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Emergency department observation unit

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https://www.readbyqxmd.com/read/28812025/baseline-characteristics-of-the-paediatric-observation-priority-score-in-emergency-departments-outside-its-centre-of-derivation
#1
Damian Roland, Fawaz Arshad, Tim Coats, Ffion Davies
OBJECTIVES AND BACKGROUND: Scoring systems in Emergency Departments (EDs) are rarely validated. This study aimed to examine the Paediatric Observation Priority Score (POPS), a method of quantifying patient acuity, in EDs in the United Kingdom, and determine baseline performance characteristics. METHODS: POPS was implemented in 4 EDs for children (ages of 0 to 16) with participants grouped into 3 categories: discharged from ED, discharged but with return within 7 days, and admitted for less or more than 24 hours...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28811209/prevalence-of-pulmonary-embolism-in-patients-presenting-to-the-emergency-department-with-syncope
#2
Alison Frizell, Nicole Fogel, Jacob Steenblik, Margaret Carlson, Joseph Bledsoe, Troy Madsen
OBJECTIVES: A recent study reported a high prevalence of pulmonary embolism (PE) among patients admitted with syncope. We sought to determine whether these findings were validated in our patient population. METHODS: We performed a retrospective, secondary analysis of prospectively gathered data from patients presenting with syncope to an academic emergency department (ED) from July 2010 to December 2015. We analyzed baseline information from the time of the ED visit, recorded outcomes during the hospital stay, and contacted patients by phone at least 30days after the ED visit...
July 31, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28810975/adaptation-of-screening-brief-intervention-referral-to-treatment-to-active-duty-military-personnel-in-an-emergency-department-findings-from-a-formative-research-study
#3
Megan Holt, Mark Reed, Susan I Woodruff, Gerard DeMers, Michael Matteucci, Suzanne L Hurtado
BACKGROUND: The transient nature of military life coupled with environmental and psychosocial stressors increase the risk for alcohol misuse and abuse among active duty (AD) military service members and recent epidemiological studies demonstrate high rates of heavy drinking among AD personnel. Over the past decade, Department of Defense health care systems have observed increases in the utilization of substance use services among military personnel demobilizing from Operation Enduring Freedom and Operation Iraqi Freedom...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810888/hospitalisation-in-an-emergency-department-short-stay-unit-compared-to-an-internal-medicine-department-is-associated-with-fewer-complications-in-older-patients-an-observational-study
#4
Camilla Strøm, Talie Khadem Mollerup, Laurits Schou Kromberg, Lars Simon Rasmussen, Thomas Andersen Schmidt
BACKGROUND: Older patients are at particular risk of experiencing adverse events during hospitalisation. OBJECTIVE: To compare the frequencies and types of adverse events during hospitalisation in older persons acutely admitted to either an Emergency Department Short-stay Unit (SSU) or an Internal Medicine Department (IMD). METHODS: Observational study evaluating adverse events during hospitalisation in non-emergent, age-matched, internal medicine patients ≥75 years, acutely admitted to either the SSU or the IMD at Holbaek Hospital, Denmark, from January to August, 2014...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28807040/management-of-upper-gastrointestinal-bleeding-in-emergency-departments-from-bleeding-symptoms-to-diagnosis-a-prospective-multicenter-observational-study
#5
Pierre-Clément Thiebaud, Youri Yordanov, Jacques-Emmanuel Galimard, Pierre-Alexis Raynal, Sébastien Beaune, Laurent Jacquin, François-Xavier Ageron, Dominique Pateron
BACKGROUND: Upper gastrointestinal bleeding (UGB) is common in emergency departments (EDs) and can be caused by many eso-gastro-duodenal lesions. Most available epidemiological data and data on the management of UGB comes from specialized departments (intensive care units or gastroenterology departments), but little is known from the ED perspective. We aimed to determine the distribution of symptoms revealing UGB in EDs and the hemorrhagic lesions identified by endoscopy. We also describe the characteristics of patients consulting for UGB, UGB management in the ED and patients outcomes...
August 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28803163/-hirschsprung-associated-enterocolitis-observational-study-in-a-paediatric-emergency-care-unit
#6
Margarita Sellers, Clara Udaondo, Bárbara Moreno, Gonzalo Martínez-Alés, Jesús Díez, Leopoldo Martínez, María de Ceano-Vivas
INTRODUCTION: Hirschsprung-associated enterocolitis is a significant cause of morbidity and mortality in infants with Hirschsprung's disease. The fact that the symptoms are so variable and unspecific leads to a slow or incorrect diagnosis. The purpose of this study is to identify clinical factors associated with the diagnosis, as well as to evaluate the subsequent management of children with suspected Hirschsprung-associated enterocolitis in a paediatric emergency department. MATERIAL AND METHODS: A retrospective descriptive study was conducted on patients with Hirschsprung's disease who were seen in a paediatric emergency department between April 2011 and November 2015 due to clinical symptoms compatible with enterocolitis...
August 9, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28799452/syncope-current-knowledge-uncertainties-and-strategies-for-management-optimisation-in-the-emergency-department
#7
Filippo Numeroso, Gianluigi Mossini, Giuseppe Lippi, Gianfranco Cervellin
Admission rates and expenditures for syncope remain high. This unsatisfactory management could be due to several factors, including lack of evidence-based strategy, poor accuracy of clinical decision rules, difficulty in disseminating guidelines, as well as uncertainties concerning management of intermediate-risk patients and role of observation protocols and syncope units. To optimise management, it has been proposed to adopt a pragmatic, symptoms-based definition of syncope and a classification related to the underlying mechanism rather than suspected aetiology...
August 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28796559/improvements-in-patient-and-health-system-outcomes-using-an-integrated-oncology-and-palliative-medicine-approach-on-a-solid-tumor-inpatient-service
#8
Richard F Riedel, Kim Slusser, Steve Power, Christopher A Jones, Thomas W LeBlanc, Arif H Kamal, Devi Desai, Deborah Allen, Yinxi Yu, Steven Wolf, Anthony N Galanos
PURPOSE: Early palliative care (PC) improves outcomes for outpatients with advanced cancer. Its effect on hospitalized patients with cancer is unknown. Herein, we report on the influence of a novel, fully integrated inpatient medical oncology and PC partnership at a tertiary medical center during its first year of implementation. METHODS: We conducted a retrospective, longitudinal, pre- and postintervention cohort study at Duke University Hospital. Pre- and postintervention cohorts were defined as all patients admitted to the solid tumor inpatient service from September 1, 2009, to June 30, 2010, and September 1, 2011 to June 30, 2012, respectively...
August 10, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28768699/use-of-a-23-hour-emergency-department-observation-unit-for-the-management-of-patients-with-toxic-exposures
#9
Rupeng Mong, Gabriel Joseph Arciaga, Hock Heng Tan
BACKGROUND: A significant proportion of patients with toxic exposures presenting to the ED require admission. However, most will improve within 24 hours, and so could potentially be managed in a short-stay observation unit. We describe the management and outcomes of these patients in a 23-hour ED observation unit (EDOU). METHODS: A retrospective chart review of all patients with toxic exposures admitted to the EDOU in Singapore between 1 April 2013 and 31 March 2015 was performed...
August 2, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28763872/-research-of-the-biomarkers-in-pulmonary-and-extrapulmonary-acute-respiratory-distress-syndrome
#10
Q Yang, Z Q Li, H B Lan, S S Xiong, S S Wang, C S Yan
Objective: To explore the biomarkers that applied to pulmonary acute respiratory distress syndrome (ARDS) and extrapulmonary ARDS respectively. Methods: A total of 49 eligible patients with ARDS were selected from Department of Respiratory intensive care unite (ICU) , Department of General ICU and Department of Emergency ICU, the Second Affiliated Hospital of Nanchang University, during April 2015 and February 2016, and divided into pulmonary ARDS group (n=26) and extrapulmonary ARDS group (n=23) according to primary causes...
July 11, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28763181/-triage-duration-times-a-prospective-descriptive-study-in-a-level-1%C3%A2-emergency-department
#11
Chiara Sanson, Monica Gandar, Roberta Aloisi
OBJECTIVE: To analyze nursing complexity level and its relationship with mortality and length of stay. METHOD: Observational study carried out between 1/06/2014 to 21/06/2015 at High Dependency Unit of an Italian University Hospital. The nursing needs and the Index of Caring Complexity (Indice di Complessità Assistenziale, ICA) were collected following the "Modello delle Prestazioni Infermieristiche". RESULTS: Data from 506 patients were collected for a maximum of 4 days of hospital stay (1,436 data collection)...
April 2017: Professioni Infermieristiche
https://www.readbyqxmd.com/read/28757746/characteristics-and-outcomes-of-patients-with-emergency-department-revisits-within-72-hours-and-subsequent-admission-to-the-intensive-care-unit
#12
I-Ting Tsai, Cheuk-Kwan Sun, Chao-Sung Chang, Kuo-Hsin Lee, Chih-Yu Liang, Chih-Wei Hsu
OBJECTIVE: This study aimed to investigate the characteristics and outcomes of patients with emergency department (ED) revisits within 72 hours and subsequent admission to the intensive care unit (ICU). MATERIALS AND METHODS: The medical records of all adult patients revisiting the ED of a single tertiary referral medical center with ICU admissions between January 2012 and September 2014 were reviewed in terms of patient characteristics, clinical manifestations, diagnoses, triage according to the Taiwan Triage and Acuity Scale, causes of revisits, and mortality...
October 2016: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28748625/multiple-risk-factor-counseling-to-promote-heart-healthy-lifestyles-in-the-chest-pain-observation-unit-pilot-randomized-controlled-trial
#13
David A Katz, Mark Graber, Patricia Lounsbury, Mark W Vander Weg, Emily K Phillips, Christina Clair, Phillip A Horwitz, Xueya Cai, Alan J Christensen
OBJECTIVE: Admission to the chest pain observation unit (CPOU) may be an advantageous time for patients to consider heart-healthy lifestyle changes while undergoing diagnostic evaluation to rule out myocardial ischemia. The aim of this pragmatic trial was to assess the effectiveness of a multiple risk factor intervention in changing CPOU patients' health beliefs and readiness to change health behaviors. A secondary aim was to obtain preliminary estimates of the intervention's effect on diet, physical activity, and smoking...
July 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28740667/discordance-of-physician-clinical-judgment-vs-pneumonia-severity-index-psi-score-to-admit-patients-with-low-risk-community-acquired-pneumonia-a-prospective-multicenter-study
#14
Pedro J Marcos, Marcos I Restrepo, Francisco J González-Barcala, Nilam J Soni, Iria Vidal, Pilar Sanjuàn, Diego Llinares, Lucía Ferreira-Gonzalez, Carlos Rábade, Isabel Otero-González, Pedro Marcos, Héctor Verea-Hernando
BACKGROUND: The relationship between clinical judgment and the pneumonia severity index (PSI) score in deciding the site of care for patients with community-acquired pneumonia (CAP) has not been well investigated. The objective of the study was to determine the clinical factors that influence decision-making to hospitalize low-risk patients (PSI ≤2) with CAP. METHODS: An observational, prospective, multicenter study of consecutive CAP patients was performed at five hospitals in Spain...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28734637/-asthma-and-heroin-use
#15
Michel Underner, Jean Perriot, Gérard Peiffer, Nematollah Jaafari
INTRODUCTION: Heroin use can be responsible for many respiratory complications including asthma. OBJECTIVES: Systematic literature review of data on asthma in heroin users. DOCUMENTARY SOURCES: Medline(®), on the period 1980-2017 with the following keywords: keywords: "asthma" or "bronchospasm" and "heroin" or "opiate" or "opiates", limits "title/abstract"; the selected languages were English or French. Among 97 articles, 67 abstracts have given use to a dual reading to select 23 studies...
July 19, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#16
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
July 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28718257/risk-factors-for-heat-related-deaths-during-the-june-2015-heat-wave-in-karachi-pakistan
#17
Syed Ghazanfar Saleem, Tehreem Ansari, Ashraf Shamshad Ali, Sara Fatima, Mariam Hassan Rizvi, Muhammad Abdul Samad
BACKGROUND: Mortality as a consequence of heat related illness is a public health concern. Emergency department (ED) experiences increased patients' flow and decreased survival as a consequence of heat stroke during the episodes of heat wave. The present study was conducted to identify the risk factors for mortality among victims of heat wave (17th - 23rd June), 2015 evaluated in the Emergency Department of The Indus Hospital (TIH), Karachi. METHODS: In this cross-sectional study data was retrospectively collected...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28716670/nationwide-study-on-peripheral-venous-catheter-associated-bloodstream-infections-in-internal-medicine-departments
#18
María Guembe, María Jesús Pérez-Granda, José Antonio Capdevila, José Barberán, Blanca Pinilla, Pablo Martín-Rabadán, Emilio Bouza
BACKGROUND: The use of peripheral venous catheters (PVCs) has increased outside the intensive care unit, as have rates of peripheral venous catheter associated-bloodstream infection (PVC-BSI). The internal medicine department (IMD) is one of the main wards where PVCs are widely used. However, data on the incidence of PVC-BSI and its characteristics in the IMD are scarce. AIM: Our objective was to assess the incidence of PVC-BSI episodes detected in IMDs in Spain...
July 14, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28711130/care-of-traumatic-conditions-in-an-observation-unit
#19
REVIEW
Christopher G Caspers
Patients presenting to the emergency department with certain traumatic conditions can be managed in observation units. The evidence base supporting the use of observation units to manage injured patients is smaller than the evidence base supporting the management of medical conditions in observation units. The conditions that are eligible for management in an observation unit are not limited to those described in this article, and investigators should continue to identify types of conditions that may benefit from this type of health care delivery...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28711128/care-of-respiratory-conditions-in-an-observation-unit
#20
REVIEW
Margarita E Pena, Viviane M Kazan, Michael N Helmreich, Sharon E Mace
In adults, respiratory disorders are the second most frequent diagnoses treated in emergency department observation units (EDOUs) and account for the most frequent indication for placement of pediatric patients into an EDOU. With appropriate patient selection, chronic obstructive pulmonary disease exacerbations, and community-acquired pneumonia can be managed in the EDOU. EDOU management results in equivalent or better outcomes than inpatient care with decreased length of stay, increased patient satisfaction, lower cost and in some studies decreased mortality...
August 2017: Emergency Medicine Clinics of North America
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