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triage abdominal pain

Helena A Watson, Jenny Carter, Paul T Seed, Rachel M Tribe, Andrew H Shennan
OBJECTIVES: To evaluate the impact of a treat-all policy (advocated by NICE) compared to the QUIPP app (predictive model combining history of spontaneous preterm birth gestation and quantitative fetal fibronectin) for women in threatened preterm labour at <30 weeks gestation. METHODS: We conducted a subanalysis of prospectively collected data of pregnant women presenting with symptoms of preterm labour from the EQUIPP (REC Ref. 10/H0806/68) and PETRA (REC Ref...
April 24, 2017: Ultrasound in Obstetrics & Gynecology
Sarah J Rhoads, Hari Eswaran, Christian E Lynch, Songthip T Ounpraseuth, Everett F Magann, Curtis L Lowery
PURPOSE: High-risk obstetrical care can be challenging for women in rural states with limited access. MATERIALS AND METHODS: Data were evaluated from 62,342 obstetrical calls from pregnant and postpartum patients within rural Arkansas to a nurse call center. Call center nurses provided triage using evidence-based guidelines to patients across the state. Data were extracted and analyzed using retrospective data collection and descriptive statistical methods. RESULTS: Women had an average maternal age of 28 years old, average weeks gestation was 27...
March 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
L N Goldstein, L M Morrow, T A Sallie, K Gathoo, K Alli, T M M Mothopeng, F Samodien
BACKGROUND: Triage in the emergency department (ED) is necessary to prioritise management according to the severity of a patient's condition.The South African Triage Scale (SATS) is a hospital-based triage tool that has been adopted by numerous EDs countrywide.Many factors can influence the outcome of a patient's triage result, and evaluation of performance is therefore pivotal. OBJECTIVES: To determine how often patients were allocated to the correct triage category and the extent to which they were incorrectly promoted or demoted, and to determine the main reasons for errors in a nurse-led triage system...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
John R Marshall, Robert Katzer, Shahram Lotfipour, Bharath Chakravarthy, Siri Shastry, Jessica Andrusaitis, Craig L Anderson, Erik D Barton
INTRODUCTION: Given the nationwide increase in emergency department (ED) visits it is of paramount importance for hospitals to find efficient ways to manage patient flow. The purpose of this study was to determine whether there is a significant difference in success rates, length of stay (LOS), and other demographic factors in two cohorts of patients admitted directly to an ED observation unit (EDOU) under an abdominal pain protocol by a physician in triage (bypassing the main ED) versus those admitted via the traditional pathway (evaluated and treated in the main ED prior to EDOU admission)...
February 2017: Western Journal of Emergency Medicine
Itaru Hayakawa, Hiroshi Sakakibara, Yukari Atsumi, Hiroshi Hataya, Toshiro Terakawa
BACKGROUND: Abdominal pain is common in children, but expeditious diagnosis of life- or organ-threatening diseases can be challenging. An evidence-based definition of tachycardia in children was established recently, but its diagnostic utility has not yet been studied. OBJECTIVE: To test the hypothesis that abdominal pain with tachycardia may pose a higher likelihood of life- or organ-threatening diseases in children. METHODS: A nested case-control study was conducted in a pediatric emergency department in 2013...
January 24, 2017: American Journal of Emergency Medicine
Oliver William McKinney, Paul Anthony Heaton, Jane Gamble, Siba Prosad Paul
Foreign body ingestion and foreign body aspiration commonly affect children. The most vulnerable age is between six months and four years, when children tend to explore new objects with their mouths. Many of these events remain asymptomatic, with the swallowed object passing through the gastrointestinal tract without causing harm. However, the frequency of serious complications as a result of the ingestion of hazardous objects has increased in recent years, in particular button batteries and magnets. To increase the likelihood of identifying foreign body ingestion and aspiration, healthcare professionals should maintain a high index of suspicion, be aware of the variation in presentations and include it as a differential diagnosis in children presenting with non-specific symptoms, such as fever, cough, drooling, dysphagia and abdominal pain...
February 1, 2017: Nursing Standard
Junxiong Pang, Jung Pu Hsu, Tsin Wen Yeo, Yee Sin Leo, David C Lye
Progression to severe organ involvement due to dengue infection has been associated with severe dengue disease, intensive care treatment, and mortality. However, there is a lack of understanding of the impact of pre-existing comorbidities and other risk factors of severe organ involvement among dengue adults. The aim of this retrospective case-control study is to characterize and identify risk factors that predispose dengue adults at risk of progression with severe organ involvement. This study involved 174 dengue patients who had progressed with severe organ involvement and 865 dengue patients without severe organ involvement, matched by the year of presentation of the cases, who were admitted to Tan Tock Seng Hospital between year 2005 and 2008...
January 3, 2017: Scientific Reports
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
Ben Smith, Stephane Bouchoucha, Elizabeth Watt
OBJECTIVES: The aim in this study was to investigate the impact of overcrowding on the Australasian Triage Score's (ATS) time to treatment target and the National Emergency Access Target (NEAT) for patients who self-present to the Emergency Department (ED) with abdominal pain. BACKGROUND: The causes and effects of ED overcrowding have been well described in the literature. It is a widespread phenomenon throughout the world and it can cause serious harm to patients and have a negative impact on access to emergency care...
November 2016: International Emergency Nursing
Alistair Robertson, Amin Rahemtulla
A young man with a rare unstable haemoglobinopathy presented with a high fever, worsening shortness of breath and abdominal pain. At triage his pulse oximetry (SpO2) suggested that his blood oxygen saturation was 84% at room air. However, an arterial blood gas (ABG) oxygen saturation reading (SaO2) was 100%. The significant disparity between the two measurements demonstrates that using pulse oximetry in some unstable haemoglobinopathies may significantly underestimate the actual reading. This error is most probably due to the structural differences in the variant haemoglobin causing light to be absorbed at a different wavelength beyond the normal range of the oximeter...
September 6, 2016: BMJ Case Reports
Amy Hui Sian Chan, Shu Fang Ho, Stephanie Man Chung Fook-Chong, Sherman Wei Qiang Lian, Nan Liu, Marcus Eng Hock Ong
INTRODUCTION: 72-hour emergency department (ED) reattendance is a widely-used quality indicator for quality of care and patient safety. It is generally assumed that patients who return within 72 hours of ED discharge (72-hour re-attendees) received inadequate treatment or evaluation. The current literature also suggests considerable variation in probable causes of 72-hour ED reattendances internationally. This study aimed to understand the characteristics of these patients at the ED of a Singapore tertiary hospital...
June 2016: Singapore Medical Journal
Shweta Batra, Elaine Yu Ching Ng, Feng Foo, Omar Noori, Mary McCaskill, Katharine Steinbeck
OBJECTIVES: To describe the characteristics, diagnoses and outcomes of older adolescents, aged 16-19 years, presenting to a paediatric ED. METHODS: A retrospective review of total ED presentations by older adolescents to a tertiary paediatric hospital between 2010 and 2012, inclusive, was undertaken to determine if behavioural or mental health problems were common. RESULTS: A total of 1184 ED presentations by 730 older adolescents were identified...
August 2016: Emergency Medicine Australasia: EMA
M Kulla, S Kraus, F Walcher, R Somasundaram, C E Wrede, L Lampl, M Helm
Background: Up to 11 % of patients in an Emergency Department (ED) present with non-traumatic acute abdominal pain. Based on this presenting symptom, this study aimed to analyse how residents (surgery, internal medicine, anaesthesiology and other fields) working in an ED during their second and third year of education treat these patients. Material and Methods: We performed a prospective, monocentric observation study in an ED in accordance with the STROBE recommendations, following the recommendations from the Ethics Committee of the University of Ulm (application no...
December 2016: Zentralblatt Für Chirurgie
Jessica Palmer, Elizabeth Pontius
Emergency department providers have become skilled at triaging patients with abdominal pain requiring surgical interventions. Abdominal pain mimics, medical conditions that cause the sensation of abdominal pain without abdominal abnormality, continue to puzzle the best physicians.
May 2016: Emergency Medicine Clinics of North America
Heather G Zook, Anupam B Kharbanda, Andrew Flood, Brian Harmon, Susan E Puumala, Nathaniel R Payne
BACKGROUND: Racial disparities are frequently reported in emergency department (ED) care. OBJECTIVES: To examine racial differences in triage scores of pediatric ED patients. We hypothesized that racial differences existed but could be explained after adjusting for sociodemographic and clinical factors. METHODS: We examined all visits to two urban, pediatric EDs between August 2009 and March 2010. Demographic and clinical data were electronically extracted from the medical record...
May 2016: Journal of Emergency Medicine
Joshua G X Wong, Tun Linn Thein, Yee-Sin Leo, Junxiong Pang, David C Lye
BACKGROUND: Clinically significant bleeding is important for subsequent optimal case management in dengue patients, but most studies have focused on dengue severity as an outcome. Our study objective was to identify differences in admission parameters between patients who developed clinically significant bleeding and those that did not. We sought to develop a model for discriminating between these patients. METHODS: We conducted a retrospective study of 4,383 adults aged >18 years who were hospitalized with dengue infection at Tan Tock Seng Hospital, Singapore from 2005 to 2008...
2016: PloS One
U Menakaya, S Reid, C Lu, G Bassem, F Infante, G Condous
OBJECTIVE: To develop and assess the performance of a preoperative ultrasound-based endometriosis staging system (UBESS) to predict the level of complexity of laparoscopic surgery for endometriosis. METHODS: This was a multicenter prospective and retrospective cohort study on consecutive women with suspected endometriosis who underwent laparoscopy between June 2009 and July 2013. Each woman underwent a systematic transvaginal ultrasound evaluation to assess the pelvis for different phenotypes of endometriosis, and the diagnostic performance of ultrasound for these different phenotypes was evaluated relative to the gold standard, laparoscopy...
December 2016: Ultrasound in Obstetrics & Gynecology
Kathryn Eastwood, Amee Morgans, Karen Smith, Angela Hodgkinson, Gareth Becker, Johannes Stoelwinder
Objective The aim of the present study was to describe the Ambulance Victoria (AV) secondary telephone triage service, called the Referral Service (RS), for low-priority patients calling triple zero. This service provides alternatives to ambulance dispatch, such as doctor or nurse home visits.Methods A descriptive epidemiological review of all the cases managed between 2009 and 2012 was conducted, using data from AV case records, the Victorian Admitted Episodes Dataset and the Australian Bureau of Statistics...
November 9, 2015: Australian Health Review: a Publication of the Australian Hospital Association
Peter Bannas, Perry J Pickhardt
Cross-sectional imaging plays a crucial role in the triage of patients with acute abdominal pain. Ionizing radiation exposure is a recognized drawback of computed tomography (CT), the primary imaging technique. MR imaging is a promising alternative to CT; it provides excellent image quality with high-contrast resolution without the disadvantages of ionizing radiation and iodinated contrast. This article provides a basic overview of the typical MR findings of the most frequent disease entities encountered in the setting of the nontraumatic acute abdomen, including direct comparison with CT findings to familiarize the readers with these same findings on MR...
November 2015: Radiologic Clinics of North America
Ciro Paolillo, Ilenia Spallino
Up to 10% of all patients at the Emergency Department present for acute abdominal pain. The C-reactive protein (CRP) and white blood cell (WBC) are routinely determined as part of the workup of patients with abdominal pain. Three large prospective cohort studies comprising a total of 2961 adult patients with acute abdominal pain were selected. CRP levels and WBC counts were compared between patients with urgent and nonurgent final diagnoses. These studies conclude that the laboratory values individually are weak discriminators and cannot be used as a triage instrument in the selection of patients with acute abdominal pain requiring additional diagnostic tests...
February 2016: Internal and Emergency Medicine
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