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https://www.readbyqxmd.com/read/28817392/minimum-operational-standards-for-24-7-available-emergency-departments-in-the-netherlands-a-first-step-taken-by-emergency-physicians-using-an-e-delphi-approach
#1
Menno I Gaakeer, Rebekka Veugelers, Peter Patka, Robbert Huijsman
OBJECTIVE: The objective of this study was to effectuate a consensus of emergency physicians on minimum requirements for facility, diagnostic, and medical specialist availability as a first step toward minimum operational standards for 24/7 available emergency departments (EDs) in the Netherlands. PATIENTS AND METHODS: A two-part e-Delphi through online survey was performed between January 2015 and May 2016, using a panel of 20 experts in emergency medicine. The aim of part I was to reach an agreement on a list of possible ED elements and their definitions...
August 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28816011/lessons-learnt-from-incidents-involving-the-airway-and-breathing-reported-from-australasian-emergency-departments
#2
Carmel Crock, Kim Hansen, Toby Fogg, Angela Cahill, Anita Deakin, William B Runciman
OBJECTIVE: To review incident reports relating to problems encountered during the ED management of patients with 'airway or breathing' problems, with the aim of finding and highlighting common themes within these rare events, and making recommendations to further improve patient safety in the areas in which deficiencies have been identified. METHODS: Thematic analysis of 36 incidents reported from Australasian EDs, which were related to problems with airway and breathing...
August 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28814584/examining-self-reported-and-biological-stress-and-near-misses-among-emergency-medicine-residents-a-single-centre-cross-sectional-assessment-in-the-usa
#3
Bengt B Arnetz, Philip Lewalski, Judy Arnetz, Karen Breejen, Karin Przyklenk
OBJECTIVES: To examine the relationship between perceived and biological stress and near misses among Emergency Medicine residents. DESIGN: Self-rated stress and stress biomarkers were assessed in residents in Emergency Medicine before and after a day shift. The supervising physicians and residents reported numbers of near misses. SETTING: The study took place in the Emergency Department of a large trauma 1 centre, located in Detroit, USA...
August 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28811044/learning-how-to-teach-one-a-needs-assessment-of-the-state-of-faculty-development-within-the-consortium-of-the-american-college-of-surgeons-accredited-education-institutes
#4
John T Paige, Nehal N Khamis, Jeffrey B Cooper
BACKGROUND: Developing faculty competencies in curriculum development, teaching, and assessment using simulation is critical for the success of the Consortium of the American College of Surgeons Accredited Education Institutes program. The state of and needs for faculty development in the Accredited Education Institute community are unknown currently. The Faculty Development Committee of the Consortium of the Accredited Education Institutes conducted a survey of Accredited Education Institutes to ascertain what types of practices are used currently, with what frequency, and what needs are perceived for further programs and courses to guide the plan of action for the Faculty Development Committee...
August 12, 2017: Surgery
https://www.readbyqxmd.com/read/28809180/exploring-socio-technical-insights-for-safe-nursing-handover
#5
Ming Chao Wong, Kwang Chien Yee, Paul Turner
Current efforts to improve nursing handover frequently use prescriptive approaches based on research evidence of handover issues within a single nursing ward or nursing specialty. Despite reported handover improvement, few studies adequately consider the transferability of results to other nursing handover environments or acknowledge the unique attributes that supported sustained improvement. With the increasing diffusion of electronic tools it has become even more critical to ensure that socio-technical issues that may impact on the quality and safety of nursing handovers are identified...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28808821/-airway-anatomy-relevant-structures-in-emergency-medicine
#6
M Schulze, A Wree
The subject of this article is the anatomy of the respiratory tract with an emphasis on the larynx. A differentiation is made between the upper and lower airways according to topographical and functional aspects, the limits of which are marked by the lower section of the larynx. The focus is on the anatomy of the structures involved, which are relevant for emergency medicine.
August 14, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28807040/management-of-upper-gastrointestinal-bleeding-in-emergency-departments-from-bleeding-symptoms-to-diagnosis-a-prospective-multicenter-observational-study
#7
Pierre-Clément Thiebaud, Youri Yordanov, Jacques-Emmanuel Galimard, Pierre-Alexis Raynal, Sébastien Beaune, Laurent Jacquin, François-Xavier Ageron, Dominique Pateron
BACKGROUND: Upper gastrointestinal bleeding (UGB) is common in emergency departments (EDs) and can be caused by many eso-gastro-duodenal lesions. Most available epidemiological data and data on the management of UGB comes from specialized departments (intensive care units or gastroenterology departments), but little is known from the ED perspective. We aimed to determine the distribution of symptoms revealing UGB in EDs and the hemorrhagic lesions identified by endoscopy. We also describe the characteristics of patients consulting for UGB, UGB management in the ED and patients outcomes...
August 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28803593/predictors-of-obtaining-follow-up-care-in-the-province-of-ontario-canada-following-a-new-diagnosis-of-atrial-fibrillation-heart-failure-and-hypertension-in-the-emergency-department
#8
Clare L Atzema, Bing Yu, Noah M Ivers, Paula A Rochon, Douglas S Lee, Michael J Schull, Peter C Austin
OBJECTIVE: Patients with cardiovascular diseases are common in the emergency department (ED), and continuity of care following that visit is needed to ensure that they receive evidence-based diagnostic tests and therapy. We examined the frequency of follow-up care after discharge from an ED with a new diagnosis of one of three cardiovascular diseases. METHODS: We performed a retrospective cohort study of patients with a new diagnosis of heart failure, atrial fibrillation, or hypertension, who were discharged from 157 non-pediatric EDs in Ontario, Canada, between April 2007 and March 2014...
August 14, 2017: CJEM
https://www.readbyqxmd.com/read/28802868/development-and-implementation-of-an-ultrasound-guided-peripheral-intravenous-catheter-program-for-emergency-nurses
#9
Courtney Edwards, Jodi Jones
PROBLEM: Emergency medical care often necessitates placement of peripheral intravenous (PIV) catheters. When traditional methods for obtaining PIV access are not successful, ultrasound guidance is a rescue technique for peripheral vascular placement that improves the quality of patient care. METHODS: The aim of this training program was to develop a process where emergency nurses would be competent to perform ultrasound guided PIV to improve the quality of patient care delivered while reducing throughput time...
August 9, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28802783/an-emergency-medicine-primary-care-partnership-to-improve-rural-population-health-expanding-the-role-of-emergency-medicine
#10
Margaret B Greenwood-Ericksen, Renuka Tipirneni, Mahshid Abir
The health of rural America is failing and our traditional approaches have proved ineffective at improving health in rural communities. Rural populations are now a health disparity population, facing higher mortality rates for the 5 leading causes of death compared with their urban counterparts. We must generate novel, rural-specific approaches to solve this challenge-and there is a clear role for the field of emergency medicine. Building on emergency departments' (EDs') expanding role in health care delivery and emergency medicine's increasing involvement in population health, we propose a new health care delivery model for rural population health based on partnership between emergency medicine and primary care that embraces the important role that EDs play in rural areas...
August 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28802638/spiritual-perspectives-of-emergency-medicine-doctors-and-nurses-in-caring-for-end-of-life-patients-a-mixed-method-study
#11
Yingting Zhang, Rakhee Yash Pal, Wai San Wilson Tam, Alice Lee, Mabel Ong, Lay Hwa Tiew
BACKGROUND: End-of-life care is becoming more prevalent in the Emergency Department. Quality end-of-life care includes spiritual support. As spirituality is a relatively vague concept, understanding healthcare professionals' spiritual perspectives is important. AIMS: To explore the perspectives of Emergency Department doctors and nurses in (i) spirituality, (ii) spiritual care domain in end-of-life care and (iii) factors influencing spiritual care provision in the Emergency Department...
August 9, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28801485/identifying-discordance-between-senior-physicians-and-trainees-on-the-root-cause-of-ed-revisits
#12
Michael P Goldman, Michael C Monuteaux, Catherine Perron, Richard G Bachur
OBJECTIVE: Analysis of 72-hour ED revisits is a common emergency medicine quality assurance (QA) practice. Our aim was to compare the perceived root cause for 72-hour ED revisits between senior physicians (attendings) and trainees. We proposed that discordance in perception of why the revisit occurred would guide improvements in 72-hour revisits QA and elucidate innovative educational opportunities. METHODS: Questionnaire-based observational study conducted in an urban academic paediatric ED...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28800808/legal-and-ethical-challenges-part-1-general-population
#13
REVIEW
Britta Ostermeyer, Anim N Shoaib, Swapna Deshpande
Several federal and state laws and regulations, as well as ethical medical principles, govern the emergency clinician's practice of care. Although some common legal-medical and ethical principles are shared with other medical specialties, emergency medicine and emergency psychiatry have unique legal and ethical challenges. This article presents and discusses these challenges, including the physician-patient relationship, malpractice, confidentiality and privilege, duty to report, decision-making capacity and vicarious decision-making, the Emergency Medical Treatment and Labor Act, right to treatment, hospital admissions, involuntary commitment, forced medication administration, and child and elder abuse...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800799/emergency-department-medical-clearance-of-patients-with-psychiatric-or-behavioral-emergencies-part-2-special-psychiatric-populations-and-considerations
#14
REVIEW
Al Alam, James Rachal, Veronica Theresa Tucci, Nidal Moukaddam
Patients who present to the emergency department (ED) with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, there are wide variations in quality of care for these individuals. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach to patients. Our group has long advocated a dynamic comanagement approach for medical clearance in the ED, and this article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical/physical examination, and common pitfalls in the medical clearance process...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800798/emergency-department-medical-clearance-of-patients-with-psychiatric-or-behavioral-emergencies-part-1
#15
REVIEW
Veronica Theresa Tucci, Nidal Moukaddam, Al Alam, James Rachal
Patients presenting to the emergency department with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, interdisciplinary consensus on medical clearance is lacking, leading to wide variations in quality of care and, quite often, poor medical care. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach. This article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical or physical examination, and common pitfalls in the medical clearance process...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800059/the-impact-of-educational-interventions-on-attitudes-of-emergency-department-staff-towards-patients-with-substance-related-presentations-a-quantitative-systematic-review
#16
Miriam Gonzalez, Diana E Clarke, Asha Pereira, Krystal Boyce-Gaudreau, Celeste Waldman, Lisa Demczuk, Carol Legare
BACKGROUND: Visits to emergency departments for substance use/abuse are common worldwide. However, emergency department health care providers perceive substance-using patients as a challenging group to manage which can lead to negative attitudes. Providing education or experience-based exercises may impact positively on behaviors towards this patient population. Whether staff attitudes are similarly impacted by knowledge acquired through educational interventions remains unknown. OBJECTIVES: To synthesize available evidence on the relationship between new knowledge gained through substance use educational interventions and emergency department health care providers' attitudes towards patients with substance-related presentations...
August 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28798907/building-sustainable-partnerships-to-strengthen-pediatric-capacity-at-a-government-hospital-in-malawi
#17
Michelle Eckerle, Heather L Crouse, Msandeni Chiume, Ajib Phiri, Peter N Kazembe, Hanny Friesen, Tisungane Mvalo, Marideth C Rus, Elizabeth F Fitzgerald, Allyson McKenney, Irving F Hoffman, Megan Coe, Beatrice M Mkandawire, Charles Schubert
INTRODUCTION: To achieve sustained reductions in child mortality in low- and middle-income countries, increased local capacity is necessary. One approach to capacity building is support offered via partnerships with institutions in high-income countries. However, lack of cooperation between institutions can create barriers to successful implementation of programs and may inadvertently weaken the health system they are striving to improve. A coordinated approach is necessary. BACKGROUND: Three U...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28797315/the-case-for-quality-improvement-in-emergency-medicine
#18
Shawn Mondoux
No abstract text is available yet for this article.
August 11, 2017: CJEM
https://www.readbyqxmd.com/read/28796433/understanding-emergency-care-delivery-through-computer-simulation-modeling
#19
Lauren F Laker, Elham Torabi, Daniel J France, Craig M Froehle, Eric J Goldlust, Nathan R Hoot, Parastu Kasaie, Michael S Lyons, Laura H Barg-Walkow, Michael J Ward, Robert L Wears
In 2017, Academic Emergency Medicine convened a consensus conference entitled, "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes." This manuscript, a product of the breakout session on "understanding complex interactions through systems modeling," explores the role that computer simulation modeling can and should play in research and development of emergency care delivery systems. This manuscript discusses areas central to the use of computer simulation modeling in emergency care research...
August 10, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28795915/where-teachers-are-few-documenting-available-faculty-in-five-tanzanian-medical-schools
#20
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
Background Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. Objective To describe the availability of faculty in medical schools in Tanzania. Design We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
December 2016: Global Health Action
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