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Acute pain service

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https://www.readbyqxmd.com/read/28096024/improving-satisfaction-among-established-patients-in-a-midwestern-pain-clinic
#1
Kathy A Baule, Linda D Scott, Kelly D Rosenberger, W Stephen Minore
BACKGROUND: A problem in many health care practices is deciding the appropriate appointment length for new and established patients. Patients become frustrated when there is inadequate time to have their needs met, yet when a patient's clinic time is spontaneously lengthened, the provider gets behind in schedule, causing delays and greater frustration for others. AIM: The aims of this evidence based project were to determine whether implementation of a flexible appointment system would improve the current scheduling process in a pain clinic by allowing complex patients the opportunity to schedule a longer clinic appointment and would improve patient satisfaction...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28076734/effect-of-a-mass-media-campaign-on-ambulance-use-for-chest-pain
#2
Ziad Nehme, Peter A Cameron, Muhammad Akram, Harry Patsamanis, Janet E Bray, Ian T Meredith, Karen Smith
OBJECTIVES: To evaluate the impact of comprehensive public awareness campaigns by the National Heart Foundation of Australia on emergency medical service (EMS) use by people with chest pain. DESIGN, SETTING AND PARTICIPANTS: A retrospective analysis of 253428 emergency ambulance attendances for non-traumatic chest pain in Melbourne, January 2008 - December 2013. Time series analyses, adjusted for underlying trend and seasonal effects, assessed the impact of mass media campaigns on EMS use...
January 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28066970/implementation-of-a-pharmacist-led-patient-controlled-analgesia-dosing-service
#3
Alen L Dezia, Tim D Baccus, Allycia M Natavio, Sean M Conroy, Levi M Hall
PURPOSE: The development and implementation of a pharmacist-led patient controlled analgesia (PCA) dosing service in a large academic institution is described. SUMMARY: To improve pain management at our institution and expand pharmacy clinical services, a pharmacist-led PCA dosing service was developed and implemented. The service is modeled after established antimicrobial and anticoagulation dosing services at our institution. A core group of pharmacists (service leaders) and a pain physician champion developed a policy and guideline and designed electronic medical record (EMR) tools to support the service...
January 9, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28039801/persuasive-technology-in-teaching-acute-pain-assessment-in-nursing-results-in-learning-based-on-pre-and-post-testing
#4
Ana Graziela Alvarez, Grace T Marcon Dal Sasso, M Sriram Iyengar
BACKGROUND: Thousands of patients seek health services every day with complaints of pain. However, adequate pain assessment is still flawed, a fact that is partly related to gaps in professional learning on this topic. Innovative strategies such as the use of a virtual learning object mediated by persuasive technology in the learning of undergraduate nursing students can help to fill these gaps and to provide different ways of learning to learn. OBJECTIVE: To evaluate the results in learning among undergraduate nursing students about assessment of acute pain in adults and newborns, before and after an online educational intervention...
December 22, 2016: Nurse Education Today
https://www.readbyqxmd.com/read/28032571/readmissions-after-general-surgery-a-prospective-multicenter-audit
#5
Matthew J Lee, Sarah L Daniels, Jonathan R L Wild, Timothy R Wilson
BACKGROUND: Readmission rates after surgical procedures are viewed as a marker of quality of care and as a driver to improve outcomes in the United Kingdom, they are not remunerated. However, readmissions are not wholly avoidable. The aim of this study was to develop a regional overview of readmissions to determine the proportion that might be avoidable and to examine predictors of readmissions at a unit level. METHODS: We undertook a prospective multicenter audit of readmissions following National Health Service funded general surgical procedures in five National Health Service hospitals and three independent sector providers over a 2-wk period...
September 19, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28008258/incidence-risk-factors-and-phenomenological-characteristics-of-postoperative-delirium-in-patients-receiving-intravenous-patient-controlled-analgesia-a-prospective-cohort-study
#6
Yao Tsung Lin, Kuo Mao Lan, Li-Kai Wang, Chin-Chen Chu, Su-Zhen Wu, Chia-Yu Chang, Jen-Yin Chen
BACKGROUND: Intravenous patient-controlled analgesia (IVPCA) is a common method of relieving pain which is a risk factor of postoperative delirium (POD). However, research concerning POD in IVPCA patients is limited. OBJECTIVE: We aimed to determine the incidence, risk factors, and phenomenological characteristics of POD in patients receiving IVPCA. METHODS: A prospective, cohort study was conducted in post-general anesthesia IVPCA patients aged ≥60 years...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28001292/predictors-for-unplanned-hospitalization-of-new-home-care-clients
#7
Jukka K Rönneikkö, Matti Mäkelä, Esa R Jämsen, Heini Huhtala, Harriet Finne-Soveri, Anja Noro, Jaakko N Valvanne
OBJECTIVES: To identify factors predicting unplanned hospitalization of new home care clients using the Resident Assessment Instrument for Home Care (RAI-HC). DESIGN: A register-based study based on RAI-HC assessments and nationwide hospital discharge records. SETTING: Municipal home care services in Finland. PARTICIPANTS: New Finnish home care clients aged 63 and older (N = 15,700). MEASUREMENTS: Information from home care clients' first RAI-HC assessment was connected to information regarding their first hospitalization over 1 year of follow-up...
December 21, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27982422/update-review-of-the-acute-porphyrias
#8
REVIEW
Penelope E Stein, Michael N Badminton, David C Rees
Acute porphyrias are rare inherited disorders due to deficiencies of haem synthesis enzymes. To date, all UK cases have been one of the three autosomal dominant forms, although penetrance is low and most gene carriers remain asymptomatic. Clinical presentation is typically with acute neurovisceral attacks characterised by severe abdominal pain, vomiting, tachycardia and hypertension. Severe attacks may be complicated by hyponatraemia, peripheral neuropathy sometimes causing paralysis, seizures and psychiatric features...
December 16, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27965310/rare-cause-of-back-pain-staphylococcus-aureus-vertebral-osteomyelitis-complicated-by-recurrent-epidural-abscess-and-severe-sepsis
#9
Louise Dunphy, Shabnam Iyer, Christopher Brown
An epidural abscess represents a rare acute medical emergency, with a reported incidence of 2.5/10 000 hospital admissions annually. The clinical features include fever, spinal pain, radiating nerve root pain and leg weakness. When sepsis is present, prompt recognition is required to initiate appropriate antimicrobial therapy and surgical decompression. We present the case of a man aged 68 years presenting to the emergency department with a 3-day history of fever, low back, right hip and leg pain. He was hypoxic, tachycardic and hypotensive...
December 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27903774/-they-shouldn-t-be-coming-to-the-ed-should-they-a-descriptive-service-evaluation-of-why-patients-with-palliative-care-needs-present-to-the-emergency-department
#10
Emilie Green, Sarah Ward, Will Brierley, Ben Riley, Henna Sattar, Tim Harris
BACKGROUND: Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED. METHODS: This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period...
November 30, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27881283/cost-effectiveness-of-introducing-point-of-care-test-for-detection-of-level-of-glycogen-phosphorylase-in-early-diagnostic-algorithm-of-acute-coronary-syndrome
#11
Slobodan M Janković, Marina Kostić
BACKGROUND: The detection of specific biomarkers in the early phase of acute coronary syndrome (ACS) is important for the early diagnosis and appropriate management of patients with ACS. OBJECTIVES: To estimate the cost-effectiveness of introducing a diagnostic point-of-care (POC) test for determining the levels of glycogen phosphorylase BB isoform (GPBB) in a standard diagnostic algorithm for the early diagnosis of ACS within the health system of the Republic of Serbia...
September 2016: Value in Health Regional Issues
https://www.readbyqxmd.com/read/27860148/a-review-of-rapid-access-cardiology-services-can-these-reduce-the-burden-of-acute-chest-pain-on-australian-and-new-zealand-health-services
#12
REVIEW
Harry Klimis, Aravinda Thiagalingam, Mikhail Altman, Emily Atkins, Gemma Figtree, Harry Lowe, N Wah Cheung, Pramesh Kovoor, A Robert Denniss, Clara K Chow
Chest pain is common and places a significant burden on hospital resources. Many patients with undifferentiated low to intermediate risk chest pain are admitted to hospital. Rapid Access Cardiology (RAC) services are hospital co-located cardiologist-led outpatient clinics that provide rapid assessment and immediate management but not long term management. This service model is described as part of chest pain management and the National Service Framework for coronary heart disease in the United Kingdom (UK)...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27798367/presenting-symptoms-pre-hospital-delay-time-and-28-day-case-fatality-in-patients-with-peripheral-arterial-disease-and-acute-myocardial-infarction-from-the-monica-kora-myocardial-infarction-registry
#13
Inge Kirchberger, Ute Amann, Margit Heier, Bernhard Kuch, Christian Thilo, Annette Peters, Christa Meisinger
BACKGROUND: Previous studies have indicated that patients with acute myocardial infarction (AMI) who have a history of peripheral arterial disease (PAD) have different characteristics and poorer outcomes than patients without PAD. However, data on short-term mortality are conflicting and it is unclear whether patients with PAD have a different scope of AMI symptoms or differences in pre-hospital delay time (PHDT) compared with patients without PAD. The objective of this study was to determine the associations between a history of PAD and presenting AMI symptoms, PHDT and 28-day case fatality in a population-based sample of patients with AMI...
October 25, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27769613/synthetic-cannabinoid-abuse-resulting-in-st-segment-elevation-myocardial-infarction-requiring-percutaneous-coronary-intervention
#14
Richard J Hamilton, Vadim Keyfes, Sahil S Banka
BACKGROUND: Synthetic cannabinoids (SC) are recreational designer drugs intended to mimic delta-9-tetrahydrocannabinol while surreptitiously circumventing classification by the Drug Enforcement Administration. CASE REPORT: A 50-year-old black male arrived in the Emergency Department transported by Emergency Medical Services (EMS) for altered mental status after complaining of chest pain associated with smoking SCs. EMS found the patient with an empty foil pack labeled "Scooby Snax Limited Edition Blueberry Potpourri...
October 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27765707/subsequent-health-care-utilization-associated-with-early-physical-therapy-for-new-episodes-of-low-back-pain-in-older-adults
#15
Deven A Karvelas, Sean D Rundell, Janna L Friedly, Alfred C Gellhorn, Laura S Gold, Bryan A Comstock, Patrick J Heagerty, Brian W Bresnahan, David R Nerenz, Jeffrey G Jarvik
BACKGROUND: The association between early physical therapy (PT) and subsequent health-care utilization following a new visit for low back pain is not clear, particularly in the setting of acute low back pain. PURPOSE: This study aimed to estimate the association between initiating early PT following a new visit for an episode of low back pain and subsequent back pain-specific health-care utilization in older adults. DESIGN/SETTING: This is a prospective cohort study...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27756422/a-rare-presentation-of-ectopic-ovary-in-a-female-adolescent-and-the-impact-of-obesity-a-case-report
#16
Valirie Ndip Agbor, Tsi Njim, Leopold Ndemnge Aminde
BACKGROUND: Inguinal hernias in women of reproductive age containing the ovary are very rare. When they occur in this age group, they are mostly associated with malformations of the urogenital system. Prompt surgical intervention is the key to ensure survival of the ovary. Here we present a case of an ectopic ovary presenting like an acute appendicitis. CASE PRESENTATION: A 16-year-old Cameroonian girl presented at our emergency service with an acute exacerbation of a mild and intermittent right iliac fossa pain of 5 days' duration...
October 19, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27755226/discharge-of-non-acute-coronary-syndrome-chest-pain-patients-from-emergency-care-to-an-advanced-nurse-practitioner-led-chest-pain-clinic-a-cross-sectional-study-of-referral-source-and-final-diagnosis
#17
Shirley J Ingram, Gabrielle McKee, Mary B Quirke, Niamh Kelly, Ashling Moloney
BACKGROUND: Chest pain is a common presentation to emergency departments (EDs). Pathways for patients with non-acute coronary syndrome (ACS) chest pain are not optimal. An advanced cardiology nurse-led chest pain service was commenced to address this. The aim of the study was to assess the outcomes of non-ACS patients discharged from ED to an advanced cardiology nurse-led chest pain clinic and compare by referral type (nurse or ED physician). METHODS: The service consisted of advanced cardiology nurse or ED physician consultation in the ED and discharge to advanced nurse-led chest pain clinic review less than 72 hours after discharge...
October 14, 2016: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/27734446/exertional-rhabdomyolysis-epidemiology-diagnosis-treatment-and-prevention
#18
Joseph J Knapik, Francis G O'Connor
Exertional rhabdomyolysis (ER) is a medical condition whereby damage to skeletal muscle is induced by excessive physical activity in otherwise healthy individuals. The individual performs so much activity that he/ she presumably depletes local muscle energy stores and muscle cells are unable to maintain cellular integrity, resulting in cell damage and the release of cellular contents, with resultant secondary complications. In the military services, the incidence of ER appeared to increase in the period 2004 to 2015...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27734435/lower-extremity-compartment-syndrome-from-prolonged-limb-compression-and-immobilization-during-an-airborne-operation
#19
Brian C Smedick, David van Wyck
Acute compartment syndrome (ACS) involving the leg can occur in association with various traumatic and nontraumatic conditions, and it can have serious longterm consequences when unrecognized or untreated. Nontraumatic causes of ACS, such as those associated with cases of prolonged immobilization and/or extremity compression, can be easily overlooked, and several cases of ACS occurring with prolonged surgical positioning can be found in the literature. We present the case of a 19-year-old Army paratrooper who developed acute anterior and lateral compartment syndrome of the lower extremity after being immobilized in an aircraft for hours with several hundred pounds of equipment compressing his lower extremities...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27728959/symptom-to-door-delay-among-patients-with-st-segment-elevation-myocardial-infarction-in-singapore
#20
Win Wah, Pin Pin Pek, Andrew Fu Wah Ho, Stephanie Fook-Chong, Huili Zheng, En Yun Loy, Terrance Siang Jin Chua, Tian Hai Koh, Khuan Yew Chow, Arul Earnest, Junxiong Pang, Marcus Eng Hock Ong
OBJECTIVES: Symptom-to-door time (S2D) is one of the important components of ischaemic time, which might affect the infarct size and outcomes of acute myocardial infarction. The aim of the present study was to identify patients' characteristics associated with delayed symptom-onset-to-arrival at EDs in ST-segment elevation myocardial infarction (STEMI) patients in Singapore. METHODS: Retrospective data of STEMI patients presenting to the ED of all public hospitals with onsite primary percutaneous coronary intervention facilities between 2010 and 2012 were obtained from the Singapore Myocardial Infarction Registry...
October 11, 2016: Emergency Medicine Australasia: EMA
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