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Emergency department observation unit

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https://www.readbyqxmd.com/read/28412721/are-admission-procalcitonin-levels-universal-mortality-predictors-across-different-medical-emergency-patient-populations-results-from-the-multi-national-prospective-observational-triage-study
#1
Ramon Sager, Yannick Wirz, Devendra Amin, Adina Amin, Pierre Hausfater, Andreas Huber, Sebastian Haubitz, Alexander Kutz, Beat Mueller, Philipp Schuetz
BACKGROUND: Procalcitonin (PCT), an inflammatory blood biomarker, is well studied in infectious diseases. Its prognostic value in unselected emergency department (ED) patients remains yet undefined. Herein, we investigated association of admission PCT levels and mortality in a large, international-multicenter ED patient cohort. METHODS: We prospectively enrolled 6970 unselected, consecutive, adult, medical patients seeking ED care in three tertiary-care hospitals in Switzerland, France and the USA...
April 17, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28412493/the-clinical-impact-and-prevalence-of-emergency-point-of-care-ultrasound-a-prospective-multicentre-study
#2
Xavier Bobbia, Laurent Zieleskiewicz, Christophe Pradeilles, Chloé Hudson, Laurent Muller, Pierre Géraud Claret, Marc Leone, Jean-Emmanuel de La Coussaye
OBJECTIVE: The main objectives of our study were to evaluate the prevalence of emergency point-of-care ultrasound (POCUS) use and to assess the impact of POCUS on: diagnostic, therapeutic, patient-orientation and imaging practices. METHODS: This was a one-day, prospective, observational study carried out across multiple centres. Fifty emergency departments (EDs) recorded all POCUS performed over a 24h period. The prevalence of POCUS was defined as the number of POCUS/number of patients seen in all units...
April 12, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28409028/impact-of-delayed-admission-to-the-intensive-care-unit-from-the-emergency-department-upon-sepsis-outcomes-and-sepsis-protocol-compliance
#3
Michael Agustin, Lori Lyn Price, Augustine Andoh-Duku, Peter LaCamera
Rationale. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. Methods. We performed a retrospective observational study of septic patients admitted to the ICU from the ED between January 2012 and December 2015 in a single tertiary care teaching hospital. 287 patients with severe sepsis and septic shock were included. Study population was divided into patients with EDLOS < 6 hrs (early admission) versus ≥6 hours (delayed admission)...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28401961/development-and-validation-of-a-prognostic-model-for-predicting-30-day-mortality-risk-in-medical-patients-in-emergency-department-ed
#4
Duc T Ha, Tam Q Dang, Ngoc V Tran, Thao N T Pham, Nguyen D Nguyen, Tuan V Nguyen
The primary aim of this prospective study is to develop and validate a new prognostic model for predicting the risk of mortality in Emergency Department (ED) patients. The study involved 1765 patients in the development cohort and 1728 in the validation cohort. The main outcome was mortality up to 30 days after admission. Potential risk factors included clinical characteristics, vital signs, and routine haematological and biochemistry tests. The Bayesian Model Averaging method within the Cox's regression model was used to identify independent risk factors for mortality...
April 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28398566/twelve-month-health-care-use-and-mortality-in-commercially-insured-young-people-with-incident-psychosis-in-the-united-states
#5
Michael Schoenbaum, Jason M Sutherland, Andre Chappel, Susan Azrin, Amy B Goldstein, Agnes Rupp, Robert K Heinssen
OBJECTIVE: To assess 12-month mortality and patterns of outpatient and inpatient treatment among young people experiencing an incident episode of psychosis in the United States. METHOD: Prospective observational analysis of a population-based cohort of commercially insured individuals aged 16-30 receiving a first observed (index) diagnosis of psychosis in 2008-2009. Data come from the US Department of Health and Human Services' Multi-Payer Claims Database Pilot...
April 7, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/28387901/endocarditis-sustained-by-streptococcus-viridans-with-normal-levels-of-procalcitonin-an-unexpected-finding
#6
G Merra, D Marsiliani, S Di Giambenedetto, F Franceschi
OBJECTIVE: Procalcytonin is a useful marker of bacterial infections. Several studies have reported elevated serum levels of PCT in patients with infective endocarditis (IE) and/or other infections sustained by cocci. We report a rare case of IE attributed to Streptococcus viridans in whom levels of PCT were normal. CASE REPORT: A 67 years-old male was admitted to the Emergency Department for a 25-day history of recurring night fever. Upon admission, patient underwent blood test, including PCT, showing normal levels, except for a slight increased creatinine concentration (1...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28385138/community-acquired-syndromes-causing-morbidity-and-mortality-in-australia%C3%A2
#7
Shweta Sharma, Emmy Sneath, Allen C Cheng, N Deborah Friedman
The clinical and economic burden of infectious diseases is a substantial public health problem. The determination of the relative contributions of these diseases to the overall healthcare burden can inform priority setting, planning, and decision-making in healthcare and establish a baseline for future comparisons. Few recent studies have presented definitive data on the incidence of infectious diseases requiring hospitalisation in the Southern Hemisphere. We identified the age-specific number of hospitalisations and severe infections requiring intensive care unit admissions in the Geelong region...
March 31, 2017: Communicable Diseases Intelligence Quarterly Report
https://www.readbyqxmd.com/read/28379349/enterovirus-d68-infection-among-children-with-medically-attended-acute-respiratory-illness-cincinnati-ohio-july%C3%A2-october-2014
#8
Holly M Biggs, Monica McNeal, W Allan Nix, Carolyn Kercsmar, Aaron T Curns, Beverly Connelly, Marilyn Rice, Shur-Wern Wang Chern, Mila M Prill, Nancy Back, M Steven Oberste, Susan I Gerber, Mary A Staat
Background: Enterovirus D68 (EV-D68) caused a widespread outbreak of respiratory illness in the United States in 2014, predominantly affecting children. We describe EV-D68 rates, spectrum of illness and risk factors from prospective, population-based acute respiratory illness (ARI) surveillance at a large U.S. pediatric hospital. Methods: Children <13 years of age with ARI and residence in Hamilton County, Ohio were enrolled from the inpatient and emergency department (ED) settings at a children's hospital in Cincinnati, Ohio, from July 1-October 31, 2014...
April 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28370979/cohort-study-on-emergency-general-surgery-patients-and-an-observation-unit
#9
Marilla Dickfos, Hany Ibrahim, Andrew Evans, Robert 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...
March 30, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28363619/body-mass-index-and-outcome-of-out-of-hospital-cardiac-arrest-patients-not-treated-by-targeted-temperature-management
#10
Ioanna Galatianou, George Karlis, Aristotelis Apostolopoulos, Georgios Intas, Eleftheria Chalari, Anil Gulati, Nicoletta Iacovidou, Athanasios Chalkias, Theodoros Xanthos
BACKGROUND: Obesity has been demonstrated to increase the risk of out-of-hospital cardiac arrest (OHCA) and may influence the quality and effectiveness of cardiopulmonary resuscitation. Our aim was to investigate the association between body mass index (BMI) and the outcome of OHCA victims not treated by targeted temperature management. METHODS: This was a prospective observational study of OHCA patients. The patients were categorized according to BMI into two groups: the normal BMI group (nBMI) and the elevated BMI group (eBMI)...
March 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28353184/high-pneumococcal-dna-load-procalcitonin-and-supar-levels-correlate-to-severe-disease-development-in-patients-with-pneumococcal-pneumonia
#11
A J M Loonen, C Kesarsing, R Kusters, M Hilbink, P C Wever, A J C van den Brule
Community-acquired pneumonia (CAP) is mostly caused by Streptococcus pneumoniae. Identification of the pathogen causing CAP can be achieved by conventional culture techniques of sputum and/or blood, antigen detection from urine or molecular analysis. However, it remains difficult to determine patients who are at risk of severe disease development (intensive care unit [ICU] admittance and/or death). In this retrospective study, 121 patients admitted to the emergency department with pneumonia symptoms were included...
March 29, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28346243/modeling-flowsheet-data-to-support-secondary-use
#12
Bonnie L Westra, Beverly Christie, Steven G Johnson, Lisiane Pruinelli, Anne LaFlamme, Suzan G Sherman, Jung In Park, Connie W Delaney, Grace Gao, Stuart Speedie
The purpose of this study was to create information models from flowsheet data using a data-driven consensus-based method. Electronic health records contain a large volume of data about patient assessments and interventions captured in flowsheets that measure the same "thing," but the names of these observations often differ, according to who performs documentation or the location of the service (eg, pulse rate in an intensive care, the emergency department, or a surgical unit documented by a nurse or therapist or captured by automated monitoring)...
March 24, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28345070/are-scoring-systems-sufficient-for-predicting-mortality-due-to-sepsis-in-the-emergency-department
#13
Merve Gunes Ozaydin, Ozlem Guneysel, Fatma Saridogan, Vehbi Ozaydin
OBJECTIVES: Scoring systems have been used to risk stratify in intensive care units (ICU), but not routinely used in emergency departments. The aim of this study was to determine accuracy for predicting mortality in emergency medicine with Sequential Organ Failure Assessment (SOFA), Mortality in ED Sepsis (MEDS) score and Simplified Acute Physiology Score (SAPSII). METHODS: This is a prospective observational study. Patients presenting with evidence of sepsis were all included...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343274/predictive-score-of-haematological-toxicity-in-patients-treated-with-linezolid
#14
J González-Del Castillo, F J Candel, R Manzano-Lorenzo, L Arias, E J García-Lamberechts, F J Martín-Sánchez
OBJECTIVE: The aims of our study were to determine the factors associated with developing haematological toxicity (HT) in patients taking linezolid (LZD), to develop a predictive model of HT in these patients, and to evaluate factors associated with 30-day mortality. METHODS: This was an observational retrospective cohort study of patients treated for at least 5 days with LDZ in 2015. Demographic, clinical and analytical data were collected. Development of HT was defined as a 25% platelet count decrease between the basal count and the 1-week lab test...
March 25, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28341086/recurrent-priapism-gone-wrong-st-elevation-myocardial-infarction-and-cardiogenic-shock-after-penile-corporal-phenylephrine-irrigation
#15
S Tyler Constantine, Anand Gopalsami, Gregg Helland
BACKGROUND: Recurrent priapism secondary to sickle cell trait in an African-American male has been reported in the literature. A common treatment for these low-flow priapism cases is aspiration and injection of the corpus cavernosum with a sympathomimetic agent. We report a rare complication not described previously in the literature of ST-elevation myocardial infarction (STEMI) and cardiogenic shock in a 29-year-old male with sickle cell trait undergoing a routine detumescence procedure...
March 21, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28338416/impact-of-a-complex-care-management-model-on-cost-and-utilization-among-adolescents-and-young-adults-with-special-care-and-health-needs
#16
Daniel D Maeng, Susan R Snyder, Thomas W Davis, Janet F Tomcavage
Adolescents and young adults with special care and health needs in the United States-many of whom have Medicaid coverage-at the transition phase between pediatric and adult care often experience critical care gaps. To address this challenge, a new model-referred to as Comprehensive Care Clinic (CCC)-has been developed and implemented by Geisinger Health System since 2012. CCC comprises a care team, consisting of a generalist physician, advanced practitioner, pharmacist, and a nurse case manager, that develops and closely follows a coordinated care plan...
March 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28330420/arthroplasty-treatment-of-proximal-humerus-fractures-14-year-trends-in-the-united-states
#17
William W Schairer, Benedict U Nwachukwu, Stephen Lyman, Lawrence V Gulotta
OBJECTIVES: Proximal humerus fractures are a common injury in the elderly population that can usually be managed non-operatively. However, arthroplasty has become increasingly utilized for complex fractures and poor bone quality. We evaluated national trends in treatment, specifically looking at the adoption of reverse total shoulder arthroplasty. METHODS: The incidence of proximal humerus fractures was calculated from the Nationwide Emergency Department Database (NEDD) from 2006-2012...
March 22, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28321299/successful-emergency-department-interventions-that-reduce-time-to-antibiotics-in-febrile-pediatric-cancer-patients
#18
Sandra Spencer, MIchele Nypaver, Katherine Hebert, Christopher Benner, Rachel Stanley, Daniel Cohen, Alexander Rogers, Jason Goldstick, Prashant Mahajan
Children with cancer and fever are at high risk for sepsis related death. Rapid antibiotic delivery (< 60 minutes) has been shown to reduce mortality. We compared patient outcomes and describe interventions from three separate quality improvement (QI) projects conducted in three United States (US) tertiary care pediatric emergency departments (EDs) with the shared aim to reduce time to antibiotic (TTA) to < 60 minutes in febrile pediatric oncology patients (Temperature > 38.0 C). A secondary objective was to identify interventions amenable to translation to other centers...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28319006/high-rates-of-severe-hypoglycemia-among-african-american-patients-with-diabetes-the-surveillance-prevention-and-management-of-diabetes-mellitus-supreme-dm-network
#19
Andrew J Karter, Kasia J Lipska, Patrick J O'Connor, Jennifer Y Liu, Howard H Moffet, Emily B Schroeder, Jean M Lawrence, Gregory A Nichols, Katherine M Newton, Ram D Pathak, Jay Desai, Beth Waitzfelder, Melissa G Butler, Abraham Thomas, John F Steiner
AIMS: Seven-year surveillance study (2005-2011) to evaluate race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population of insured, at-risk adults with diabetes. METHODS: SH events were identified via any primary or principal diagnosis from emergency department or inpatient encounters among African American, Asian, Latino and White adult diabetes patients treated with insulin or secretagogues (Sulfonylureas or Meglitinides), receiving care from integrated healthcare delivery systems across the United States...
February 21, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28314685/association-of-psoriasis-and-psoriatic-arthritis-with-osteoporosis-and-pathological-fractures
#20
Parul Kathuria, Kenneth B Gordon, Jonathan I Silverberg
BACKGROUND: Previous studies examining the relationship between psoriasis (Pso), osteoporosis, and pathological fractures found conflicting results. OBJECTIVE: To determine whether Pso and psoriatic arthritis (PsA) are associated with osteoporosis and fractures in US adults. METHODS: Cross-sectional study of 198,102,435 children and adults, including 183,725 with Pso and 28,765 with PsA from the 2006-2012 National Emergency Department Sample, including 20% of the emergency care visits throughout the United States...
March 14, 2017: Journal of the American Academy of Dermatology
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