Van Meter, Nazanin Mirshahi, Kyle Ferber, Robert Gerwien, Vani Rao, Haris Iqbal Sair, Ramon Diaz-Arrastia, Frederick K Korley
Background: Nearly 5 million emergency department (ED) visits for head injury occur each year in the United States, of which <10% of patients show abnormal computed tomography (CT) findings. CT negative patients frequently suffer protracted somatic, behavioral, and neurocognitive dysfunction. Our goal was to evaluate biomarkers to identify mild TBI (mTBI) in patients with suspected head injury. Methods: An observational ED study of head-injured and control patients was conducted at Johns Hopkins University (HeadSMART)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29238804/efficacy-of-high-sensitivity-troponin-t-in-identifying-very-low-risk-patients-with-possible-acute-coronary-syndrome
#20
W Frank Peacock, Brigette M Baumann, Deborah Bruton, Thomas E Davis, Beverly Handy, Christopher W Jones, Judd E Hollander, Alexander T Limkakeng, Abhi Mehrotra, Martin Than, Andre Ziegler, Carina Dinkel
Importance: Physicians need information on how to use the first available high-sensitivity troponin (hsTnT) assay in the United States to identify patients at very low risk for 30-day adverse cardiac events (ACE). Objective: To determine whether a negative hsTnT assay at 0 and 3 hours following emergency department presentation could identify patients at less than 1% risk of a 30-day ACE. Design, Setting, and Participants: A prospective, observational study at 15 emergency departments in the United States between 2011 and 2015 that included individuals 21 years and older, presenting to the emergency department with suspected acute coronary syndrome...
December 13, 2017: JAMA Cardiology
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