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Point-of-care systems and emergency medicine

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https://www.readbyqxmd.com/read/29864976/-what-about-me-a-qualitative-explorative-study-on-perspectives-of-spouses-living-with-complex-chronic-pain-patients
#1
L Thrysøe Hansen, L I Nielsen, P Gazerani, L Petrini
Aims Being a close relative of a chronic pain patient affects family life. No study has been carried out in Denmark to explore relatives' life experiences and challenges while living with complex chronic pain patients. Hence, the aim of the study was to investigate the experiences of living with chronic pain patients from their spouses' perspectives. In particular, this study focused on how spouses describe: (i) their everyday tasks and roles as a spouse; (ii) the types of changes and challenges that the pain condition brings into their partnership lives; (iii) a gender difference in these experiences; and (iv) the type of help they wish to receive from the healthcare system...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29807546/surgical-plate-fixation-of-multiple-rib-fractures-a-case-report
#2
Konstantin Mitev, Dashurie Neziri, Emil Stoicovski, Zan Mitrev
BACKGROUND: The healthcare system in developing countries is limited; particularly, medical specialties such as emergency and trauma medicine are underdeveloped. Consequently, trauma injuries sustained in traffic accidents result in chronic morbidity more often than similar cases in developed countries. Multiple rib fractures induce significant patient morbidity. Current international guidelines recommend a multidisciplinary, surgery-based treatment approach to achieve optimal clinical benefit...
May 29, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29781806/the-need-for-understanding-and-engaging-the-patient-as-consumer-of-products-developed-by-neural-engineering
#3
Jennifer French, J Luis Lujan, Dawn Bardot, Emily Lauren Graczyk, Allison Hess-Dunning, Ronald J Triolo, Megan Moynahan, Winny Tan, Adeline Zbrzeski
Neural Engineering is a discipline at the intersection of neuroscience, engineering, and clinical care. Recent major efforts by government and industry aimed at bringing forth personalized therapies, increasing the potential of the neural engineering industry for future growth, eg. the National Institutes of Health (NIH) Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative and Stimulating Peripheral Activity to Relieve Conditions (SPARC) Common Fund Program, the Defense Advanced Research Projects Agency (DARPA) Electrical Prescriptions (ElectRx) and Systems-Based Neurotechnology for Emerging Therapies (SUBNETS) Programs, and the GlaxoSmithKline Bioelectric Medicines Initiative...
May 21, 2018: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29733722/patient-centered-precision-health-in-a-learning-health-care-system-geisinger-s-genomic-medicine-experience
#4
Marc S Williams, Adam H Buchanan, F Daniel Davis, W Andrew Faucett, Miranda L G Hallquist, Joseph B Leader, Christa L Martin, Cara Z McCormick, Michelle N Meyer, Michael F Murray, Alanna K Rahm, Marci L B Schwartz, Amy C Sturm, Jennifer K Wagner, Janet L Williams, Huntington F Willard, David H Ledbetter
Health care delivery is increasingly influenced by the emerging concepts of precision health and the learning health care system. Although not synonymous with precision health, genomics is a key enabler of individualized care. Delivering patient-centered, genomics-informed care based on individual-level data in the current national landscape of health care delivery is a daunting challenge. Problems to overcome include data generation, analysis, storage, and transfer; knowledge management and representation for patients and providers at the point of care; process management; and outcomes definition, collection, and analysis...
May 2018: Health Affairs
https://www.readbyqxmd.com/read/29602433/improving-resident-s-skills-in-the-management-of-circulatory-shock-with-a-knowledge-based-e-learning-tool
#5
David Riaño, Francis Real, Jose Ramon Alonso
BACKGROUND: Correct clinical management of circulatory shock in emergency departments (ER) and intensive care units (ICU) is critical. In this context, the transmission of professional skills by means of the practical supervision of real cases at the point of care entails important issues that can be widely overcome with the use of computer knowledge-based e-learning tools. OBJECTIVE: Shock-Instructor is a web-based e-learning tool implementing the already tested training program model (TPM) that uses a knowledge base about the evidence found in the clinical practice guidelines about seven types of shock...
May 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29577222/-establishment-of-comprehensive-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients
#6
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the comprehensive prediction model of acute gastrointestinal injury (AGI) grades of critically ill patients. METHODS: From April 2015 to November 2015, the binary channel gastrointestinal sounds (GIS) monitor system which has been developed and verified by the research group was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of Chinese PLA General Hospital. Also, the AGI grades (Grande I(-IIII(, the higher the level, the heavier the gastrointestinal dysfunction) were evaluated...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29527576/multidisciplinary-analysis-of-invasive-meningococcal-disease-as-a-framework-for-continuous-quality-and-safety-improvement-in-regional-australia
#7
Kathryn A Taylor, David N Durrheim, Tony Merritt, Peter Massey, John Ferguson, Nick Ryan, Carolyn Hullick
Background: System factors in a regional Australian health district contributed to avoidable care deviations from invasive meningococcal disease (IMD) management guidelines. Traditional root cause analysis (RCA) is not well-suited to IMD, focusing on individual cases rather than system improvements. As IMD requires complex care across healthcare silos, it presents an opportunity to explore and address system-based patient safety issues. Context: Baseline assessment of IMD cases (2005-2006) identified inadequate triage, lack of senior clinician review, inconsistent vital sign recording and laboratory delays as common issues, resulting in antibiotic administration delays and inappropriate or premature discharge...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29409084/-infectiological-rapid-tests-in-practices-and-at-home
#8
Christoph D Spinner, Matthias C Müller, Berit Lange
Bedside laboratory procedures so called "point of care testing - POCT" plays an emerging role in clinical routine practice. While glucose or urine protein screening has been established since a while, newer lateral flow assays (LFID), mostly as rapid diagnostic tests (RDT), play and upcoming role, as well as nucleic amplification based and micro carrier based systems. Hereby an accurate and precise diagnostic allows clinical decisions; in infectious diseases as well as other disciplines in medicine...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29404658/-miscommunication-as-a-risk-focus-in-patient-safety-work-process-analysis-in-prehospital-emergency-care
#9
S Wilk, L Siegl, K Siegl, C Hohenstein
BACKGROUND: In an analysis of a critical incident reporting system (CIRS) in out-of-hospital emergency medicine, it was demonstrated that in 30% of cases deficient communication led to a threat to patients; however, the analysis did not show what exactly the most dangerous work processes are. Current research shows the impact of poor communication on patient safety. OBJECTIVES: An out-of-hospital workflow analysis collects data about key work processes and risk areas...
April 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29273028/implementation-of-a-novel-population-panel-management-curriculum-among-interprofessional-health-care-trainees
#10
Catherine P Kaminetzky, Lauren A Beste, Anne P Poppe, Daniel B Doan, Howard K Mun, Nancy Fugate Woods, Joyce E Wipf
BACKGROUND: Gaps in chronic disease management have led to calls for novel methods of interprofessional, team-based care. Population panel management (PPM), the process of continuous quality improvement across groups of patients, is rarely included in health professions training for physicians, nurses, or pharmacists. The feasibility and acceptance of such training across different healthcare professions is unknown. We developed and implemented a novel, interprofessional PPM curriculum targeted to diverse health professions trainees...
December 22, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29209788/-reform-of-emergency-physician-training-in-austria-finally-up-to-date
#11
REVIEW
H Trimmel, M Baubin, J Kreutziger, G Frank, G Prause
During the last 20 years Austrian prehospital emergency medical services (EMS) have significantly improved. The structure and organization of Austrian EMS comply with European standards but training requirements for prehospital EMS physicians are insufficient when compared with other countries. Although some EMS systems follow the German or Swiss postgraduate training concepts, the legal requirements in Austria defining the scope of mandatory training for physicians in the prehospital setting are only minimal...
February 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29169287/point-of-care-testing-poct-and-evidence-based-laboratory-medicine-eblm-does-it-leverage-any-advantage-in-clinical-decision-making
#12
REVIEW
Christopher Florkowski, Andrew Don-Wauchope, Nuria Gimenez, Karina Rodriguez-Capote, Julien Wils, Annalise Zemlin
Point-of-care testing (POCT) is the analysis of patient specimens outside the clinical laboratory, near or at the site of patient care, usually performed by clinical staff without laboratory training, although it also encompasses patient self-monitoring. It is able to provide a rapid result near the patient and which can be acted upon immediately. The key driver is the concept that clinical decision making may be delayed when samples are sent to the clinical laboratory. Balanced against this are considerations of increased costs for purchase and maintenance of equipment, staff training, connectivity to the laboratory information system (LIS), quality control (QC) and external quality assurance (EQA) procedures, all required for accreditation under ISO 22870...
November 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/29144490/neonatal-lung-ultrasound-exam-guidelines
#13
D Kurepa, N Zaghloul, L Watkins, J Liu
Point-of-care ultrasound (POC-US) is increasingly used especially in emergency and critical-care medicine. It is focused, quick and does not expose patients to ionizing radiation. It encompasses all organ systems and has well-defined indications. Lung ultrasound (LUS) represents one of the most exciting applications in the field of POC-US. It is particularly important to emphasize the role of LUS in neonatology due to the specific pathology inherent in lung immaturity as well as in the particular sensitivity of neonates to repeated radiation exposure...
January 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29100653/understanding-the-struggles-to-be-a-medical-provider-view-through-medical-student-essays
#14
William J Peterson, Joseph B House, Cemal B Sozener, Sally A Santen
BACKGROUND: The clinical learning environment helps to shape the professional identity of medical students. This process begins from existing personal identity and is influenced by various factors, including clinical experiences and clinical learning environment. OBJECTIVE: The purpose of this study was to examine medical students' reflections as a way to identify and better characterize the modern struggles that medical students face, in order to inform the development of professional identity...
January 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29063523/evaluation-of-existing-and-desired-antimicrobial-stewardship-activities-and-strategies-in-swiss-hospitals
#15
M Osthoff, Julia Belicki, Andreas F-X Widmer, For Swissnoso
Antimicrobial stewardship (AMS) is an important component in the fight against antimicrobial resistance. Currently, few hospitals have an ongoing institutional AMS programme. Swissnoso - the national centre for infection prevention - has launched a national Swiss AMS initiative supported by the office of public health. To guide AMS priorities and resources, current AMS activities in Switzerland were assessed. We distributed an internet-based questionnaire directed mainly to board-certified infectious diseases specialists and, if not available, senior internal medicine staff...
October 24, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29016516/barriers-to-effective-teamwork-relating-to-pediatric-resuscitations-perceptions-of-pediatric-emergency-medicine-staff
#16
Joshua M Sherman, Todd P Chang, Nurit Ziv, Alan L Nager
BACKGROUND: In the pediatric emergency department (PED), resuscitations require medical teams form ad hoc, rarely communicating beforehand. Literature has shown that the medical community has deficiencies in communication and teamwork. However, we as medical providers do not know or understand the perceived barriers of our colleagues. Physicians may perceive a barrier that is different from nurses, respiratory therapists, pharmacists, or technicians. Perhaps we do not know in which area of teamwork and communication we are deficient...
October 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28963294/new-criteria-for-sepsis-induced-coagulopathy-sic-following-the-revised-sepsis-definition-a-retrospective-analysis-of-a-nationwide-survey
#17
Toshiaki Iba, Marcello Di Nisio, Jerrold H Levy, Naoya Kitamura, Jecko Thachil
OBJECTIVE: Recent clinical studies have shown that anticoagulant therapy might be effective only in specific at-risk subgroups of patients with sepsis and coagulation dysfunction. The definition of sepsis was recently modified, and as such, old scoring systems may no longer be appropriate for the diagnosis of sepsis-associated coagulopathy. The aim of this study was to evaluate prognostic factors in patients diagnosed with sepsis and coagulopathy according to the new sepsis definition and assess their accuracy in comparison with existing models...
September 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28934995/quality-improvement-primer-part-2-executing-a-quality-improvement-project-in-the-emergency-department
#18
Lucas B Chartier, Antonia S Stang, Samuel Vaillancourt, Amy H Y Cheng
The topics of quality improvement (QI) and patient safety have become important themes in health care in recent years, particularly in the emergency department setting, which is a frequent point of contact with the health care system for patients. In the first of three articles in this series meant as a QI primer for emergency medicine clinicians, we introduced the strategic planning required to develop an effective QI project using a fictional case study as an example. In this second article we continue with our example of improving time to antibiotics for patients with sepsis, and introduce the Model for Improvement...
September 22, 2017: CJEM
https://www.readbyqxmd.com/read/28780235/dilated-right-coronary-sinus-identified-on-point-of-care-ultrasound
#19
Damali Nakitende, Michael Gottlieb
Point-of-care cardiac ultrasound (POCUS) is a common application in Emergency Medicine. Here we present a case of an incidentally discovered dilated right coronary sinus on ultrasound. This case involved a 55-year-old female who presented with chest pain, shortness of breath, and lightheadedness. Her initial presentation was concerning for congestive heart failure (CHF) exacerbation. A bedside ultrasound was performed to assess cardiac function, where a dilated right coronary sinus was discovered. The right coronary sinus is the vein that serves as the venous return for the coronary system...
October 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28765464/the-effect-of-new-oral-care-technologies-on-the-need-for-dentists-in-2040
#20
Peter M Milgrom, Jeremy A Horst
This article addresses changes in technology of oral self-care or professional care that may increase or decrease the demand for dentists by 2040. The focus is on dental caries, periodontitis, and temporomandibular joint disorders (TMD), as the first two are the main areas of current practice and because TMD is an area for growth. To address this question, the authors examined the scientific literature and government registries to identify recent or soon-to-be-available technologies. They also examined the state of translational efficiency, dissemination, and adoption of advances into dental practice...
August 2017: Journal of Dental Education
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