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Emergency room care

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https://www.readbyqxmd.com/read/29785703/a-cross-sectional-study-evaluating-the-use-of-free-clinics-in-syracuse-ny-patient-demographics-and-barriers-to-accessing-healthcare-in-traditional-settings
#1
Simone Arvisais-Anhalt, Matthew MacDougall, Michael Rosenthal, Peter Congelosi, Daniel F Farrell, Paula Rosenbaum
Free clinics provide healthcare to underserved patient populations, playing a critical role in the medical safety-net. Syracuse, New York has notable racial, socioeconomic, and educational disparities and is home to four free clinics. Little is known about these clinics' patient population. This study attempts to better define this population and the barriers they face accessing traditional care. We developed a 27-question survey investigating patient demographics, barriers to traditional healthcare, and experience at local free clinics...
May 21, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#2
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29780586/asthma-related-health-services-and-asthma-control-among-women-in-puerto-rico
#3
María Calixta Ortiz-Rivera
Objectives: This study evaluates social, behavioral, and environmental determinants to differentiate between active and inactive asthma and how predisposing, enabling, and need factors elucidate asthma-related health services and asthma control among women in Puerto Rico. Methods: This study analyzed secondary cross-sectional data from a subsample of 625 adult females who participated in the Asthma Call Back Survey in Puerto Rico. Logistic and multinomial regression analyses were conducted to examine associations between explanatory variables and asthma outcomes...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29775092/a-prospective-multi-centre-us-clinical-trial-to-determine-accuracy-of-febridx-point-of-care-testing-for-acute-upper-respiratory-infections-with-and-without-a-confirmed-fever
#4
Nathan I Shapiro, Wesley H Self, Jeffrey Rosen, Stephan C Sharp, Michael R Filbin, Peter C Hou, Amisha D Parekh, Michael C Kurz, Robert Sambursky
BACKGROUND: FebriDx is a 10-minute disposable point-of-care test designed to identify clinically significant systemic host immune responses and aid in the differentiation of bacterial and viral respiratory infection by simultaneously detecting C-reactive protein (CRP) and myxovirus resistance protein A (MxA) from a fingerstick blood sample. FebriDx diagnostic accuracy was evaluated in the emergency room and urgent care setting. METHODS: A prospective, multicentre, observational cohort study of acute upper respiratory tract infections (URIs), with and without a confirmed fever at the time of enrolment, was performed to evaluate the diagnostic accuracy of FebriDx to identify clinically significant bacterial infection with host response and acute pathogenic viral infection...
May 18, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29769091/use-of-health-services-among-international-migrant-children-a-systematic-review
#5
REVIEW
Niina Markkula, Baltica Cabieses, Venla Lehti, Eleonora Uphoff, Sofia Astorga, Francisca Stutzin
BACKGROUND: Migrant children have specific health needs, and may face difficulties in accessing health care, but not enough is known about their health service use. This study aims to describe patterns of use of health services of international migrant children and differences to respective native populations. METHODS: Electronic databases PubMed and Web of Science, references of identified publications, and websites of relevant international agencies were searched...
May 16, 2018: Globalization and Health
https://www.readbyqxmd.com/read/29768938/double-blind-placebo-controlled-randomized-clinical-trial-of-ginger-zingiber-officinale-rosc-addition-in-migraine-acute-treatment
#6
Laís Bhering Martins, Ana Maria Dos Santos Rodrigues, Débora Fernandes Rodrigues, Luana Caroline Dos Santos, Antônio Lúcio Teixeira, Adaliene Versiani Matos Ferreira
Background Previous studies have demonstrated the analgesic effects of ginger in different conditions, but evidence about its efficacy in migraine treatment is scarce. Objective This study aimed to evaluate the potential of ginger to improve acute migraine as an add-on strategy to standard treatment. Methods A double-blind placebo-controlled randomized clinical trial in the emergency room of a general hospital was conducted. Patients who sought medical care at the time of migraine attack were enrolled in this study...
January 1, 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29767446/hydroxycarbamide-adherence-and-cumulative-dose-associated-with-hospital-readmission-in-sickle-cell-disease-a-6-year-population-based-cohort-study
#7
Jifang Zhou, Jin Han, Edith A Nutescu, Victor R Gordeuk, Santosh L Saraf, Gregory S Calip
Sickle cell disease (SCD) is a congenital haemoglobinopathy that causes frequent acute care/emergency room visits and hospital admissions for affected individuals. Evidence from population-based studies demonstrating the role of hydroxycarbamide (HC, also termed hydroxyurea) in reducing hospital readmission rates is limited. Our objective was to describe the use of HC and its association with acute care utilization and readmission rates using a large, nationally-representative US health insurance claims database over a 6-year period between 2009 and 2014...
May 16, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29766136/can-necrotizing-soft-tissue-infection-be-reliably-diagnosed-in-the-emergency-department
#8
Sharon M Henry, Kimberly A Davis, Jonathan J Morrison, Thomas M Scalea
Necrotizing soft tissue infections (NSTIs) are associated with a high mortality and require prompt recognition and treatment, consisting of aggressive surgical debridement and critical care support. Diagnosis is a key step, which is generally made in the operating room (OR), but the decision to debride requires guidance. This is frequently made on clinical grounds, but NSTI can be occult in presentation and several other infective processes can mimic NSTI. It is unknown whether the various scoring systems described in the literature can enable clinicians to reliably diagnose NSTI in the emergency department, rather than the OR...
2018: Trauma Surg Acute Care Open
https://www.readbyqxmd.com/read/29766127/grey-s-anatomy-effect-television-portrayal-of-patients-with-trauma-may-cultivate-unrealistic-patient-and-family-expectations-after-injury
#9
Rosemarie O Serrone, Jordan A Weinberg, Pamela W Goslar, Erin P Wilkinson, Terrell M Thompson, Jonathan L Dameworth, Shawna R Dempsey, Scott R Petersen
Background: Expectations of the healthcare experience may be influenced by television dramas set in the hospital workplace. It is our perception that the fictional television portrayal of hospitalization after injury in such dramas is misrepresentative. The purpose of this study was to compare trauma outcomes on television dramas versus reality. Methods: We screened 269 episodes of Grey's Anatomy , a popular medical drama. A television (TV) registry was constructed by collecting data for each fictional trauma portrayed in the television series...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29764844/second-look-laparostomy-for-perforated-gangrenous-gastric-volvulus-to-prevent-total-gastrectomy
#10
Paul K Okeny, Omar Abbassi, Ali Warsi
A 42-year-old Caucasian woman presented to the emergency department with severe upper abdominal pain and vomiting. Clinically, she was septic, and abdominal examination suggested peritonitis. Following immediate resuscitation, the patient was stabilised and underwent urgent contrast-enhanced CT of the abdomen and pelvis. This revealed a mesenteroaxial gastric volvulus with traction on the mesentery and a small volume of free fluid. She underwent laparotomy revealing gangrenous gastric fundus perforation complicated by persistent intraoperative hypotension...
May 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#11
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29757869/end-of-life-care-for-patients-with-advanced-ovarian-cancer-is-aggressive-despite-hospice-intervention-a-population-based-study
#12
Jui-Kun Chiang, Chun-Shuo Hsu, Chih-Wen Lin, Yee-Hsin Kao
OBJECTIVE: To date, few studies have examined end-of-life (EOL) care and healthcare costs for patients with ovarian cancer. We evaluated the effects of hospice care on the quality of EOL care and healthcare costs for patients with ovarian cancer in the final month of life. MATERIALS AND METHODS: We conducted a population-based study and analyzed data from Taiwan's Longitudinal Health Insurance Database, which contains claims information for medical records of patients, healthcare costs, and insurance system exit dates: our proxy for death between 1997 and 2011...
May 11, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29755579/exploring-ptsd-in-emergency-operators-of-a-major-university-hospital-in-italy-a-preliminary-report-on-the-role-of-gender-age-and-education
#13
Claudia Carmassi, Camilla Gesi, Martina Corsi, Ivan M Cremone, Carlo A Bertelloni, Enrico Massimetti, Maria Cristina Olivieri, Ciro Conversano, Massimo Santini, Liliana Dell'Osso
Background: Emergency services personnel face frequent exposure to potentially traumatic events, with the potential for chronic symptomatic distress. The DSM-5 recently recognized a particular risk for post-traumatic stress disorder (PTSD) among first responders (criterion A4) but data are still scarce on prevalence rates and correlates. Objective: The aim of the present study was to explore the possible role of age, gender, and education training in a sample of emergency personnel diagnosed with DSM-5 PTSD...
2018: Annals of General Psychiatry
https://www.readbyqxmd.com/read/29752817/national-treatment-guidelines-decreased-the-use-of-racemic-adrenaline-for-bronchiolitis-in-four-finnish-university-hospitals
#14
Sauli Palmu, Minna Mecklin, Paula Heikkilä, Katri Backman, Ville Peltola, Marjo Renko, Matti Korppi
AIM: Inhaled racemic adrenaline was used for bronchiolitis in many hospitals in Finland prior to new national current care guidelines for bronchiolitis in 2014, which limited its recommendations to on-demand rescue therapy. We studied the drug's use before and after the new guidelines to gauge changes in prescribing habits. METHODS: This 2012-2016 study analysed how many 0.5 ml doses of racemic adrenaline were used for children by emergency rooms, paediatric wards and paediatric intensive care units at four university hospitals and estimated drug and staff costs...
May 12, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29743759/knowledge-and-attitude-of-er-and-intensive-care-unit-physicians-toward-do-not-resuscitate-in-a-tertiary-care-center-in-saudi-arabia-a-survey-study
#15
Alaa Gouda, Norah Alrasheed, Alaa Ali, Ahmad Allaf, Najd Almudaiheem, Youssuf Ali, Ahmad Alghabban, Sami Alsalolami
Introduction: Only a few studies from Arab Muslim countries address do-not-resuscitate (DNR) practice. The knowledge of physicians about the existing policy and the attitude towards DNR were surveyed. Objective: The objective of this study is to identify the knowledge of the participants of the local DNR policy and barriers of addressing DNR including religious background. Methods: A questionnaire has been distributed to Emergency Room (ER) and Intensive Care Unit (ICU) physicians...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29742036/emergency-department-telepsychiatry-service-model-for-a-rural-regional-health-system-the-first-steps
#16
James D Meyer, Alastair J S McKean, Rebecca N Blegen, Bart M Demaerschalk
BACKGROUND: Emergency departments (EDs) have recognized an increasing number of patients presenting with mental health (MH) concerns. This trend imposes greater demands upon EDs already operating at capacity. Many ED providers do not feel they are optimally prepared to provide the necessary MH care. One consideration in response to this dilemma is to use advanced telemedicine technology for psychiatric consultation. INTRODUCTION: We examined a rural- and community-based health system operating 21 EDs, none of which has direct access to psychiatric consultation...
May 9, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29739432/emergency-management-of-patients-with-st-segment-elevation-myocardial-infarction-in-eastern-austria-a-descriptive-quality-control-study
#17
Helmut Trimmel, Thomas Bayer, Wolfgang Schreiber, Wolfgang G Voelckel, Lukas Fiedler
BACKGROUND: Myocardial infarction is a time-critical condition and its outcome is determined by appropriate emergency care. Thus we assessed the efficacy of a supra-regional ST-segment elevation myocardial infarction (STEMI) network in Easternern Austria. METHODS: The Eastern Austrian STEMI network serves a population of approx. 766.000 inhabitants within a region of 4186 km2 . Established in 2007, it now comprises 20 pre-hospital emergency medical service (EMS) units (10 of these physician-staffed), 4 hospitals and 3 cardiac intervention centres...
May 9, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29735771/opinion-and-special-articles-amateur-fundus-photography-with-various-new-devices-our-experience-as-neurology-residents
#18
Saman Zafar, Ylec Mariana Cardenas, Lakshmi Leishangthem, Sridhara Yaddanapudi
Times are changing in the way we secure and share patient fundus photographs to enhance our diagnostic skills in neurology. At the recent American Academy of Neurology meeting, the use of a fundus camera and smartphones to secure good-quality fundus photographs of patients presenting with headache to the emergency department (ED) was presented. We were enthusiastic to replicate the success of the Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study in our neurology department, but encountered problems in terms of cost, setup, feasibility, and portability of the device...
May 8, 2018: Neurology
https://www.readbyqxmd.com/read/29735234/intracerebral-hemorrhage-with-herniation-in-a-second-trimester-pregnant-female
#19
Donald S MacMillan
A 30-year-old woman, gravida 1, para 2, in her second trimester presented to the local emergency department complaining of an atraumatic headache described as the worst headache of her life. While undergoing evaluation, she became unresponsive with signs of herniation, including a blown pupil and bradycardia. Emergent imaging identified an intracerebral hemorrhage requiring immediate surgical decompression. The patient was transferred by helicopter to tertiary care. Upon arrival, the patient was taken directly to the operating room and underwent a decompressive craniotomy...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29734486/pharmacogenetic-testing-among-patients-with-mood-and-anxiety-disorders-is-associated-with-decreased-utilization-and-cost-a-propensity-score-matched-study
#20
Roy H Perlis, Rajesh Mehta, Alison M Edwards, Arun Tiwari, Guido W Imbens
BACKGROUND: Naturalistic and small randomized trials have suggested that pharmacogenetic testing may improve treatment outcomes in depression, but its cost-effectiveness is not known. There is growing enthusiasm for personalized medicine, relying on genetic variation as a contributor to heterogeneity of treatment effects. We sought to examine the relationship between a commercial pharmacogenetic test for psychotropic medications and 6-month cost of care and utilization in a large commercial health plan...
May 7, 2018: Depression and Anxiety
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