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https://www.readbyqxmd.com/read/29667890/novel-quality-indicators-for-radiologists-interpreting-abdominopelvic-ct-images-risk-adjusted-outcomes-among-emergency-department-patients-with-right-lower-quadrant-pain
#1
Matthew S Davenport, Shokoufeh Khalatbari, James H Ellis, Richard H Cohan, Suzanne T Chong, Keith E Kocher
OBJECTIVE: The purpose of this study was to determine whether individual radiologists are predictive of important relevant health outcomes among emergency department (ED) patients undergoing abdominopelvic CT for right lower quadrant pain. MATERIALS AND METHODS: This single-institution retrospective cohort study included 2169 patients undergoing abdominopelvic CT for right lower quadrant pain in the ED from February 1, 2012, through August 31, 2016. CT examinations were interpreted by 15 radiologists (four emergency, 11 abdominal) who each reported on more than 70 CT examinations in the cohort...
April 18, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29582964/-the-nephrology-outpatient-triage-an-organizational-model-for-the-ambulatory-care-of-patients-with-advanced-renal-disease
#2
Giorgio Soragna, Francesca Bermond, Laura Fabbrini, Amelia Rodofili, Aldo Soragna, Maggiorina Bauducco, Aspasia Panunzi, Ada Ramondetti, Cristiana Cerri, Corrado Vitale
The clinical course of outpatients with advanced chronic kidney disease requires a close monitoring by the nephrology team, in order to identify emerging clinical problems promptly and prevent subsequent complications. With the aim of improving the outpatient management in our clinic dedicated to advanced renal failure, we implemented the "Nephrology Clinic Triage" (NCT). This organizational model is coordinated by the nephrologist and supported by nurses. In case the outpatients, or their caregivers, have clinical problems or need advice, they can easily get in touch with a nephrology nurse by a dedicated telephone line...
March 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29486733/development-and-evaluation-of-a-risk-assessment-tool-to-improve-clinical-triage-accuracy-for-colonoscopic-investigations
#3
Anton R Lord, Lisa A Simms, Allison Brown, Katherine Hanigan, Krupa Krishnaprasad, Belinda Schouten, Anthony R Croft, Mark N Appleyard, Graham L Radford-Smith
BACKGROUND: Gastroenterology Departments at hospitals within Australia receive thousands of General Practitioner (GP)-referral letters for gastrointestinal investigations every month. Many of these requests are for colonoscopy. This study aims to evaluate the performance of the current symptoms-based triage system compared to a novel risk score using objective markers. METHODS: Patients with lower abdominal symptoms referred by their GPs and triaged by a Gastroenterology consultant to a colonoscopy consent clinic were recruited into the study...
February 27, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29324631/pediatric-appendicitis-association-of-chief-complaint-with-missed-appendicitis
#4
Zachary Drapkin, Jennifer Dunnick, Troy E Madsen, Matthew Bryce, Jeff E Schunk
OBJECTIVES: We evaluated the association between the emergency department (ED) triage chief complaint and rate of missed appendicitis in children. METHODS: We performed a retrospective chart review of patients who presented to a pediatric ED and were diagnosed with appendicitis over 5 years (July 1, 2009 to June 30, 2014). We reviewed the medical record for any additional ED visits in the 7 days preceding the diagnosis of appendicitis. Triage chief complaints were classified as "suggestive of appendicitis" (abdominal pain, right lower quadrant pain, or rule out appendicitis) or "nonspecific" (fever, vomiting, dehydration, etc)...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29131768/from-inguinal-hernias-to-spermatic-cord-lipomas-pearls-pitfalls-and-mimics-of-abdominal-and-pelvic-hernias
#5
Miguel C Cabarrus, Benjamin M Yeh, Andrew S Phelps, Jao J Ou, Spencer C Behr
Abdominal and pelvic hernias may be indolent and detected incidentally, manifest acutely with pain and distress, or cause chronic discomfort. Physical examination findings are often ambiguous and insufficient for optimal triage. Therefore, accurate anatomic delineation and identification of complications are critical for effective treatment planning. Imaging, particularly computed tomography, provides a vital understanding of the hernia's location and size, involved viscera, and severity of associated complications...
November 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28793384/factors-that-influence-care-priority-for-chest-pain-patients-using-the-manchester-triage-system
#6
Carine Lais Nonnenmacher, Ananda Ughini Bertoldo Pires, Vítor Monteiro Moraes, Amália de Fátima Lucena
AIMS AND OBJECTIVES: To analyse crucial factors for determining care priority for patients with acute myocardial infarction based on the Manchester Triage System. BACKGROUND: Triage is the first potentially critical step in the care of myocardial infarction patients. However, there are still very few studies on the factors interfering in the lack of care priority for these patients, impacting their treatment and prognosis. DESIGN: Retrospective cohort study with 217 patients in the emergency department of a Brazilian hospital...
March 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28757746/characteristics-and-outcomes-of-patients-with-emergency-department-revisits-within-72-hours-and-subsequent-admission-to-the-intensive-care-unit
#7
I-Ting Tsai, Cheuk-Kwan Sun, Chao-Sung Chang, Kuo-Hsin Lee, Chih-Yu Liang, Chih-Wei Hsu
OBJECTIVE: This study aimed to investigate the characteristics and outcomes of patients with emergency department (ED) revisits within 72 hours and subsequent admission to the intensive care unit (ICU). MATERIALS AND METHODS: The medical records of all adult patients revisiting the ED of a single tertiary referral medical center with ICU admissions between January 2012 and September 2014 were reviewed in terms of patient characteristics, clinical manifestations, diagnoses, triage according to the Taiwan Triage and Acuity Scale, causes of revisits, and mortality...
October 2016: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28750691/the-use-of-interpreters-in-medical-triage-during-a-refugee-mass-gathering-incident-in-europe
#8
Lykourgos Christos Alexakis, Anastasia Papachristou, Chiara Baruzzi, Angeliki Konstantinou
Introduction During a refugees' mass-gathering incident in Kos Island, Greece, Médecins Sans Frontières (MSF; Brussels, Belgium) teams provided emergency medical care. A case report of the event focusing on difficulties encountered by the interpreters during triage and emergency response was prepared. METHODS: Data collected during the event were reviewed from the patient's register and qualitative interviews were obtained from the MSF interpreters involved in the response. In addition, a description of the event and a literature review were included...
December 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28670052/imaging-and-clinical-predictors-of-spontaneous-bacterial-peritonitis-diagnosed-by-ultrasound-guided-paracentesis
#9
Andrew Sideris, Pooja Patel, Hearns W Charles, James Park, David Feldman, Amy R Deipolyi
Spontaneous bacterial peritonitis (SBP) is a potentially life-threatening complication of ascites diagnosed by paracentesis. We determined predictors of SBP to facilitate patient selection. The 301 paracenteses performed in 119 patients (51 women, 68 men) from July to November 2015 were retrospectively reviewed. Presentation, lab data, depth of the deepest ascites pocket on ultrasound, total volume of ascites removed, absolute neutrophil count, and complications were studied. Of 301 paracenteses, 16 (5%) diagnosed SBP...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28632578/acute-abdominal-pain-recognition-and-management-of-constipation-in-the-emergency-department
#10
Stefania Norbedo, Giulia Bassanese, Francesca Barbieri, Egidio Barbi
OBJECTIVE: The main aim of the study was to investigate the incidence and the clinically relevant features of functional constipation in patients evaluated for acute abdominal pain in a tertiary care pediatric emergency department. METHODS: This is a retrospective study. We analyzed 4394 medical records and recorded the information (demographics, triage code, symptoms, medical history, physical evaluation, laboratory tests, radiological studies, procedures, and treatments) of all patients admitted for acute abdominal pain to the emergency department of the IRCCS Burlo Garofolo, Trieste, during 2010 to 2013...
October 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28436125/the-quipp-app-a-safe-alternative-to-a-treat-all-strategy-for-threatened-preterm-labor
#11
H A Watson, J Carter, P T Seed, R M Tribe, A H Shennan
OBJECTIVE: To evaluate the impact of triaging women at risk of spontaneous preterm birth (sPTB) using the QUiPP App, which incorporates a predictive model combining history of sPTB, gestational age and quantitative measurements of fetal fibronectin, compared with a treat-all policy (advocated by the UK National Institute for Health and Care Excellence) among women with threatened preterm labor before 30 weeks' gestation. METHODS: Prospectively collected data of pregnant women presenting with symptoms of preterm labor (abdominal pain or tightening) at 24-34 weeks' gestation were retrieved from the research databases of the EQUIPP and PETRA studies for subanalysis...
September 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28316278/high-risk-obstetrical-call-center-a-model-for-regions-with-limited-access-to-care
#12
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...
April 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28281431/the-accuracy-of-nurse-performance-of-the-triage-process-in-a-tertiary-hospital-emergency-department-in-gauteng-province-south-africa
#13
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
https://www.readbyqxmd.com/read/28210350/use-of-physician-in-triage-model-in-the-management-of-abdominal-pain-in-an-emergency-department-observation-unit
#14
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
https://www.readbyqxmd.com/read/28148468/tachycardia-may-prognosticate-life-or-organ-threatening-diseases-in-children-with-abdominal-pain
#15
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...
June 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28145196/recognition-and-management-of-foreign-body-ingestion-and-aspiration
#16
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
https://www.readbyqxmd.com/read/28045096/diabetes-cardiac-disorders-and-asthma-as-risk-factors-for-severe-organ-involvement-among-adult-dengue-patients-a-matched-case-control-study
#17
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
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#18
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 2017: CJEM
https://www.readbyqxmd.com/read/27640310/-care-in-a-chair-the-impact-of-an-overcrowded-emergency-department-on-the-time-to-treatment-and-length-of-stay-of-self-presenting-patients-with-abdominal-pain
#19
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
https://www.readbyqxmd.com/read/27599809/pulse-oximetry-error-in-a-patient-with-a-santa-ana-haemoglobinopathy
#20
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
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