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https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#1
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/28509774/the-role-of-the-anaesthesiologist-in-air-ambulance-medicine
#2
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...
May 13, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28505027/automated-surveillance-of-healthcare-associated-infections-state-of-the-art
#3
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...
May 12, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28499680/a-systematic-review-of-the-prevalence-and-types-of-adverse-events-in%C3%A2-interfacility-critical-care-transfers-by-paramedics
#4
Abdullah Alabdali, Joanne D Fisher, Chetan Trivedy, Richard J Lilford
OBJECTIVE: The aim of this study was to investigate if paramedics can safely transfer interfacility critically ill adult patients and to determine the prevalence and types of adverse events when paramedics lead interfacility critical care transfers. METHODS: MEDLINE, Web of Science, Embase, and CINAHL databases were searched from 1990 up to February 2016. Eligibility criteria were adult patients (16 years and over), interfacility transfer (between two health care facilities), quantitative or qualitative description of adverse events, and a paramedic as the primary care provider or the sole health care provider...
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28495830/establishing-recommendations-for-stroke-systems-in-the-thrombectomy-era-the-upstate-new-york-stakeholder-proceedings
#5
Zainab Magdon-Ismail, Curtis Benesch, Jeremy T Cushman, Ian Brissette, Andrew M Southerland, Ethan S Brandler, Cemal B Sozener, Sue Flor, Roseanne Hemmitt, Kathleen Wales, Krystal Parrigan, Steven R Levine
BACKGROUND AND PURPOSE: The American Heart Association/American Stroke Association and Department of Health Stroke Coverdell Program convened a stakeholder meeting in upstate NY to develop recommendations to enhance stroke systems for acute large vessel occlusion. METHODS: Prehospital, hospital, and Department of Health leadership were invited (n=157). Participants provided goals/concerns and developed recommendations for prehospital triage and interfacility transport, rating each using a 3-level impact (A [high], B, and C [low]) and implementation feasibility (1 [high], 2, and 3 [low]) scale...
May 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28492814/implementation-of-rapid-treatment-and-interfacility-transport-for-patients-with-suspected-stroke-by-large-vessel-occlusion-in-one-door-and-out-the-other
#6
Kori Sauser Zachrison, Lee H Schwamm
No abstract text is available yet for this article.
May 8, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28490566/a-retrospective-cohort-study-of-the-utility-of-the-modified-early-warning-score-for-interfacility-transfer-of-patients-with-traumatic-injury
#7
Kristin Salottolo, Matthew Carrick, Jacob Johnson, Mark Gamber, David Bar-Or
OBJECTIVE: The modified early warning score (MEWS) is a 'track and trigger' score using routine physiological vital signs. The objective is to determine if the pretransfer MEWS can be used for predicting outcomes in trauma patients requiring interfacility transfer to higher levels of care. DESIGN, SETTING AND PARTICIPANTS: Retrospective study of consecutively transferred trauma patients into a level-II trauma centre from 2013 to 2014. INTERVENTIONS: None...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28481163/body-temperature-after-ems-transport-association-with-traumatic-brain-injury-outcomes
#8
Joshua B Gaither, Vatsal Chikani, Uwe Stolz, Chad Viscusi, Kurt Denninghoff, Bruce Barnhart, Terry Mullins, Amber D Rice, Moses Mhayamaguru, Jennifer J Smith, Samuel M Keim, Bentley J Bobrow, Daniel W Spaite
INTRODUCTION: Low body temperatures following prehospital transport are associated with poor outcomes in patients with traumatic brain injury (TBI). However, a minimal amount is known about potential associations across a range of temperatures obtained immediately after prehospital transport. Furthermore, a minimal amount is known about the influence of body temperature on non-mortality outcomes. The purpose of this study was to assess the correlation between temperatures obtained immediately following prehospital transport and TBI outcomes across the entire range of temperatures...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28475785/mrsa-transmission-dynamics-among-interconnected-acute-intermediate-term-and-long-term-healthcare-facilities-in-singapore
#9
Angela Chow, Vanessa W Lim, Ateeb Khan, Kerry Pettigrew, David C B Lye, Kala Kanagasabai, Kelvin Phua, Prabha Krishnan, Brenda Ang, Kalisvar Marimuthu, Pei-Yun Hon, Jocelyn Koh, Ian Leong, Julian Parkhill, Li-Yang Hsu, Matthew T G Holden
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common healthcare-associated multidrug-resistant organism. Despite the interconnectedness between acute care hospitals (ACHs) and intermediate- and long-term care facilities (ILTCFs), the transmission dynamics of MRSA between healthcare settings is not well understood. Methods: We conducted a cross-sectional study in a network comprising an ACH and 5 closely affiliated ILTCFs in Singapore...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28463947/impact-of-interfacility-transport-method-and-specialty-teams-on-outcomes-of-pediatric-trauma-patients
#10
Shetal C Patel, Stephen Murphy, Scott Penfil, Debra Romeo, James H Hertzog
OBJECTIVE: The aim of the study was to evaluate the impact of ground versus air transport and use of pediatric specialty versus generalist transport teams on outcomes of pediatric trauma victims requiring interfacility transport. METHODS: A retrospective review of our hospital's trauma registry database was performed. Children with traumatic injuries who were transported from a referring hospital by either our pediatric specialty transport team or an outside generalist transport team were included in the analysis...
May 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28350723/reasons-for-interfacility-emergency-department-transfer-and-care-at-the-receiving-facility
#11
Joyce Li, Stephanie Pryor, Ben Choi, Chris A Rees, Mamata V Senthil, Nicholas Tsarouhas, Sage R Myers, Michael C Monuteaux, Richard G Bachur
OBJECTIVES: The aims of this study were to (1) assess the reasons for pediatric interfacility transfers as identified by transferring providers and review the emergency medical care delivered at the receiving facilities and (2) investigate the emergency department (ED) care among the subpopulation of patients discharged from the receiving facility. METHODS: We performed a multicenter, cross-sectional survey of ED medical providers transferring patients younger than 18 years to 1 of 4 US tertiary care pediatric hospitals with a subsequent medical record review at the receiving facility...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28328689/adult-chest-pain-in-the-pediatric-emergency-department-treatment-and-timeliness-from-door-in-to-door-out
#12
Jeffrey H Sacks, Peter B Flueckiger, Philip R Spandorfer, William T Mahle, Brian E Costello
OBJECTIVES: The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. METHODS: Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28275613/development-of-a-new-interfacility-extracorporeal-membrane-oxygenation-transport-program-for-pediatric-lung-transplantation-evaluation
#13
REVIEW
W Joshua Frazier, Edward G Shepherd, Samantha W Gee
Pediatric lung transplantation is a life-saving intervention for children with irreversible end-stage lung disease. Access to transplant can be limited by geographic isolation from a center or the presence of comorbidities affecting transplant eligibility. Extracorporeal membrane oxygenation (ECMO)-supported patients are an uncommon but historically high-risk cohort of patients considered for lung transplant. We report the development of a service at our center to provide transport services to our hospital for patients unable to wean from ECMO support at their local institution for the purpose of evaluation for lung transplantation by our program...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28222816/successful-hospital-evacuation-after-the-kumamoto-earthquakes-japan-2016
#14
Takashi Nagata, Shinkichi Himeno, Akihiro Himeno, Manabu Hasegawa, Alan Kawarai Lefor, Makoto Hashizume, Yoshihiko Maehara, Masami Ishii
Two major earthquakes struck Kumamoto Prefecture in Japan in April 2016. Disaster response was immediately provided, including disaster medical services. Many hospitals were damaged and patients needed immediate evacuation to alternative facilities. The hospital bed capacity of Kumamoto Prefecture was overwhelmed, and transportation of more than 100 patients was needed. Hospital evacuation was carried out smoothly with the coordinated efforts of multiple agencies. The overall operation was deemed a success because patients were transported in a timely manner without any significant adverse events...
February 22, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28212167/the-varying-roles-of-nurses-during-interfacility-care-transitions
#15
Lianne Jeffs, Marianne Saragosa, Madelyn Law, Kerry Kuluski, Sherry Espin, Heidi Parker, Kristen Collins
This study explored health care professionals' perceptions and experiences associated with the role of point-of-care nurses during care transitions from an acute care hospital to a rehabilitation setting to being discharged home. We used a qualitative exploratory design and semistructured interviews. Content analysis revealed 3 themes that point to the ambiguity related to the roles that nurses enact with older patients during care transitions. We suggest ways to better support nurses to engage in quality care transitions...
February 15, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28109306/impact-of-trauma-system-structure-on-injury-outcomes-a-systematic-review-protocol
#16
Lynne Moore, Howard Champion, Gerard O'Reilly, Ari Leppaniemi, Peter Cameron, Cameron Palmer, Fikri M Abu-Zidan, Belinda Gabbe, Christine Gaarder, Natalie Yanchar, Henry Thomas Stelfox, Raul Coimbra, John Kortbeek, Vanessa Noonan, Amy Gunning, Luke Leenan, Malcolm Gordon, Monty Khajanchi, Michèle Shemilt, Valérie Porgo, Alexis F Turgeon
BACKGROUND: Injury represents one of the greatest public health challenges of our time with over 5 million deaths and 100 million people temporarily or permanently disabled every year worldwide. The effectiveness of trauma systems in decreasing injury mortality and morbidity has been well demonstrated. However, the organisation of trauma care varies significantly across trauma systems and we know little about which components of trauma systems contribute to their effectiveness. The objective of the study described in this protocol is to systematically review evidence of the impact of trauma system components on clinically significant outcomes including mortality, function and disability, quality of life, and resource utilization...
January 21, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28103121/comparison-of-helicopter-emergency-medical-services-transport-types-and-delays-on-patient-outcomes-at-two-level-i-trauma-centers
#17
Brodie Nolan, Homer Tien, Bruce Sawadsky, Sandro Rizoli, Amanda McFarlan, Andrea Phillips, Alun Ackery
BACKGROUND: Helicopter emergency medical services (HEMS) have become an engrained component of trauma systems. In Ontario, transportation for trauma patients is through one of three ways: scene call, modified scene call, or interfacility transfer. We hypothesize that differences exist between these types of transports in both patient demographics and patient outcomes. This study compares the characteristics of patients transported by each of these methods to two level 1 trauma centers and assesses for any impact on morbidity or mortality...
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28030520/parent-perceptions-on-transfers-to-pediatric-emergency-departments-and-the-role-of-telemedicine
#18
Cynthia J Mollen, Mira Henien, Lisa M Jacobs, Sage Myers
OBJECTIVE: Real-time audiovisual consultation (telemedicine) has been proven feasible and is a promising alternative to interfacility transfer. We sought to describe caregiver perceptions of the decision to transfer his or her child to a pediatric emergency department and the potential use of telemedicine as an alternative to transfer. METHODS: Semistructured interviews of caregivers of patients transferred to a pediatric emergency department. Purposive sampling was used to recruit caregivers of patients who were transferred from varying distances and different times of the day...
December 28, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27989619/determinants-of-treatment-eligibility-in-veterans-with-hepatitis-c-viral-infection
#19
Janice Taylor, Sian Carr-Lopez, Amy Robinson, Robert Malmstrom, Karsten Duncan, Archana Maniar, A C Del Re, Jannet M Carmichael
PURPOSES: The objective of this study was to determine the percentage of veterans with active hepatitis C virus (HCV) infection who were deemed to be candidates for treatment and to identify factors associated with treatment ineligibility. METHODS: This was a multisite, retrospective cohort analysis of veterans with HCV infection within the Veteran Integrated Service Network 21. Patients evaluated between August and November 2015 who were viremic and not receiving HCV treatment were included in the analysis...
January 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/27850754/1117-staff-safety-during-interfacility-pediatric-ambulance-transport
#20
Joonghyun Ahn, Kyle Candela, Philomena Costabile, Eric Henderson, Sarabdeep Singh, Oritsetimeyin Moju, Theophilus Moss, Corina Noje
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
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