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Clinical practice guidelines in the emergency room

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https://www.readbyqxmd.com/read/27852427/monitoring-the-hospital-management-of-acute-asthma-the-italian-pediatric-network-experience
#1
A G Martelli, R Bianchi, B Boldrighini, M Bosoni, A De Vuono, A Flores D'Arcais, G Gargantini, R Longhi, M T Ortisi, E Racchi, L Parola
BACKGROUND: The Study Group on Accreditation and Quality Improvement of the Italian Society of Pediatrics has developed an observational study about the hospital management of pediatric patients affected by severe asthma, in order to evaluate how the Guidelines for severe asthma in childhood are applied in the daily practice. METHODS: This study included patients between 2 and 17 years, hospitalized or under short intensive observation for acute asthma. The data collection was carried out through the compilation of on-line forms...
November 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27777546/pre-burn-centre-management-of-the-airway-in-patients-with-face-burns
#2
D Costa Santos, F Barros, M Frazão, M Maia
Face burns expose patients to a higher respiratory risk, and early prophylactic intubation before they enter the burn unit might be life-saving. However, unnecessary intubation may compromise their clinical evolution. Hence, the decision to perform pre-burn centre endotracheal intubation remains a clinical challenge. A retrospective study was developed to characterize the experience of the tertiary burn unit of the Hospital da Prelada with face burn patients arriving endotracheally-intubated between January 2009 and September 2013...
December 31, 2015: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/27662389/effects-of-antibiotic-timing-on-culture-results-and-clinical-outcomes-in-pediatric-musculoskeletal-infection
#3
Michael A Benvenuti, Thomas J An, Megan E Mignemi, Jeffrey E Martus, Isaac P Thomsen, Jonathan G Schoenecker
INTRODUCTION: Musculoskeletal infection (MSI) is a common cause of morbidity and hospital resource utilization in the pediatric population. Many physicians prefer to withhold antibiotics until tissue cultures can be taken in an effort to improve culture yields. However, there is little evidence that this practice improves culture results or outcomes in pediatric MSI. Therefore, investigating the effects of antibiotic timing may lead to improved clinical practice guidelines for treating children with MSI...
September 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27604617/12th-winfocus-world-congress-on-ultrasound-in-emergency-and-critical-care
#4
Yahya Acar, Onur Tezel, Necati Salman, Erdem Cevik, Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás, Mustafa Z Mahmoud, Abdelmoneim Sulieman, Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H Lester Kirchner, Gregor Prosen, Ajda Anzic, Paul Leeson, Maryam Bahreini, Fatemeh Rasooli, Houman Hosseinnejad, Gabriel Blecher, Robert Meek, Diana Egerton-Warburton, Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević, Nadan Rustemović, Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim, Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung, Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić, Abiola Fasina, Anthony J Dean, Nova L Panebianco, Patricia S Henwood, Oliviero Fochi, Moreno Favarato, Ezio Bonanomi, Ivan Tomić, Youngrock Ha, Hongchuen Toh, Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Angela Hua, Sharon Kim, James Tsung, Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay, Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim, Ji-Han Lee, Jana Ambrozic, Katja Prokselj, Miha Lucovnik, Gabrijela Brzan Simenc, Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas, Sharad Mohite, Zoltan Narancsik, Hugon Možina, Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann, Chun-I Pan, Chien-Hung Wu, Sarah Pasquale, Stephanie J Doniger, Sharon Yellin, Gerardo Chiricolo, Maja Potisek, Borut Drnovšek, Boštjan Leskovar, Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi, Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic, Ana Godan Hauptman, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Vedran Radonic, Luka Bielen, Peh Wee Ming, Nur Hafiza Yezid, Fatahul Laham Mohammed, Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W Yus Haniff W Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan
A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
September 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27583928/effect-of-opioid-prescribing-guidelines-in-primary-care
#5
Jonathan H Chen, Jason Hom, Ilana Richman, Steven M Asch, Tanya Podchiyska, Nawal Atwan Johansen
Long-term opioid use for noncancer pain is increasingly prevalent yet controversial given the risks of addiction, diversion, and overdose. Prior literature has identified the problem and proposed management guidelines, but limited evidence exists on the actual effectiveness of implementing such guidelines in a primary care setting.A multidisciplinary working group of institutional experts assembled comprehensive guidelines for chronic opioid prescribing, including monitoring and referral recommendations. The guidelines were disseminated in September 2013 to our medical center's primary care clinics via in person and electronic education...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27475878/the-room-where-it-happens-a-skeptic-s-analysis-of-the-new-heart-failure-guidelines
#6
Milton Packer
New heart failure guidelines have been issued during the past several months, both in the United States and in Europe, in response to recent advances in and the approval of new drugs for the treatment of heart failure. Although guidelines documents are often viewed as authoritative and purely evidence-based, there are replete with meaningful (and inexplicable) inconsistencies, which derive from a review of the same body of scientific data by different groups. This satirical review highlights several examples of the entertaining foolishness of recent guideline documents in the good-natured hope that physicians will understand what the guidelines are, and more importantly, what they are not...
September 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27318182/shoulder-dystocia-guidelines-for-clinical-practice-from-the-french-college-of-gynecologists-and-obstetricians-cngof
#7
REVIEW
Loïc Sentilhes, Marie-Victoire Sénat, Anne-Isabelle Boulogne, Catherine Deneux-Tharaux, Florent Fuchs, Guillaume Legendre, Camille Le Ray, Emmanuel Lopez, Thomas Schmitz, Véronique Lejeune-Saada
Shoulder dystocia (SD) is defined as a vaginal delivery in cephalic presentation that requires additional obstetric maneuvers to deliver the fetus after the head has delivered and gentle traction has failed. It complicates 0.5-1% of vaginal deliveries. Risks of brachial plexus birth injury (level of evidence [LE]3), clavicle and humeral fracture (LE3), perinatal asphyxia (LE2), hypoxic-ischemic encephalopathy (LE3) and perinatal mortality (LE2) increase with SD. Its main risk factors are previous SD and macrosomia, but both are poorly predictive; 50-70% of SD cases occur in their absence, and most deliveries when they are present do not result in SD...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/26691143/a-clinical-network-project-improves-care-of-patients-with-atrial-fibrillation-with-rapid-ventricular-response-in-victorian-emergency-departments
#8
MULTICENTER STUDY
Anne-Maree Kelly, Jan Pannifex
OBJECTIVES: Atrial fibrillation with rapid ventricular response is a common condition in emergency departments (ED) and despite published guidelines, variation in practice is common. The aim of this nine-month evidence-based care improvement project was improving the management of atrial fibrillation with rapid ventricular response (AFRVR). METHODS: This was a quality improvement project, evaluated using before and after chart review methodology. The outcomes of interest were the proportion of patients managed according to a local treatment pathway, the proportion with duration of symptoms documented, the proportion with rate control versus rhythm control strategy documented and the proportion with a CHADS2 score (or equivalent) documented...
March 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/26541561/-shoulder-dystocia-guidelines-for-clinical-practice-short-text
#9
REVIEW
L Sentilhes, M-V Sénat, A-I Boulogne, C Deneux-Tharaux, F Fuchs, G Legendre, C Le Ray, E Lopez, T Schmitz, V Lejeune-Saada
OBJECTIVES: To determine the available evidence to prevent and treat shoulder dystocia to attempt to decrease its related neonatal and maternal morbidity. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Shoulder dystocia, defined as a vaginal delivery that requires additional obstetric maneuvers to deliver the fetus after the head has delivered and gentle traction has failed, complicates 0...
December 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/26527019/-post-partum-management-after-cesarean-delivery-guidelines-for-clinical-practice
#10
REVIEW
F Fuchs, D Benhamou
OBJECTIVE: To determine guidelines for post-partum management after cesarean delivery regarding patient monitoring, organization, postoperative analgesia, time of urinary catheter removal, resumption of feeding and drinking, timing of ambulation, indication and modalities of thromboprophylaxis. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Immediate postoperative monitoring after caesarean delivery should be performed in the recovery room, but in exceptional circumstances, it may be performed in the delivery unit provided safety rules are maintained and regulatory authorities are informed (professional consensus)...
December 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/26486272/routine-use-of-contact-precautions-for-methicillin-resistant-staphylococcus-aureus-and-vancomycin-resistant-enterococcus-which-way-is-the-pendulum-swinging
#11
Dana Russell, Susan E Beekmann, Philip M Polgreen, Zachary Rubin, Daniel Z Uslan
BACKGROUND Studies have suggested that contact precautions (CP) for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus may have risks that outweigh the benefits. These risks, coupled with more widespread use of horizontal interventions such as daily bathing with chlorhexidine gluconate, have brought into question the value of routine CP for these organisms. OBJECTIVE To assess the state of utilization of CP as well as adjunctive measures to reduce the risk of transmission in US hospitals...
January 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/26424762/observation-for-assessment-of-clinician-performance-a-narrative-review
#12
REVIEW
Arianna F Yanes, Lisa M McElroy, Zachary A Abecassis, Jane Holl, Donna Woods, Daniela P Ladner
BACKGROUND: Video recorded and in-person observations are methods of quality assessment and monitoring that have been employed in high risk industries. In the medical field, observations have been used to evaluate the quality and safety of various clinical processes. This review summarises studies utilising video recorded or in-person observations for assessing clinician performance in medicine and surgery. METHODS: A search of MEDLINE (PubMed) was conducted using a combination of medical subject headings (MeSH) terms...
January 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/26381997/management-of-fever-and-neutropenia-in-paediatric-cancer-patients-room-for-improvement
#13
REVIEW
Gabrielle M Haeusler, Lillian Sung, Roland A Ammann, Bob Phillips
PURPOSE OF REVIEW: Fever and neutropenia is the most common complication in the treatment of childhood cancer. This review will summarize recent publications that focus on improving the management of this condition as well as those that seek to optimize translational research efforts. RECENT FINDINGS: A number of clinical decision rules are available to assist in the identification of low-risk fever and neutropenia however few have undergone external validation and formal impact analysis...
December 2015: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/26334607/guidelines-for-the-management-of-a-pregnant-trauma-patient
#14
Venu Jain, Radha Chari, Sharon Maslovitz, Dan Farine, Emmanuel Bujold, Robert Gagnon, Melanie Basso, Hayley Bos, Richard Brown, Stephanie Cooper, Katy Gouin, N Lynne McLeod, Savas Menticoglou, William Mundle, Christy Pylypjuk, Anne Roggensack, Frank Sanderson
OBJECTIVE: Physical trauma affects 1 in 12 pregnant women and has a major impact on maternal mortality and morbidity and on pregnancy outcome. A multidisciplinary approach is warranted to optimize outcome for both the mother and her fetus. The aim of this document is to provide the obstetric care provider with an evidence-based systematic approach to the pregnant trauma patient. OUTCOMES: Significant health and economic outcomes considered in comparing alternative practices...
June 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/26251399/in-hospital-organization-of-primary-care-of-patients-presenting-a-life-threatening-emergency-a-french-national-survey-in-32-university-hospitals
#15
Hervé Quintard, Mathilde Severac, Claude Martin, Carole Ichai
INTRODUCTION: The development of specialized units dedicated to life-threatening management has demonstrated to improve the prognosis of patients requiring such treatments. However, apart those focused on trauma and stroke, networks are still lacking in France. Despite, the implementation of standardisation of practices and guidelines, particularly in prehospital care, in-hospital clinical practices at admission remain heterogenous. This survey aimed to assess the structural and human organization of teaching hospitals in France concerning the primary in-hospital care for critically ill patients...
August 2015: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/26108353/-the-abcs-of-ad-a-prospective-evaluation-of-the-efficacy-of-an-educational-intervention-to-increase-knowledge-of-autonomic-dysreflexia-management-among-emergency-health-care-professionals
#16
Andrei Krassioukov, Jennifer R Tomasone, Melissa Pak, B Catharine Craven, Mohammad H Ghotbi, Karen Ethans, Kathleen A Martin Ginis, Michael Ford, Dmitri Krassioukov-Enns
CONTEXT/OBJECTIVE: Despite the availability of consensus-based resources, first responders and emergency room (ER) health care professionals (HCPs) have limited knowledge regarding autonomic dysreflexia (AD) recognition and treatment. The purpose of this study was to assess the efficacy of "The ABCs of AD" educational seminar for improving HCPs' short- and long-term knowledge of AD recognition, diagnosis, and management. DESIGN: Multi-center prospective pre, post, and follow-up questionnaire study...
2016: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/26002947/infection-prevention-and-control-in-nursing-homes-a-qualitative-study-of-decision-making-regarding-isolation-based-practices
#17
Catherine Crawford Cohen, Monika Pogorzelska-Maziarz, Carolyn T A Herzig, Eileen J Carter, Ragnhildur Bjarnadottir, Patricia Semeraro, Jasmine L Travers, Patricia W Stone
BACKGROUND: Isolation-based practices in nursing homes (NHs) differ from those in acute care. NHs must promote quality of life while preventing infection transmission. Practices used in NHs to reconcile these goals of care have not been characterised. PURPOSE: To explore decision-making in isolation-based infection prevention and control practices in NHs. METHODS: A qualitative study was conducted with staff (eg, staff nurses, infection prevention directors and directors of nursing) employed in purposefully sampled US NHs...
October 2015: BMJ Quality & Safety
https://www.readbyqxmd.com/read/25758570/current-concepts-on-magnetic-resonance-imaging-mri-perfusion-diffusion-assessment-in-acute-ischaemic-stroke-a-review-an-update-for-the-clinicians
#18
REVIEW
Ernesto Roldan-Valadez, Mariana Lopez-Mejia
Recently, several medical societies published joint statements about imaging recommendations for acute stroke and transient ischaemic attack patients. In following with these published guidelines, we considered it appropriate to present a brief, practical and updated review of the most relevant concepts on the MRI assessment of acute stroke. Basic principles of the clinical interpretation of diffusion, perfusion, and MRI angiography (as part of a global MRI protocol) are discussed with accompanying images for each sequence...
December 2014: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/25676887/defining-moderate-asthma-exacerbations-in-clinical-trials-based-on-ats-ers-joint-statement
#19
REVIEW
J Christian Virchow, Vibeke Backer, Frédéric de Blay, Piotr Kuna, Christian Ljørring, Jesus L Prieto, Hanne H Villesen
BACKGROUND: Exacerbations are a key outcome in clinical research, providing patient-relevant information about symptomatic control, health state and disease progression. Generally considered as an episode of (sub)acute deterioration of respiratory symptoms, a precise, clinically useful definition is needed for use in clinical trials. AIM AND METHODS: Focussing on moderate exacerbations, this opinion piece reviews landmark trials and current guidelines to provide a practical definition of a moderate exacerbation...
May 2015: Respiratory Medicine
https://www.readbyqxmd.com/read/25569664/gastrointestinal-bleeding-and-anticoagulant-or-antiplatelet-drugs-systematic-search-for-clinical-practice-guidelines
#20
REVIEW
Irit Kaye Gutermann, Verena Niggemeier, Lukas U Zimmerli, Barbara M Holzer, Edouard Battegay, Michael Scharl
Gastrointestinal (GI) bleeding is a frequently encountered and very serious problem in emergency room patients who are currently being treated with anticoagulant or antiplatelet medications. There is, however, a lack of clinical practice guidelines about how to respond to these situations. The goal of this study was to find published articles that contain specific information about how to safely adjust anticoagulant and antiplatelet therapy when GI bleeding occurs.The investigators initiated a global search on the PubMed and Google websites for published information about GI bleeding in the presence of anticoagulant or antiplatelet therapy...
January 2015: Medicine (Baltimore)
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