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Emergency department observation unit

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https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28711127/care-of-neurologic-conditions-in-an-observation-unit
#6
REVIEW
Matthew A Wheatley, Michael A Ross
As a group, neurologic conditions represent a substantial portion of emergency department (ED) visits. Cerebrovascular disease, headache, vertigo and seizures are all common reasons for patients to seek care in the ED. Patients being treated for each of these conditions are amenable to care in an ED observation unit (EDOU) if they require further diagnostic or therapeutic interventions beyond their ED stay. EDOUs are the ideal setting for patients who require advanced imaging such as MRIs, frequent neuro checks or specialist consultation in order to determine if they require admission or can be discharged home...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28711125/care-of-acute-gastrointestinal-conditions-in-the-observation-unit
#7
REVIEW
Jason J Ham, Edgar Ordonez, R Gentry Wilkerson
The Emergency Department Observation Unit (EDOU) provides a viable alternative to inpatient admission for the management of many acute gastrointestinal conditions with additional opportunities of reducing resource utilization and reducing radiation exposure. Using available evidence-based criteria to determine appropriate patient selection, evaluation, and treatment provides higher-quality medical care and improved patient satisfaction. Discussions of factors involved in creating an EDOU capable of caring for acute gastrointestinal conditions and clinical protocol examples of acute appendicitis, gastrointestinal hemorrhage, and acute pancreatitis provide a framework from which a successful EDOU can be built...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28711124/cardiovascular-conditions-in-the-observation-unit-beyond-chest-pain
#8
REVIEW
Jeremiah D Gaddy, Kathleen T P Davenport, Brian C Hiestand
The first emergency department observation units (EDOUs) focused on chest pain and potential acute coronary syndromes. However, most EDOUs now cover multiple other conditions that lend themselves to protocolized, aggressive diagnostic and therapeutic regimens. In this article, the authors discuss the management of 4 cardiovascular conditions that have been successfully deployed in EDOUs around the country.
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28711123/care-of-the-patient-with-chest-pain-in-the-observation-unit
#9
REVIEW
Joseph B Borawski, Louis G Graff, Alexander T Limkakeng
Care of the patient presenting to an emergency department (ED) with chest pain remains a common yet challenging aspect of emergency medicine. Acute coronary syndrome presents in nonspecific fashion. The development and evolution of the ED-based observation unit has helped to safely assess and diagnose those most at risk for an adverse cardiac event. Furthermore, there are several provocative testing modalities to help assess for coronary artery disease. This article serves to describe and discuss the modern ED-based observation unit approach to patients with chest pain and/or angina equivalents presenting to an ED...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28711121/history-principles-and-policies-of-observation-medicine
#10
REVIEW
Michael A Ross, Michael Granovsky
The history of observation medicine has paralleled the rise of emergency medicine over the past 50 years to meet the needs of patients, emergency departments, hospitals, and the US health care system. Just as emergency departments are the safety net of the health system, observation units are the safety net of emergency departments. The growth of observation medicine has been driven by innovations in health care, an ongoing shift of patients from inpatient to outpatient settings, and changes in health policy...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28709581/trends-in-end-of-life-care-and-healthcare-spending-in-women-with-uterine-cancer
#11
Benjamin Margolis, Ling Chen, Melissa K Accordino, Grace Clarke Hillyer, June Y Hou, Ana I Tergas, William M Burke, Alfred I Neugut, Cande V Ananth, Dawn L Hershman, Jason D Wright
BACKGROUND: High intensity care including hospitalizations, chemotherapy and other interventions at the end of life is costly and often of little value for cancer patients. Little is known about patterns of end of life care and resource utilization for women with uterine cancer. OBJECTIVE: We examined the costs and predictors of aggressive end of life care for women with uterine cancer. METHODS: In this observational cohort study the Surveillance, Epidemiology and End Results-Medicare linked database was used to identify women >65 who died from uterine cancer from 2000-2011...
July 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28705744/the-relationship-between-ocular-trauma-and-substance-abuse-in-emergency-department-patients
#12
Sylvia L Chang, Vaama Patel, John Giltner, Richard Lee, Catherine A Marco
INTRODUCTION: Eye injury is the second most common cause of visual impairment and a leading cause of monocular blindness in the United States. There are approximately 6 million ED visits related to drug use annually, including misuse or abuse of pharmaceuticals and illicit drug use. The purpose of this study was to assess the relationship between ocular trauma and substance abuse among emergency department patients and to assess that relationship with demographic factors, including age and gender...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28705743/the-influence-of-crowding-on-clinical-practice-in-the-emergency-department
#13
I-Min Chiu, Yan-Ren Lin, Yuan-Jhen Syue, Chia-Te Kung, Kuan-Han Wu, Chao-Jui Li
BACKGROUND: This study aimed to clarify the association between the crowding and clinical practice in the emergency department (ED). METHODS: This 1-year retrospective cohort study conducted in two EDs in Taiwan included 70,222 adult non-trauma visits during the day shift between July 1, 2011, and June 30, 2012. The ED occupancy status, determined by the number of patients staying during their time of visit, was used to measure crowding, grouped into four quartiles, and analyzed in reference to the clinical practice...
July 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28702257/the-relationship-between-diabetes-mellitus-and-30-day-readmission-rates
#14
Stephanie Ostling, Jennifer Wyckoff, Scott L Ciarkowski, Chih-Wen Pai, Hae Mi Choe, Vinita Bahl, Roma Gianchandani
BACKGROUND: It is estimated that 9.3% of the population in the United States have diabetes mellitus (DM), 28% of which are undiagnosed. The high prevalence of DM makes it a common comorbid condition in hospitalized patients. In recent years, government agencies and healthcare systems have increasingly focused on 30-day readmission rates to determine the complexity of their patient populations and to improve quality. Thirty-day readmission rates for hospitalized patients with DM are reported to be between 14...
2017: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/28695836/a-case-series-of-imported-malaria-caused-by-plasmodium-falciparum-in-kayseri-and-review-of-literature
#15
Necati Mumcu, Hayati Demiraslan, Ahmet Dündar, Salih Kuk, Süleyman Yazar, Mehmet Doğanay
Malaria is a major worldwide public health problem. In the last years, no domestic cases of malaria have been detected and cases of imported malaria exist only in Turkey. In this study, clinical and laboratory findings of five Plasmodium falciparum (P. falciparum) malaria patients who were admitted to the emergency department between January 2013 and December 2015 were retrospectively presented. One of the patients was an African student, and the other patients had a history of travelling to Africa. Ring formation was observed when Giemsa staining was performed on the blood smears of all patients, and in three patients, P...
June 2017: Türkiye Parazitolojii Dergisi
https://www.readbyqxmd.com/read/28692390/use-of-emergency-department-data-to-monitor-and-respond-to-an-increase-in-opioid-overdoses-in-new-hampshire-2011-2015
#16
Elizabeth R Daly, Kenneth Dufault, David J Swenson, Paul Lakevicius, Erin Metcalf, Benjamin P Chan
OBJECTIVES: Opioid-related overdoses and deaths in New Hampshire have increased substantially in recent years, similar to increases observed across the United States. We queried emergency department (ED) data in New Hampshire to monitor opioid-related ED encounters as part of the public health response to this health problem. METHODS: We obtained data on opioid-related ED encounters for the period January 1, 2011, through December 31, 2015, from New Hampshire's syndromic surveillance ED data system by querying for (1) chief complaint text related to the words "fentanyl," "heroin," "opiate," and "opioid" and (2) opioid-related International Classification of Diseases ( ICD) codes...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28682895/acute-decompensated-heart-failure-in-the-emergency-department-identification-of-early-predictors-of-outcome
#17
Luigi Mario Castello, Luca Molinari, Alessandra Renghi, Elena Peruzzi, Andrea Capponi, Gian Carlo Avanzi, Mario Pirisi
Identification of clinical factors that can predict mortality and hospital early readmission in acute decompensated heart failure (ADHF) patients can help emergency department (ED) physician optimize the care-path and resource utilization.We conducted a retrospective observational study of 530 ADHF patients evaluated in the ED of an Italian academic hospital in 2013.Median age was 82 years, females were 55%; 31.1% of patients were discharged directly from the ED (12.5% after short staying in the observation unit), while 68...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28681948/impact-of-an-acute-surgical-unit-on-patient-outcomes-in-south-australia
#18
Ned Kinnear, Philip Britten-Jones, Derek Hennessey, Diwei Lin, Darren Lituri, Subhita Prasannan, Greg Otto
BACKGROUND: Compared with traditional (Trad) systems of managing emergency surgical presentations, the acute surgical unit (ASU) model provides an on-site registrar, on-call surgeon and dedicated emergency theatre, 24 h/day. To date, there have been no Australasian ASU studies of >3000 patients, nor from South Australia. METHODS: A retrospective historical control study compared the outcomes of adults admitted to the Lyell McEwin Hospital in the Trad (1 February 2010 to 31 July 2012) and ASU periods (1 August 2012 to 31 January 2015), who underwent an emergency general surgical procedure...
July 6, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28657429/safety-profile-of-snake-antivenom-use-in-hong-kong-a-review-of-191-cases-from-2008-to-2015
#19
Rupeng Mong, Vember C H Ng, Man Li Tse
INTRODUCTION: The mainstay of treatment for significant envenoming from snakebites is antivenom. However, there is insufficient data regarding the safety of antivenom used in Hong Kong. We describe the incidence of hypersensitivity reactions from antivenom use and review the frequency and reasons for intensive care unit (ICU) admission. METHODS: The Hong Kong Poisons Information Centre database was reviewed. All patients given snake antivenom between 2008 and 2015 were included...
June 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28657380/non-specific-abdominal-pain-remains-as-the-most-common-reason-for-acute-abdomen-26-year-retrospective-audit-in-one-emergency-unit
#20
Anne Fagerström, Paavo Paajanen, Heidi Saarelainen, Mirella Ahonen-Siirtola, Mika Ukkonen, Pekka Miettinen, Hannu Paajanen
OBJECTIVE: Distribution of diagnoses causing acute abdominal pain (AAP) may change because of population aging, increased obesity, advanced diagnostic imaging and changes in nutritional habits. Our aim was to evaluate the diagnoses causing AAP during a 26-year period. MATERIALS AND METHODS: This was a retrospective cross-sectional cohort study in one emergency department (ED) covering population about 250,000. All patients admitted to the ED in 1986, 2003 and 2012 were evaluated from hospital electronic database...
June 28, 2017: Scandinavian Journal of Gastroenterology
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