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https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#1
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
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
#2
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...
September 15, 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/27599809/pulse-oximetry-error-in-a-patient-with-a-santa-ana-haemoglobinopathy
#3
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...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27353286/characteristics-of-patients-who-made-a-return-visit-within-72-hours-to-the-emergency-department-of-a-singapore-tertiary-hospital
#4
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
https://www.readbyqxmd.com/read/27206383/older-adolescent-presentations-to-a-children-s-hospital-emergency-department
#5
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
https://www.readbyqxmd.com/read/27135864/-patients-with-acute-non-traumatic-abdominal-pain-in-german-emergency-departments-a-prospective-monocentric-observation-study
#6
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...
May 2, 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27133252/abdominal-pain-mimics
#7
REVIEW
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
https://www.readbyqxmd.com/read/26899520/racial-differences-in-pediatric-emergency-department-triage-scores
#8
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
https://www.readbyqxmd.com/read/26849556/identifying-adult-dengue-patients-at-low-risk-for-clinically-significant-bleeding
#9
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
https://www.readbyqxmd.com/read/26764187/performance-of-an-ultrasound-based-endometriosis-staging-system-ubess-for-predicting-the-level-of-complexity-of-laparoscopic-surgery-for-endometriosis
#10
Uche Menakaya, Shannon Reid, Chuan Lu, Bassem Gerges, Fernando Infante, George Condous
OBJECTIVE: To develop and assess the performance of a pre-operative ultrasound based endometriosis-staging system (UBESS) that could predict the level of complexity of laparoscopic surgery for endometriosis. METHODOLOGY: Multi-centre prospective and retrospective cohort study on consecutive women with suspected endometriosis that underwent laparoscopy (June 2009 - July 2013). Each woman underwent a systematic transvaginal ultrasound (TVS) evaluation to assess the pelvis for different phenotypes of endometriosis...
January 14, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/26568037/a-novel-approach-for-managing-the-growing-demand-for-ambulance-services-by-low-acuity-patients
#11
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
https://www.readbyqxmd.com/read/26526441/mr-evaluation-of-the-nontraumatic-acute-abdomen-with-ct-correlation
#12
REVIEW
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
https://www.readbyqxmd.com/read/26506830/can-c-reactive-protein-and-white-blood-cell-count-alone-rule-out-an-urgent-condition-in-acute-abdominal-pain
#13
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
https://www.readbyqxmd.com/read/26465122/a-multicenter-evaluation-of-the-impact-of-sex-on-abdominal-and-fracture-pain-care
#14
Ammar Siddiqui, Laura Belland, Laura Rivera-Reyes, Daniel Handel, Kabir Yadav, Kennon Heard, Amanda Eisenberg, Ula Hwang
BACKGROUND: Previous studies examining sex-based disparities in emergency department (ED) pain care have been limited to a single pain condition, a single study site, and lack rigorous control for confounders. OBJECTIVE: A multicenter evaluation of the effect of sex on abdominal pain (AP) and fracture pain (FP) care outcomes. RESEARCH DESIGN: A retrospective cohort review of ED visits at 5 US hospitals in January, April, July, and October 2009...
November 2015: Medical Care
https://www.readbyqxmd.com/read/26444675/prospective-study-of-the-primary-evaluation-of-1016-horses-with-clinical-signs-of-abdominal-pain-by-veterinary-practitioners-and-the-differentiation-of-critical-and-non-critical-cases
#15
Laila Curtis, John Harold Burford, Jennifer Sara Marian Thomas, Marise Linda Curran, Tom Curtis Bayes, Gary Crane William England, Sarah Louise Freeman
BACKGROUND: The majority of research on the evaluation of horses with colic is focused on referral hospital populations. Early identification of critical cases is important to optimise outcome and welfare. The aim of this prospective study was to survey the primary evaluation of horses with clinical signs of abdominal pain by veterinary practitioners, and compare the initial presentation of critical and non-critical cases. RESULTS: Data from 1016 primary evaluations of horses presenting with clinical signs of colic were submitted by 167 veterinary practitioners across the United Kingdom over a 13 month period...
October 6, 2015: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/26444159/relationship-between-complaints-presented-by-emergency-patients-and-the-final-outcome
#16
Helisamara Mota Guedes, Kesia Meiriele Souza, Patrícia de Oliveira Lima, José Carlos Amado Martins, Tânia Couto Machado Chianca
OBJECTIVE: to relate complaints presented by emergency room patients, classified using the Manchester Triage System, with the final outcome (discharge/death/transfer). METHODS: prospective cohort study, involving 509 patients who were admitted to the emergency room and remained there for more than 24 hours after admission, being monitored to the final outcome. Data were analyzed with a statistical program using descriptive and analytical statistics. RESULTS: the mean age of the patients was 59...
July 2015: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/26341218/a-simplified-way-for-the-urgent-treatment-of-somatic-pain-in-patients-admitted-to-the-emergency-room-the-super-algorithm
#17
Francesco Franceschi, Davide Marsiliani, Andrea Alesi, Maria Grazia Mancini, Veronica Ojetti, Marcello Candelli, Maurizio Gabrielli, Gabriella D'Aurizio, Emanuele Gilardi, Enrica Adducci, Rodolfo Proietti, Francesco Buccelletti
Somatic pain is one of the most frequent symptoms reported by patients presenting to the emergency department (ED), but, in spite of this, it is very often underestimated and under-treated. Moreover, pain-killers prescriptions are usually related to the medical examination, leading to a delay in its administration, thus worsening the patient's quality of life. With our study, we want to define and validate a systematic and homogeneous approach to analgesic drugs administration, testing a new therapeutic algorithm in terms of earliness, safety, and efficacy...
December 2015: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/26334607/guidelines-for-the-management-of-a-pregnant-trauma-patient
#18
Venu Jain, Radha Chari, Sharon Maslovitz, Dan Farine, Emmanuel Bujold, Robert Gagnon, Melanie Basso, Hayley Bos, Richard Brown, Stephanie Cooper, Katy Gouin, N Lynne McLeod, Savas Menticoglou, William Mundle, Christy Pylypjuk, Anne Roggensack, Frank Sanderson
OBJECTIVE: Physical trauma affects 1 in 12 pregnant women and has a major impact on maternal mortality and morbidity and on pregnancy outcome. A multidisciplinary approach is warranted to optimize outcome for both the mother and her fetus. The aim of this document is to provide the obstetric care provider with an evidence-based systematic approach to the pregnant trauma patient. OUTCOMES: Significant health and economic outcomes considered in comparing alternative practices...
June 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/26221789/implementation-of-an-advanced-nursing-directive-for-children-with-right-lower-quadrant-pain-identifying-those-requiring-further-investigation-and-improving-flow-metrics
#19
Graham C Thompson, Simon Kwong, Niklas Bobrovitz, Stephanie Yang, Erin Kate Pols, Antonia S Stang, Robin C Eccles, Veronica Kazoleas
OBJECTIVES: Advanced nursing directives (ANDs) empower nursing staff to provide advanced levels of care before physician assessment. The objectives of this study were (1) to determine whether an AND for right lower quadrant (RLQ) pain could identify children who required any further investigation to diagnose appendicitis and (2) to determine whether children meeting AND criteria had better emergency department (ED) flow metrics compared with those who did not meet the criteria. METHODS: Health records of children aged 3 to 17 years presenting to the ED with abdominal pain who were managed using the departmental AND for RLQ pain were reviewed...
June 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/26120049/a-cross-sectional-study-of-the-clinical-characteristics-of-cancer-patients-presenting-to-one-tertiary-referral-emergency-department
#20
Meredith Oatley, Margaret Fry, Lesley Mullen
INTRODUCTION: There is increasing evidence of cancer patients presenting to emergency departments (ED). The study aim was to analyse the characteristics of adult cancer patients presenting to one ED. Understanding cancer patient presentations could assist in the development of new models of care. METHODS: A 12 month retrospective audit was conducted of a random sample of cancer patients. Demographics and characteristic variables were analysed using descriptive, comparative and correlational statistics...
January 2016: International Emergency Nursing
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