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Emergency department observation unit

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https://www.readbyqxmd.com/read/28932302/predictive-value-of-tracheal-rapid-ultrasound-exam-performed-in-the-emergency-department-for-verification-of-tracheal-intubation
#1
Babak Masoumi, Reza Azizkhani, Gilava Hedayati Emam, Morteza Asgarzadeh, Behrouz Zargar Kharazi
BACKGROUND: Verification of the correct placement of the endotracheal tube (ETT) has been one of the most challenging issues of airway management in the field of emergency medicine. Early detection of oesophagal intubation through a reliable method is important for emergency physicians. AIM: The aim of this study was to assess the diagnostic accuracy of tracheal rapid ultrasound exam (TRUE) to assess endotracheal tube misplacement during emergency intubation. METHODS: This was an observational prospective study performed in the emergency department of the major tertiary referral hospital in the city...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28930956/implications-of-the-trauma-quality-improvement-project-inclusion-of-nonsurvivable-injuries-in-performance-benchmarking
#2
Jiselle Bock Heaney, Rebecca Schroll, Jennifer Turney, Lance Stuke, Alan B Marr, Patrick Greiffenstein, Rosemarie Robledo, Amanda Theriot, Juan Duchesne, John Hunt
BACKGROUND: The Trauma Quality Improvement Project (TQIP) uses an injury prediction model for performance benchmarking. We hypothesize that at a Level I high-volume penetrating trauma center, performance outcomes will be biased due to inclusion of patients with nonsurvivable injuries. METHODS: Retrospective chart review was conducted for all patients included in the institutional TQIP analysis from 2013 to 2014 with length of stay (LOS) less than 1 day to determine survivability of the injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28924282/overcrowding-and-possible-solutions-for-a-busy-paediatric-emergency-department
#3
Muhammad Irfan Habib, Khalid Mehmood Khan
OBJECTIVE: To quantify the extent of emergency department overcrowding in a tertiary care hospital and to identify possible solutions. METHODS: This retrospective study was conducted at the National Institute of Child Health, Karachi, and comprised data of all patients presenting to the emergency department from November 2014 to January 2015. Data was collected through the health management information system which generates daily report of patients. Patients who stayed at the emergency department for 4 or more hours were included...
September 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28915898/physician-staffed-helicopter-emergency-medical-service-has-a-beneficial-impact-on-the-incidence-of-prehospital-hypoxia-and-secured-airways-on-patients-with-severe-traumatic-brain-injury
#4
Toni Pakkanen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Jouni Nurmi, Ilkka Virkkunen, Arvi Yli-Hankala
BACKGROUND: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. METHODS: This was a retrospective cohort study...
September 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28913974/impact-of-ladder-related-falls-on-the-emergency-department-and-recommendations-for-ladder-safety
#5
C J Cabilan, Kirsten Vallmuur, Rob Eley, Chantelle Judge, Sarah Cochrane, Connie Reed, Jessica Riordan, Kym Roberts, Ogilvie Thom, Gabriella Wood
OBJECTIVES: To describe the characteristics of patients who presented to the ED from a ladder-related fall and their injuries, highlight the impact of ladder-related falls on the ED, identify contributing factors of ladder falls and draw recommendations to improve ladder safety. METHODS: A prospective observational study was conducted in two EDs. Patients' demographics and ED services used were obtained from medical records. A 53-item questionnaire was used to gather information about the type of ladder used, ladder activity, circumstances of the fall, contributing factors and future recommendations...
September 14, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28902768/economic-and-clinical-outcomes-resulting-from-the-stage-4-chronic-kidney-disease-case-management-quality-improvement-initiative
#6
Beverly Everett, Liana D Castel, Matthew McGinnis, Amy Beresky, Rudolph C Cane, Tasha Cooper, Rajesh K Davda, Donna Farmer, Stella M John, Denise L Sollars, John F Rausch
PURPOSE OF STUDY: Chronic kidney disease (CKD) is a costly and burdensome public health concern. The goal of this study was to evaluate the impact on outcomes and utilization of a pilot program to identify and engage beneficiaries with CKD at risk for progression from Stage 4 to Stage 5. PRIMARY PRACTICE SETTINGS: A quality improvement initiative was conducted to assess the impact of case management on costs and outcomes among 7,720 Cigna commercial medical beneficiaries with Stage 4 CKD enrolled in the United States between January 2012 and October 2012...
September 11, 2017: Professional Case Management
https://www.readbyqxmd.com/read/28902700/effectiveness-of-collaboration-between-emergency-department-and-intensive-care-unit-teams-on-mortality-rates-of-patients-presenting-with-critical-illness-a-systematic-review
#7
Kerchelle McDowald, Svetlana Direktor, Elizabeth A Hynes, Anna Sahadeo, Margaret E Rogers
BACKGROUND: The increasing volume of adult patients with critical illness entering emergency departments (EDs) burdens the resources of EDs worldwide. This subpopulation faces a high risk of mortality because they require specialized care which many EDs are not yet poised to deliver. An element crucial to delivering care and decreasing the mortality of critically ill patients in the ED is expert collaborative practice across disciplines. Several ED and intensive care unit (ICU) collaborative models exist including: emergency department intensive care units (EDICU) and medical emergency teams (MET)...
September 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28902323/hand-hygiene-compliance-of-healthcare-professionals-in-an-emergency-department
#8
Caroline Zottele, Tania Solange Bosi de Souza Magnago, Angela Isabel Dos Santos Dullius, Adriane Cristina Bernat Kolankiewicz, Juliana Dal Ongaro
OBJECTIVE: To analyze compliance with hand hygiene by healthcare professionals in an emergency department unit. METHOD: This is a longitudinal quantitative study developed in 2015 with healthcare professionals from a university hospital in the state of Rio Grande do Sul. Each professional was monitored three times by direct non-participant observation at WHO's five recommended moments in hand hygiene, taking the concepts of opportunity, indication and action into account...
August 28, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28892440/progress-in-public-health-emergency-preparedness-united-states-2001-2016
#9
Bhavini Patel Murthy, Noelle-Angelique M Molinari, Tanya T LeBlanc, Sara J Vagi, Rachel N Avchen
OBJECTIVES: To evaluate the Public Health Emergency Preparedness (PHEP) program's progress toward meeting public health preparedness capability standards in state, local, and territorial health departments. METHODS: All 62 PHEP awardees completed the Centers for Disease Control and Prevention's self-administered PHEP Impact Assessment as part of program review measuring public health preparedness capability before September 11, 2001 (9/11), and in 2014. We collected additional self-reported capability self-assessments from 2016...
September 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28888560/unintentional-cannabis-ingestion-in-children-a-systematic-review
#10
John R Richards, Nishelle E Smith, Aimee K Moulin
OBJECTIVE: To analyze published reports of unintentional cannabis ingestions in children to determine presenting signs and symptoms, route of exposure, treatment, and outcome. STUDY DESIGN: PubMed, OpenGrey, and Google Scholar were systematically searched. Articles were selected, reviewed, and graded using Oxford Center for Evidence-Based Medicine guidelines. RESULTS: Of 3316 articles, 44 were included (3582 children age ≤12 years). We found no high quality (Oxford Center for Evidence-Based Medicine level I or II) studies and 10 level III studies documenting lethargy as the most common presenting sign and confirming increasing incidence of unintentional ingestion in states having decriminalized medical and recreational cannabis...
September 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28885390/epidemiology-of-admissions-from-the-emergency-department-among-febrile-infants-younger-than-90-days-in-the-united-states-2002-to-2012
#11
Diana K Nguyen, Ross J Fleischman, Scott Friedlander, Kenneth M Zangwill
BACKGROUND AND OBJECTIVES: Febrile infants younger than 90 days are often subjected to invasive diagnostic evaluation and hospitalization to monitor for serious bacterial infection (SBI) despite recent changes in SBI risk and advances in diagnostics. Nationwide provider practices, over time, are unknown for this group. Our objective was to determine the likelihood of admission and associated complications of care for such infants, particularly those at lowest risk for SBI. METHODS: This is a retrospective cohort study including multisite emergency department (ED) visits using administrative data from the Pediatric Emergency Care Applied Research Network Core Data Project...
September 5, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28882638/delayed-onset-of-atrial-fibrillation-and-ventricular-tachycardia-after-an-automobile-lightning-strike
#12
Dorian Drigalla, Shannon E Essler, C Keith Stone
BACKGROUND: Lightning strike is a rare medical emergency. The primary cause of death in lightning strike victims is immediate cardiac arrest. The mortality rate from lightning exposure can be as high as 30%, with up to 70% of patients left with significant morbidity. CASE REPORT: An 86-year-old male was struck by lightning while driving his vehicle and crashed. On initial emergency medical services evaluation, he was asymptomatic with normal vital signs. During his transport, he lost consciousness several times and was found to be in atrial fibrillation with intermittent runs of ventricular tachycardia during the unconscious periods...
September 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28876570/cohort-study-on-emergency-general-surgery-patients-and-an-observation-unit
#13
M Dickfos, H Ibrahim, A Evans, R Franz
BACKGROUND: Medium-sized, non-trauma hospitals experience many of the same difficulties as tertiary centres do when it comes to managing emergency general surgery patients. However, acute surgical units are not a financially viable option in these hospitals. To improve the care of emergency general surgery patients at one such hospital, a Rapid Assessment Medical Surgical (RAMS) unit was developed to decrease the time to review and increase the efficiency in caring for these patients...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28874952/duration-of-mechanical-ventilation-in-the-emergency-department
#14
Lauren B Angotti, Jeremy B Richards, Daniel F Fisher, Jeffrey D Sankoff, Todd A Seigel, Haitham S Al Ashry, Susan R Wilcox
INTRODUCTION: Due to hospital crowding, mechanically ventilated patients are increasingly spending hours boarding in emergency departments (ED) before intensive care unit (ICU) admission. This study aims to evaluate the association between time ventilated in the ED and in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS). METHODS: This was a multi-center, prospective, observational study of patients ventilated in the ED, conducted at three academic Level I Trauma Centers from July 2011 to March 2013...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28874937/antimicrobial-therapy-for-pneumonia-in-the-emergency-department-the-impact-of-clinical-pharmacists-on-appropriateness
#15
Brett A Faine, Nicholas Mohr, Jenna Dietrich, Laura Meadow, Kari K Harland, Elizabeth Chrischilles
INTRODUCTION: Pneumonia impacts over four million people annually and is the leading cause of infectious disease-related hospitalization and mortality in the United States. Appropriate empiric antimicrobial therapy decreases hospital length of stay and improves mortality. The objective of our study was to test the hypothesis that the presence of an emergency medicine (EM) clinical pharmacist improves the timing and appropriateness of empiric antimicrobial therapy for community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP)...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28874930/prevalence-of-intracranial-hemorrhage-after-blunt-head-trauma-in-patients-on-pre-injury-dabigatran
#16
James A Chenoweth, M Austin Johnson, Laura Shook, Mark E Sutter, Daniel K Nishijima, James F Holmes
INTRODUCTION: Dabigatran etexilate was the first direct-acting oral anticoagulant approved in the United States. The prevalence of intracranial hemorrhage after blunt head trauma in patients on dabigatran is currently unknown, complicating adequate ability to accurately compare the risks and benefits of dabigatran to alternative anticoagulants. We aimed to determine the prevalence of intracranial hemorrhage for patients on dabigatran presenting to a Level I trauma center. METHODS: This is a retrospective observational study of adult patients on dabigatran who presented to a Level I trauma center and received cranial computed tomography (CT) following blunt head trauma...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28874928/magnetic-resonance-imaging-utilization-in-an-emergency-department-observation-unit
#17
Yadiel Sánchez, Brian J Yun, Anand M Prabhakar, McKinley Glover, Benjamin A White, Theodore I Benzer, Ali S Raja
INTRODUCTION: Emergency department observation units (EDOUs) are a valuable alternative to inpatient admissions for ED patients needing extended care. However, while the use of advanced imaging is becoming more common in the ED, there are no studies characterizing the use of magnetic resonance imaging (MRI) examinations in the EDOU. METHODS: This institutional review board-approved, retrospective study was performed at a 999-bed quaternary care academic Level I adult and pediatric trauma center, with approximately 114,000 ED visits annually and a 32-bed adult EDOU...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28854308/association-of-neighborhood-demographics-with-out-of-hospital-cardiac-arrest-treatment-and-outcomes-where-you-live-may-matter
#18
Monique Anderson Starks, Robert H Schmicker, Eric D Peterson, Susanne May, Jason E Buick, Peter J Kudenchuk, Ian R Drennan, Heather Herren, Jamie Jasti, Michael Sayre, Dion Stub, Gary M Vilke, Shannon W Stephens, Anna M Chang, Jack Nuttall, Graham Nichol
Importance: We examined whether resuscitation care and outcomes vary by the racial composition of the neighborhood where out-of-hospital cardiac arrests (OHCAs) occur. Objective: To evaluate the association between bystander treatments (cardiopulmonary resuscitation and automatic external defibrillation) and timing of emergency medical services personnel on OHCA outcomes according to the racial composition of the neighborhood where the OHCA event occurred. Design, Setting, and Participants: This retrospective observational cohort study examined patients with OHCA from January 1, 2008, to December 31, 2011, using data from the Resuscitation Outcomes Consortium...
August 30, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28845913/alcohol-related-presentations-to-the-royal-perth-hospital-emergency-department-a-prospective-study
#19
Stuart Vb McLay, Ellen MacDonald, Daniel M Fatovich
OBJECTIVE: To quantify and describe alcohol-related presentations to our ED, as part of the binational Alcohol Harm in Emergency Departments study. METHODS: A prospective observational study at Royal Perth Hospital of every patient attending ED for the 168-h period commencing 08.00 hours Monday 1 December 2014. Patient presentations were classified as alcohol-related (alcohol-positive) using predefined criteria. These patients were compared to alcohol-negative patients on a range of demographic and clinical descriptors...
August 28, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28839512/relationship-between-capillary-refill-time-at-triage-and-abnormal-clinical-condition-a-prospective-study
#20
Claudia M Sansone, Fabiano Prendin, Greta Giordano, Paola Casati, Anne Destrebecq, Stefano Terzoni
BACKGROUND: Capillary refill time has been studied in literature as a perfusion indicator. Two pilot studies have proposed possible reference values in healthy adults. No data exist regarding capillary refill time as an indicator of abnormal clinical conditions in adults, which might be of help for triage nurses. OBJECTIVE: We wanted to assess if any relationships existed, between altered capillary refill time and abnormal clinical conditions in the emergency department...
2017: Open Nursing Journal
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