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Emergency Triage

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https://www.readbyqxmd.com/read/28926508/racial-ethnic-variation-in-emergency-department-care-for-children-with-asthma
#1
Heather G Zook, Nathaniel R Payne, Susan E Puumala, Katherine M Ziegler, Anupam B Kharbanda
OBJECTIVE: To assess the variation between racial/ethnic groups in emergency department (ED) treatment of asthma for pediatric patients. METHODS: This study was a cross-sectional analysis of pediatric (2-18 years) asthma visits among 6 EDs in the Upper Midwest between June 2011 and May 2012. We used mixed-effects logistic regression to assess the odds of receiving steroids, radiology tests, and returning to the ED within 30 days. We conducted a subanalysis of asthma visits where patients received at least 1 albuterol treatment in the ED...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28924318/pre-eclampsia-molecular-events-to-biomarkers
#2
REVIEW
Kavita Sahai, Seema Saraswathy, Tribhuvan Pal Yadav, Devendra Arora, Manu Krishnan
Pre-eclampsia is a hypertensive disorder in pregnancy, which accounts for 10-15% of the maternal and perinatal mortality worldwide. Abnormal placental development and tissue hypoxia are its main etiologic factors. The present diagnostic methods of blood pressure monitoring and renal function evaluation are insufficient in the early detection of pre-eclampsia. Since molecular events portent well ahead of the disease onset, biomarker research for the early diagnosis of pre-eclampsia has recently generated ambitious clinical targets...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28923905/acute-coronary-syndromes-the-way-forward-from-mechanisms-to-precision-treatment
#3
REVIEW
Filippo Crea, Peter Libby
Well into the 21st century, we still triage acute myocardial infarction on the basis of the presence or absence of ST-segment elevation, a century-old technology. Meanwhile, we have learned a great deal about the pathophysiology and mechanisms of acute coronary syndromes (ACS) at the clinical, pathological, cellular, and molecular levels. Contemporary imaging studies have shed new light on the mechanisms of ACS. This review discusses these advances and their implications for clinical management of the ACS for the future...
September 19, 2017: Circulation
https://www.readbyqxmd.com/read/28922385/metabolomics-analyses-identify-platelet-activating-factors-and-heme-breakdown-products-as-lassa-fever-biomarkers
#4
Trevor V Gale, Timothy M Horton, Donald S Grant, Robert F Garry
Lassa fever afflicts tens of thousands of people in West Africa annually. The rapid progression of patients from febrile illness to fulminant syndrome and death provides incentive for development of clinical prognostic markers that can guide case management. The small molecule profile of serum from febrile patients triaged to the Viral Hemorrhagic Fever Ward at Kenema Government Hospital in Sierra Leone was assessed using untargeted Ultra High Performance Liquid Chromatography Mass Spectrometry. Physiological dysregulation resulting from Lassa virus (LASV) infection occurs at the small molecule level...
September 18, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28922271/the-impact-of-telemedicine-on-pediatric-critical-care-triage
#5
Jillian B Harvey, Brooke E Yeager, Christina Cramer, David Wheeler, S David McSwain
OBJECTIVE: To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. DESIGN: Retrospective evaluation of consultations occurring between April 2012 and March 2016...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28916666/regional-evaluation-of-the-severity-based-stroke-triage-algorithm-for-emergency-medical-services-using-discrete-event-simulation
#6
Brittany M Bogle, Andrew W Asimos, Wayne D Rosamond
BACKGROUND AND PURPOSE: The Severity-Based Stroke Triage Algorithm for Emergency Medical Services endorses routing patients with suspected large vessel occlusion acute ischemic strokes directly to endovascular stroke centers (ESCs). We sought to evaluate different specifications of this algorithm within a region. METHODS: We developed a discrete event simulation environment to model patients with suspected stroke transported according to algorithm specifications, which varied by stroke severity screen and permissible additional transport time for routing patients to ESCs...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28915163/do-prehospital-providers-and-emergency-nurses-agree-on-triage-assignment-an-efficacy-study
#7
Helene Skjøt-Arkil, Louise L Pontoppidan, Jens O Laursen, Matthias Giebner, Jesper D Andersen, Christian B Mogensen
OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage? METHODS: The study was a prospective and observational efficacy study...
September 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28912964/is-the-south-african-triage-scale-valid-for-use-in-afghanistan-haiti-and-sierra-leone
#8
Mohammed Dalwai, Pola Valles, Michele Twomey, Yvonne Nzomukunda, Prince Jonjo, Manoj Sasikumar, Masood Nasim, Abdul Razaaq, Olivia Gayraud, Pierre Ronald Jecrois, Lee Wallis, Katie Tayler-Smith
OBJECTIVE: To assess the validity of the South African Triage Scale (SATS) in four Médecins Sans Frontières (MSF)-supported emergency departments (ED, two trauma-only sites, one mixed site (both medical and trauma cases) and one paediatric-only site) in Afghanistan, Haiti and Sierra Leone. METHODS: This was a retrospective cohort study conducted between June 2013 and June 2014. Validity was assessed by comparing patients' SATS ratings with their final ED outcome (ie, hospital admission, death or discharge)...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/28912165/holistic-care-of-complicated-tuberculosis-in-healthcare-settings-with-limited-resources
#9
Trevor Duke, Sharon Kasa Tom, Harry Poka, Henry Welch
In recent years, most of the focus on improving the quality of paediatric care in low-income countries has been on improving primary care using the Integrated Management of Childhood Illness, and improving triage and emergency treatment in hospitals aimed at reducing deaths in the first 24 hours. There has been little attention paid to improving the quality of care for children with chronic or complex diseases. Children with complicated forms of tuberculosis (TB), including central nervous system and chronic pulmonary TB, provide examples of acute and chronic multisystem paediatric illnesses that commonly present to district-level and second-level referral hospitals in low-income countries...
September 14, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28906260/effectiveness-of-a-post-emergency-department-discharge-multidisciplinary-bundle-in-reducing-acute-hospital-admissions-for-the-elderly
#10
Colin Ong, Marxengel Asinas-Tan, Lit-Sin Quek, Michael de Dios, Xue-Ting Cai, Beng-Leong Lim
OBJECTIVE: We evaluated the effectiveness of the Subacute Ambulatory care for the Functionally challenged and Elderly (SAFE) programme, a post-emergency department (ED) discharge intervention for elderly and functionally challenged patients, in reducing acute hospital admissions. METHODS: This study was a 32-month retrospective quasi-experimental study comparing patients with at least one of six diagnostic classifications who underwent SAFE intervention with those who were eligible but declined and received usual ED care (control)...
September 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28903795/rapid-triage-of-mental-health-risk-in-emergency-medical-workers-findings-from-typhoon-haiyan
#11
Lauren Sylwanowicz, Merritt Schreiber, Craig Anderson, Carlos Primero D Gundran, Emelie Santamaria, Jaifred Christian F Lopez
OBJECTIVE: To determine the ability of a novel responder mental health self-triage system to predict post-traumatic stress disorder (PTSD) in emergency medical responders after a disaster. METHODS: Participants in this study responded to Typhoon Haiyan, which struck the Philippines in November 2013. They completed the Psychological Simple Triage and Rapid Treatment (PsySTART) responder triage tool, the PTSD Checklist (PCL-5) and the Patient Health Questionnaire-8 (PHQ-8) shortly after responding to this disaster...
September 14, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28901005/delivery-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#12
REVIEW
Agustín Ciapponi, Simon Lewin, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Elizabeth Paulsen, Gabriel Rada, Charles S Wiysonge, Gabriel Bastías, Lilian Dudley, Signe Flottorp, Marie-Pierre Gagnon, Sebastian Garcia Marti, Claire Glenton, Charles I Okwundu, Blanca Peñaloza, Fatima Suleman, Andrew D Oxman
BACKGROUND: Delivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28900665/-questionnaire-for-the-utilization-of-the-emergency-department-department-implications-for-the-patient-survey
#13
J Frick, M Möckel, M Schmiedhofer, J Searle, B Erdmann, M Erhart, A Slagman
BACKGROUND: For several years, Emergency Departments (ED) in Germany have observed increasing patient numbers, resulting in ED crowding. This leads to the question of whether patients with nonurgent conditions could also receive adequate treatment in primary care. Our objective was to develop a quantitative questionnaire to investigate in a larger patient group the reasons for this and to describe the implications for a patient survey in the ED. METHODS: The development of the questionnaire was based on a literature search and the results of the qualitative EPICS-2 study...
September 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28894309/reliability-of-best-possible-medication-histories-completed-by-non-admitted-patients-in-the-emergency-department
#14
Nicole MacDonald, Leslie Manuel, Haley Brennan, Erin Musgrave, Richard Wanbon, George Stoica
BACKGROUND: Accreditation standards have outlined the need for staff in emergency departments to initiate the medication reconciliation process for patients who are at risk of adverse drug events. The authors hypothesized that a guided form could be used by non-admitted patients in the emergency department to assist with completion of a best possible medication history (BPMH). OBJECTIVE: To determine the percentage of patients in the non-acute care area of the emergency department who could complete a guided BPMH form with no clinically significant discrepancies (defined as no major discrepancies and no more than 1 moderate discrepancy)...
July 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28892188/person-centred-climate-and-psychometrical-exploration-of-person-centredness-and-among-patients-not-conveyed-by-the-ambulance-care-service
#15
Andreas Rantala, Anna Forsberg, Anna Ekwall
BACKGROUND: What already is known is that as many as 50% of all Swedish Ambulance Care Service assignments are considered as non-emergency. Therefore, due to medical protocols and triage system, patients are refused conveyance to the Accident and Emergency Department by the Ambulance Care Service. AIM: The aim of this study was to psychometrically explore the construct validity of a possible dimension of person-centredness, developed from a previous published qualitative study in a nonemergency ambulance care context...
September 11, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28890140/-impact-of-the-elderly-patient-in-the-emergency-department
#16
Manuel Bermúdez Menéndez de la Granda, German Guzmán Gutiérrez, María Fernández Fernández, Juan José Solano Jaurrieta
INTRODUCTION: The aging of the population, chronic diseases, and non-urgent visits to the Emergency departments (ED) are considered the reasons for the increase of the demand of care. The aim of this study is to analyse the impact of the older population in the ED, when compared to a younger population. MATERIAL AND METHODS: An observational, descriptive and retrospective study including an analysis of the 92,627 patients that attended the ED in Hospitals from Health Area IV belonging to the Principality of Asturias Health Services during 2009...
September 7, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28888332/machine-learning-based-electronic-triage-more-accurately-differentiates-patients-with-respect-to%C3%A2-clinical-outcomes-compared-with-the-emergency-severity-index
#17
Scott Levin, Matthew Toerper, Eric Hamrock, Jeremiah S Hinson, Sean Barnes, Heather Gardner, Andrea Dugas, Bob Linton, Tom Kirsch, Gabor Kelen
STUDY OBJECTIVE: Standards for emergency department (ED) triage in the United States rely heavily on subjective assessment and are limited in their ability to risk-stratify patients. This study seeks to evaluate an electronic triage system (e-triage) based on machine learning that predicts likelihood of acute outcomes enabling improved patient differentiation. METHODS: A multisite, retrospective, cross-sectional study of 172,726 ED visits from urban and community EDs was conducted...
September 6, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28875617/clinical-considerations-when-applying-vital-signs-in-pediatric-korean-triage-and-acuity-scale
#18
Bongjin Lee, Do Kyun Kim, June Dong Park, Young Ho Kwak
Initial vital signs of children at the emergency department may be abnormal because of anxiety and irritability, resulting in unrealistic triage levels. This study aimed to evaluate the effectiveness of pediatric triage by clinical decision based on the patient's general condition. The Pediatric Korean Triage and Acuity Scale (PedKTAS) has been used nationwide for triage since 2016. The triage level, as assessed by an experienced triage nurse and based on the patient's clinical condition, was defined as the 'real practice (RP)-level,' while the re-calculated triage level, as assessed by the direct application of initial vital signs, was defined as the 'simulation (S)-level...
October 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28872046/racial-and-ethnic-differences-in-antibiotic-use-for-viral-illness-in-emergency-departments
#19
Monika K Goyal, Tiffani J Johnson, James M Chamberlain, T Charles Casper, Timothy Simmons, Evaline A Alessandrini, Lalit Bajaj, Robert W Grundmeier, Jeffrey S Gerber, Scott A Lorch, Elizabeth R Alpern
BACKGROUND AND OBJECTIVES: In the primary care setting, there are racial and ethnic differences in antibiotic prescribing for acute respiratory tract infections (ARTIs). Viral ARTIs are commonly diagnosed in the pediatric emergency department (PED), in which racial and ethnic differences in antibiotic prescribing have not been previously reported. We sought to investigate whether patient race and ethnicity was associated with differences in antibiotic prescribing for viral ARTIs in the PED...
September 5, 2017: Pediatrics
https://www.readbyqxmd.com/read/28870097/glycosylation-profiling-to-evaluate-glycoprotein-immunogens-against-hiv-1
#20
Anna-Janina Behrens, Weston B Struwe, Max Crispin
Introduction Much of the efforts to develop a vaccine against the human immunodeficiency virus (HIV) have focused on the design of recombinant mimics of the viral attachment glycoprotein (Env). The leading immunogens exhibit native-like antigenic properties and are being investigated for their ability to induce broadly neutralizing antibodies (bNAbs). Understanding the relative abundance of glycans at particular glycosylation sites on these immunogens is important as most bNAbs have evolved to recognize or evade the dense coat of glycans that masks much of the protein surface...
September 5, 2017: Expert Review of Proteomics
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