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https://www.readbyqxmd.com/read/28886788/logistical-concerns-for-prehospital-blood-product-use-by-air-medical-services
#1
REVIEW
Patrick Maher, Richard Utarnachitt, Max J Louzon, Roxann Gary, Nina Sen, John R Hess
Over the past few decades, reports have described favorable results from transfusion of blood products in helicopter EMS (HEMS). Nevertheless, the initiation of a HEMS transfusion program requires consideration of many factors, some unique to each clinical site. This paper describes our experience developing a HEMS transfusion program in an urban non-hospital based HEMS program with a history of long transport times. When considering blood use away from the hospital, major consideration must be given to safe storage and monitoring of blood products both on the ground and while in flight...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28870269/failure-to-communicate-transmission-of-extensively-drug-resistant-bla-oxa-237-containing-acinetobacter-baumannii-multiple-facilities-in-oregon-2012-2014
#2
Genevieve L Buser, P Maureen Cassidy, Margaret C Cunningham, Susan Rudin, Andrea M Hujer, Robert Vega, Jon P Furuno, Steven H Marshall, Paul G Higgins, Michael R Jacobs, Meredith S Wright, Mark D Adams, Robert A Bonomo, Christopher D Pfeiffer, Zintars G Beldavs
OBJECTIVE To determine the scope, source, and mode of transmission of a multifacility outbreak of extensively drug-resistant (XDR) Acinetobacter baumannii. DESIGN Outbreak investigation. SETTING AND PARTICIPANTS Residents and patients in skilled nursing facilities, long-term acute-care hospital, and acute-care hospitals. METHODS A case was defined as the incident isolate from clinical or surveillance cultures of XDR Acinetobacter baumannii resistant to imipenem or meropenem and nonsusceptible to all but 1 or 2 antibiotic classes in a patient in an Oregon healthcare facility during January 2012-December 2014...
September 5, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28862480/national-characteristics-of-emergency-medical-services-responses-for-older-adults-in-the-united-states
#3
Hieu V Duong, Lauren Nicholas Herrera, Justin Xavier Moore, John Donnelly, Karen E Jacobson, Jestin N Carlson, N Clay Mann, Henry E Wang
OBJECTIVE: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. METHODS: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses...
September 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28860727/the-role-of-caregivers-in-interfacility-care-transitions-a-qualitative-study
#4
Lianne Jeffs, Marianne Saragosa, Madelyn P Law, Kerry Kuluski, Sherry Espin, Jane Merkley
A qualitative design was used to explore the nature of caregiver involvement in care transitions of patients being transferred from an acute care hospital to a rehabilitation hospital. Participants included older adults (n=13), informal caregivers (n=9), and health care professionals (n=50) from inpatient orthopedic units in two academic health science centers and one orthopedic inpatient rehabilitation unit. Semistructured interviews were conducted, audio-taped, and transcribed. Directed content analysis revealed the following four themes: watching, being an active care provider, advocating, and navigating the health care system...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28822393/identifying-futile-interfacility-surgical-transfers
#5
Kristy Kummerow Broman, Sharon E Phillips, Jesse M Ehrenfeld, Mayur B Patel, Oscar M Guillamondegui, Kenneth W Sharp, Richard A Pierce, Benjamin K Poulose, Michael D Holzman
Surgeons perceive that some surgical transfers are futile, but the incidence and risk factors of futile transfer are not quantified. Identifying futile interfacility transfers could save cost and undue burdens to patients and families. We sought to describe the incidence and factors associated with futile transfers. We conducted a retrospective cohort study from 2009 to 2013 including patients transferred to a tertiary referral center for general or vascular surgical care. Futile transfers were defined as resulting in death or hospice discharge within 72 hours of transfer without operative, endoscopic, or radiologic intervention...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28754811/consistency-of-pressure-injury-documentation-across-interfacility-transfers
#6
Lee Squitieri, David A Ganz, Carol M Mangione, Jack Needleman, Patrick S Romano, Debra Saliba, Clifford Y Ko, Daniel A Waxman
BACKGROUND: Hospital-acquired pressure injuries (HAPIs) are publicly reported in the USA and used to adjust Medicare payment to acute inpatient facilities. Current methods used to identify HAPIs in administrative claims rely on hospital-reported present-on-admission (POA) data instead of prior patient health information. OBJECTIVE: To study the reliability of claims data for HAPIs and pressure injury (PI) stage by evaluating diagnostic coding agreement across interfacility transfers...
July 28, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28743480/the-influence-of-insurance-type-on-interfacility-pediatric-emergency-department-transfers
#7
Chris A Rees, Stephanie Pryor, Ben Choi, Mamata V Senthil, Nicholas Tsarouhas, Sage R Myers, Michael C Monuteaux, Richard G Bachur, Joyce Li
BACKGROUND: Disparities exist in the care children receive in the emergency department (ED) based on their insurance type. It is unknown if these differences exist among children transferred from outside EDs to pediatric tertiary care EDs. OBJECTIVE: To compare reasons for transfer and services received at pediatric tertiary care EDs between children with private and public insurance. METHODS: We performed a secondary analysis of a multicenter survey of ED providers transferring patients to pediatric tertiary care EDs in three major U...
July 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28739240/evaluation-of-situation-background-assessment-recommendation-tool-during-neonatal-and-pediatric-interfacility-transport
#8
Diane Wilson, Anuradha Kochar, Andrew Whyte-Lewis, Hilary Whyte, Kyong-Soon Lee
OBJECTIVE: We aimed to determine if the implementation of Situation, Background, Assessment, Recommendation (SBAR) training improved the quality of real-life telephone communication. We evaluated interfacility neonatal and pediatric transports performed by registered nurses, respiratory therapists, and physicians (MDs). METHODS: This was a quality improvement study performed to evaluate telephone communication before and after SBAR training. Training consisted of lectures, review of audio files, and simulated role-playing...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28706095/elucidating-the-information-exchange-during-interfacility-care-transitions-insights-from-a-qualitative-study
#9
Lianne Jeffs, Marianne Saragosa, Madelyn Law, Kerry Kuluski, Sherry Espin, Jane Merkley, Chaim M Bell
OBJECTIVE: To explore the perceptions of patients, their caregivers and healthcare professionals associated with the exchange of information during transitioning from two acute care hospitals to one rehabilitation hospital. DESIGN: An exploratory qualitative study using semi-structured interviews and observation. PARTICIPANTS AND SETTING: Patients over the age of 65 years admitted to an orthopaedic unit for a non-elective admission, their caregivers and healthcare professionals involved in their care...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697156/transitions-of-care-the-presence-of-written-interfacility-transfer-guidelines-and-agreements-for-pediatric-patients
#10
Andrea Lynn Genovesi, Lenora M Olson, Russell Telford, Diana Fendya, Ellen Schenk, Theresa Morrison-Quinata, Elizabeth A Edgerton
OBJECTIVE: Every year, emergency medical services agencies transport approximately 150,000 pediatric patients between hospitals. During these transitions of care, patient safety may be affected and contribute to adverse events when important clinical information is missing, incomplete, or inaccurate. Written interfacility transfer policies are one way to standardize procedures and facilitate communication between the hospitals leading to improved patient safety and satisfaction for children and families...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28697154/interfacility-transport-shock-index-is-associated-with-decreased-survival-in-children
#11
Ryan M Jennings, Bradley A Kuch, Kathryn A Felmet, Richard A Orr, Joseph A Carcillo, Ericka L Fink
BACKGROUND: Shock index, the ratio of heart rate to systolic blood pressure that changes with age, is associated with mortality in adults after trauma and in children with sepsis. We assessed the utility of shock index to predict sepsis diagnosis and survival in children requiring interfacility transport to a tertiary care center. METHODS: We studied children aged 1 month to 21 years who had at least 2 sets of vital signs recorded during interfacility transport to the Children's Hospital of Pittsburgh by our critical care transport team...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28673618/extracorporeal-membrane-oxygenation-and-interfacility-transfer-a-regional-referral-experience
#12
David N Ranney, Desiree Bonadonna, Babatunde A Yerokun, Michael S Mulvihill, Nawar Al-Rawas, Michael Weykamp, Rathnayaka M Gunasingha, Raquel R Bartz, John C Haney, Mani A Daneshmand
BACKGROUND: The number of adults referred to high-volume centers for extracorporeal membrane oxygenation (ECMO) is increasing. Outcomes of patients requiring transport are not well characterized, and referral guidelines are lacking. This study describes the experience and outcomes of a single high-volume center. METHODS: A retrospective study was performed that included adults undergoing ECMO between June 2009 and December 2015. Patient characteristics and outcomes were acquired from the medical record...
June 30, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28615088/healthcare-antibiotic-resistance-prevalence-dc-harp-dc-a-regional-prevalence-assessment-of-carbapenem-resistant-enterobacteriaceae-cre-in-healthcare-facilities-in-washington-district-of-columbia
#13
Jacqueline Reuben, Nancy Donegan, Glenn Wortmann, Roberta DeBiasi, Xiaoyan Song, Princy Kumar, Mary McFadden, Sylvia Clagon, Janet Mirdamadi, Diane White, Jo Ellen Harris, Angella Browne, Jane Hooker, Michael Yochelson, Milena Walker, Gary Little, Gail Jernigan, Kathleen Hansen, Brenda Dockery, Brendan Sinatro, Morris Blaylock, Kimary Harmon, Preetha Iyengar, Trevor Wagner, Jo Anne Nelson
OBJECTIVE Carbapenem-resistant Enterobacteriaceae (CRE) are a significant clinical and public health concern. Understanding the distribution of CRE colonization and developing a coordinated approach are key components of control efforts. The prevalence of CRE in the District of Columbia is unknown. We sought to determine the CRE colonization prevalence within healthcare facilities (HCFs) in the District of Columbia using a collaborative, regional approach. DESIGN Point-prevalence study. SETTING This study included 16 HCFs in the District of Columbia: all 8 acute-care hospitals (ACHs), 5 of 19 skilled nursing facilities, 2 (both) long-term acute-care facilities, and 1 (the sole) inpatient rehabilitation facility...
June 15, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28601830/interfacility-transfer-of-pregnant-women-using-publicly-funded-emergency-call-centre-based-ambulance-services-a-cross-sectional-analysis-of-service-logs-from-five-states-in-india
#14
Samiksha Singh, Pat Doyle, Oona Mr Campbell, Laura Oakley, Gv Ramana Rao, Gvs Murthy
OBJECTIVE: To estimate the proportion of interfacility transfers (IFTs) transported by '108' ambulances and to compare the characteristics of the IFTs and non-IFTs to understand the pattern of use of '108' services for pregnant women in India. DESIGN: A cross-sectional analysis of '108' ambulance records from five states for the period April 2013 to March 2014. Data were obtained from the call centre database for the pregnant women, who called '108'. MAIN OUTCOMES: Proportion of all pregnancies and institutional deliveries in the population who were transported by '108', both overall and for IFT...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28559362/receiving-providers-perceptions-on-information-transmission-during-interfacility-transfers-to-general-pediatric-floors
#15
Jennifer L Rosenthal, Patrick S Romano, Jolene Kokroko, Wendi Gu, Megumi J Okumura
BACKGROUND: Pediatric patients can present to a medical facility and subsequently be transferred to a different hospital for definitive care. Interfacility transfers require a provider handoff across facilities, posing risks that may affect patient outcomes. OBJECTIVES: The goal of this study was to describe the thoroughness of information transmission between providers during interfacility transfers, to describe perceived errors in care at the posttransfer facility, and to identify potential associations between thoroughness of information transmission and perceived errors in care...
June 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28546453/familial-caregiver-and-physician-perceptions-of-the-family-physician-interactions-during-interfacility-transfers
#16
Jennifer L Rosenthal, Su-Ting T Li, Lenore Hernandez, Michelle Alvarez, Roberta S Rehm, Megumi J Okumura
BACKGROUND AND OBJECTIVES: Children with special health care needs (CSHCN) have frequent hospitalizations and high specialty care utilization. If they initially present to a medical facility not capable of providing their definitive care, these children often experience an interfacility transfer. This transition has potential to impose hardships on familial caregivers. The goal of this study was to explore family-physician interactions during interfacility transfers from the perspectives of referring and accepting physicians and familial caregivers, and then develop a conceptual model for effective patient- and family-centered interfacility transfers that leverages the family-physician interaction...
June 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#17
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and healthcare costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001-2013 among 45 hospitals in Utah's statewide trauma system...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28536177/interfacility-transfer-directly-to-the-neuroangiography-suite-in-acute-ischemic-stroke-patients-undergoing-thrombectomy
#18
Ashutosh P Jadhav, Cynthia L Kenmuir, Amin Aghaebrahim, Kaustubh Limaye, Lawrence R Wechsler, Maxim D Hammer, Matthew T Starr, Bradley J Molyneaux, Marcelo Rocha, Francis X Guyette, Christian Martin-Gill, Andrew F Ducruet, Bradley A Gross, Brian T Jankowitz, Tudor G Jovin
BACKGROUND AND PURPOSE: In patients identified at referring facilities with acute ischemic stroke caused by a large vessel occlusion, bypassing the emergency department (ED) with direct transport to the neuroangiography suite may safely shorten reperfusion times. METHODS: We conducted a single-center retrospective review of consecutive patients transferred to our facility for consideration of endovascular therapy. Patients were identified as admitted directly to the neuroangiography suite (DAN), transferred to the ED before intra-arterial therapy (ED-IA), and transferred to the ED but did not receive IA therapy (ED-IV)...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28509774/the-role-of-the-anaesthesiologist-in-air-ambulance-medicine
#19
Stephen J M Sollid, Marius Rehn
PURPOSE OF REVIEW: The care administered on air ambulances has become increasing complex. This has led to a discussion among experts as to whether air ambulance travel should be manned by physicians. This review provides evidence in support of anaesthesiologists being the physician-leaders in air ambulance medicine, because of their training in advanced airway management, critical care, and resuscitation. RECENT FINDINGS: Successful prehospital care requires the ability to perform a complex set of advanced diagnostics and interventions...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28505027/automated-surveillance-of-healthcare-associated-infections-state-of-the-art
#20
Meander E Sips, Marc J M Bonten, Maaike S M van Mourik
PURPOSE OF REVIEW: This review describes recent advances in the field of automated surveillance of healthcare-associated infections (HAIs), with a focus on data sources and the development of semiautomated or fully automated algorithms. RECENT FINDINGS: The availability of high-quality data in electronic health records and a well-designed information technology (IT) infrastructure to access these data are indispensable for successful implementation of automated HAI surveillance...
August 2017: Current Opinion in Infectious Diseases
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