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https://www.readbyqxmd.com/read/29784656/lessons-identified-from-the-2017-manchester-and-london-terrorism-incidents-part-two-the-reception-and-definitive-care-hospital-phases
#1
REVIEW
Paul Hunt
The provision of medical care during the reception and definitive care phases of a terrorist incident will likely take place in designated receiving hospitals such as Major Trauma Centres. There is a need for an enhanced capability in such units to receive, initially manage and hold casualties with more serious injuries. Also, even less severely injured casualties may require significant time and clinical input such as risk management in potential bloodborne viruses.The distribution of casualties from the incident scene requires advance consideration of the injury pattern and regional network organisation of specialist services, such as maxillofacial, neurosurgery or severe burns care...
May 21, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29781972/human-trafficking-how-nurses-can-make-a-difference
#2
Meredith Scannell, Andrea E MacDonald, Amanda Berger, Nichole Boyer
Human trafficking is a human rights violation and a global health problem. Victims of human trafficking have medical and mental health sequelae requiring specific healthcare interventions. Healthcare professionals may be the initial contact that these victims make outside the world of trafficking. Healthcare professionals are key agents in the identification of human trafficking, which is essential in eliminating this public health problem. Unfortunately, healthcare professionals are not always able to detect signs of human trafficking...
April 2018: Journal of Forensic Nursing
https://www.readbyqxmd.com/read/29779623/educating-emergency-department-staff-on-the-identification-and-treatment-of-human-trafficking-victims
#3
Steven Donahue, Michael Schwien, Danielle LaVallee
INTRODUCTION: Hospitalization is one of the few circumstances in which the lives of trafficking victims intersect with the general population. Based on survivor testimonies, the majority of human trafficking victims may receive medical treatment in a hospital's emergency department while in captivity. With evidenced-based training, ED personnel have a better opportunity to screen persons who are being trafficked and intervene on their behalf. METHODS: This project examined the efficacy of an innovative, evidence-based online training module (HTEmergency...
May 17, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29779305/-expert-consensus-on-standardized-processes-of-ambulatory-biliary-surgery-2018-edition
#4
(no author information available yet)
The definition of ambulatory surgery is that the patient is admitted, operated and discharged within a day (24 hours) , but does not include outpatient surgery. It can shorten the average hospital stay, reduce medical expenses, accelerate the recovery of patients, and has been approved to have great social and economic benefits.The main contents of this consensus include: (1)the establishment of ambulatory biliary surgery system, which involves the facilities building, team building, the construction of management systems, operation management, operation state analysis and benefit evaluation; (2)Patient selection criteria, pre-hospital assessment, surgical scheduling, preoperative education, anesthesia and management of adverse reactions after anesthesia, intraoperative application of general surgical principles and postoperative emergency plans, perioperative nursing; (3)Discharge criteria and pre-discharge assessment, post-discharge follow-up and rehabilitation guidance; (4) quality and safety control index system of ambulatory biliary surgery...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29775692/exploring-canadian-physicians-experiences-providing-medical-assistance-in-dying-a-qualitative-study
#5
Narges Khoshnood, Marie-Clare Hopwood, Bhadra Lokuge, Allison Kurahashi, Anastasia Tobin, Sarina Isenberg, Amna Husain
CONTEXT: MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. OBJECTIVES: To explore the professional challenges faced by Canadian physicians who provide MAiD...
May 15, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#6
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29769369/comparison-of-severe-trauma-treatment-standards-in-civilian-china-with-current-practice-in-the-chinese-military-peacekeeping-level-2-military-hospital-in-gao-mali
#7
Jian Li, J Tian, Y B Wang, H Zhang
INTRODUCTION: The People's Republic of China has been successfully deploying medical teams to support the peacekeeping mission at the Level 2 Military Hospital in Mali since December 2013. The aim of this paper was to compare the current practice in Chinese Peacekeeping Level 2 Military Hospital with the severe trauma treatment standards reported in China. METHODS: A retrospective analysis was conducted between 26 April 2014 and 18 May 2016 using records stored in the Chinese Peacekeeping Level 2 Hospital (CHN L2)...
May 16, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29765259/shadowing-emergency-medicine-residents-by-medical-education-specialists-to-provide-feedback-on-non-medical-knowledge-based-acgme-sub-competencies
#8
Anna L Waterbrook, Karen C Spear Ellinwood, T Gail Pritchard, Karen Bertels, Ariel C Johnson, Alice Min, Lisa R Stoneking
Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29762793/a-qualitative-study-of-the-communication-process-for-medical-acupuncture-in-family-medicine
#9
Christy J W Ledford, Carla L Fisher, Paul Crawford
BACKGROUND AND OBJECTIVES: As evidence establishes the efficacy of medical acupuncture, more family physicians and family medicine residents may receive medical acupuncture training and need to know how to effectively communicate about the treatment option with patients. By identifying how physicians talk about acupuncture treatment with their patients, we aimed to develop a model for physician training that could enhance their ability to integrate and practice medical acupuncture in conventional clinical settings...
May 2018: Family Medicine
https://www.readbyqxmd.com/read/29760864/3-for-the-price-of-1-teaching-chest-pain-risk-stratification-in-a-multidisciplinary-problem-based-learning-workshop
#10
William D Alley, Cynthia Burns, Nicholas D Hartman, Kim Askew, Simon A Mahler
Introduction: Chest pain is a common chief complaint among patients presenting to health systems and often leads to complex and intensive evaluations. While these patients are often cared for by a multidisciplinary team (primary care, emergency medicine, and cardiology), medical students usually learn about the care of these patients in a fragmented, single-specialty paradigm. The present and future care of patients with chest pain is multidisciplinary, and the education of medical students on the subject should be as well...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29760863/implementation-of-an-emergency-medicine-research-associates-program-sharing-20-years-of-experience
#11
Beau Abar, Vincent DeRienzo, Joseph Glick, Nancy Wood, Manish N Shah, Sandra Schneider, David Adler
Introduction: The use of research associates (RA) programs to facilitate study enrollment in the emergency department was initiated during the mid-1990s. The University of Rochester Medical Center (URMC) was an early adopting site for this model, which has experienced considerable growth and development over the past 20 years. Methods: Our goal was to detail the Emergency Department Research Associates (EDRA) program processes developed at the URMC that has led to our program's sustainability and productivity...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759676/outcomes-associated-with-electrical-cardioversion-for-atrial-fibrillation-when-performed-autonomously-by-an-advanced-practice-provider
#12
Theresa A Strzelczyk, Rachel M Kaplan, Meena Medler, Bradley P Knight
OBJECTIVES: This study sought to determine the feasibility, safety, and efficacy of elective electrical cardioversion (CV) for atrial fibrillation (AF) when performed autonomously by a trained advanced practice provider (APP) using a guideline-directed protocol. BACKGROUND: APPs have emerged as an integral part of the cardiovascular team. METHODS: A licensed advanced practice nurse-clinical nurse specialist was trained and obtained credentials to perform CVs...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29753761/grand-rounds-alcoholic-hepatitis
#13
REVIEW
Ashwani K Singal, Alexandre Louvet, Vijay H Shah, Patrick S Kamath
Alcoholic hepatitis presents with acute on chronic liver failure among patients with chronic and active heavy use of alcohol, with high short-term mortality. These patients suffer from two problems, namely hepatic dysfunction and alcohol use disorder. Short-term outcome is impacted by liver failure and the long-term outcome by alcoholism and relapse to alcohol use. Clearly, these patients need integrated and coordinated management from the beginning by multi-disciplinary team. Herein, we describe a clinical vignette on a 33 year old male patient who survived the first episode of alcoholic hepatitis with this integrated management approach...
May 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29748188/factors-influencing-the-decision-to-proceed-to-firmware-upgrades-to-implanted-pacemakers-for-cybersecurity-risk-mitigation
#14
Leslie A Saxon, Niraj Varma, Laurence M Epstein, Leonard I Ganz, Andrew E Epstein
In August 2017, the first major recall for cybersecurity vulnerabilities in pacemakers capable of remote connectivity was released that impacted 465,000 United States patients.1,2 The FDA approved a firmware update designed by the manufacturer of the devices as a remediation (Abbott , formally St. Jude Medical). The recall was in response to the public disclosure of vulnerability by an investment firm and produced in a lab environment that could allow an unauthorized party in close proximity to a patient to impact the performance of the device or modify device settings via radio frequency communication...
May 10, 2018: Circulation
https://www.readbyqxmd.com/read/29743217/strategies-for-addressing-the-challenges-of-patient-centered-medical-home-implementation-lessons-from-oregon
#15
Sherril Gelmon, Nicole Bouranis, Billie Sandberg, Shauna Petchel
BACKGROUND: Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). METHODS: Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743054/australian-integrative-oncology-services-a-mixed-method-study-exploring-the-views-of-cancer-survivors
#16
Jennifer Hunter, Jane Ussher, Chloe Parton, Andrew Kellett, Caroline Smith, Geoff Delaney, Eleanor Oyston
BACKGROUND: The significant use of traditional and complementary medicine (T&CM) by cancer survivors is well documented. The aim of this study was to explore cancer survivors' views on integrating T&CM services with conventional cancer care. METHOD: A mixed-method study design with an emphasis on qualitative methodology was used to conduct and analyse four focus group interviews and an on-line survey. Purposive sampling recruited 33 cancer survivors and caregivers from Arabic, Vietnamese, Chinese and Anglo-European Australian backgrounds who participated in one of four focus group interviews, and 121 cancer survivors who responded to an on-line survey...
May 9, 2018: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29742625/integrating-population-health-data-on-violence-into-the-emergency-department-a-feasibility-and-implementation-study
#17
Michael N Levas, Jennifer L Hernandez-Meier, Sara Kohlbeck, Nancy Piotrowski, Stephen Hargarten
Geocoded emergency department (ED) data have allowed for the development and evaluation of novel interventions for the prevention of violence in cities outside of the United States. First implemented in Cardiff, United Kingdom, collection of these data provides public health agencies, community organizations, and law enforcement with place-based information on assaults. The purpose of this study was to assess the feasibility of translating this model within the electronic medical record (EMR) in the United States...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29739414/psychiatric-consultation-requests-by-inpatient-medical-teams-an-observational-study
#18
Carla Pezzia, Jacqueline A Pugh, Holly J Lanham, Luci K Leykum
BACKGROUND: We describe the way psychiatric issues are addressed by inpatient medical teams through analysis of discussions of patients with behavioral health concerns and examination of teams' subsequent consultation practices. METHODS: We observed morning rounds for nine inpatient medical teams for approximately month-long periods, for a total of 1941 observations. We compared discussions of patients admitted for behavioral health related medical conditions between those who did and did not receive a psychiatric consultation, developing categories to describe factors influencing consultation or other management...
May 8, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29734457/11-361-sports-injuries-in-a-15-year-survey-of-a-level-i-emergency-trauma-department-reveal-different-severe-injury-types-in-the-6-most-common-team-sports
#19
Werner Krutsch, Volker Krutsch, Franz Hilber, Christian Pfeifer, Florian Baumann, Johannes Weber, Paul Schmitz, Maximilian Kerschbaum, Michael Nerlich, Peter Angele
INTRODUCTION:  Severe sports-related injuries are a common affliction treated in Level I trauma departments. Detailed knowledge on injury characteristics from different medical settings is essential to improve the development of injury prevention strategies in different team sports. METHODS:  Team sport injuries were retrospectively analysed in a Level I trauma department registry over 15 years. Injury and treatment data were compared with regard to competition and training exposure...
May 7, 2018: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
https://www.readbyqxmd.com/read/29725559/trapped-as-a-group-escape-as-a-team-applying-gamification-to-incorporate-team-building-skills-through-an-escape-room-experience
#20
Xiao Chi Zhang, Hyunjoo Lee, Carlos Rodriguez, Joshua Rudner, Teresa M Chan, Dimitrios Papanagnou
Teamwork, a skill critical for quality patient care, is recognized as a core competency by the Accreditation Council for Graduate Medical Education (ACGME). To date, there is no consensus on how to effectively teach these skills in a forum that engages learners, immerses members in life-like activities, and builds both trust and rapport. Recreational 'Escape Rooms' have gained popularity in creating a life-like environment that rewards players for working together, solving puzzles, and completing successions of mind-bending tasks in order to effectively 'escape the room' in the time allotted...
March 2, 2018: Curēus
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