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https://www.readbyqxmd.com/read/28727521/ethical-guidance-for-disaster-response-specifically-around-crisis-standards-of-care-a-systematic-review
#1
Jonathon P Leider, Debra DeBruin, Nicole Reynolds, Angelica Koch, Judy Seaberg
BACKGROUND: Terrorism, disease outbreaks, and other natural disasters and mass casualty events have pushed health care and public health systems to identify and refine emergency preparedness protocols for disaster response. Ethical guidance, alongside legal and medical frameworks, are increasingly common components of disaster response plans. OBJECTIVES: To systematically review the prevalence and content of ethical guidance offered for disaster response, specifically around crisis standards of care (CSCs)...
July 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28727502/triage-in-psychiatric-emergency-services-in-copenhagen-results-from-a-descriptive-1-year-evaluation-study
#2
Ditte Sæbye, Erica Bernt Høegh, Joachim Knop
Inspired by the Australasian triage system, a regional psychiatric triage system was introduced in the psychiatric emergency units (PEUs) in Copenhagen in 2011. Our aim of the study is to determine the characteristics of the patient according to the defined triage criteria and check if this is in accordance with recommendations. A random 10% data sample was obtained throughout 2012 in three PEUs of Copenhagen. Triage category, demographic, social and clinically relevant variables were collected. A total of 929 contacts were registered...
July 20, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28720723/profile-and-outcomes-of-critically-ill-children-in-a-lower-middle-income-country
#3
Muhammad Irfan Habib, Khalid Mehmood A Khan
OBJECTIVE: To determine the clinical profile and outcome of critically ill children presenting to a paediatric ED in a lower middle-income country. METHODS: We performed a retrospective analysis of children (<14 years) presenting to the ED of the National Institute of Child Health, Karachi, between January and December 2014 who were assigned to acuity 1 (requiring immediate life-saving interventions) according to the Emergency Severity Index. Data included demographic variables, presenting complaints, interventions and outcomes in the ED...
July 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28720720/comparison-of-prehospital-triage-and-five-level-triage-system-at-the-emergency-department
#4
Li-Heng Tsai, Chien-Hsiung Huang, Yi-Chia Su, Yi-Ming Weng, Chung-Hsien Chaou, Wen-Cheng Li, Chan-Wei Kuo, Chip-Jin Ng
OBJECTIVE: There is lack of scientific evidence regarding the effectiveness of prehospital triage systems. This study compared the two-level Taiwan Prehospital Triage System (TPTS) with the five-level Taiwan Triage and Acuity Scale (TTAS) at ED arrival regarding the prediction of patient outcomes and the utilisation of medical resources. DESIGN: This was a retrospective cohort study. Adult patients transported via the emergency medical service (EMS), who arrived at the ED of a medical centre in northern Taiwan during the study period were enrolled...
July 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28718317/hand-surgeons-and-orthopedic-trauma-surgeons-call-coverage-of-acute-upper-extremity-injuries-where-should-the-line-be-drawn
#5
Matthew B Cantlon, Andrew J Miller, Asif M Ilyas
BACKGROUND: There is a lack of consensus as to which subspecialty service should cover acute upper extremity injuries in the emergency department (ED). The purpose of the present study is to understand how upper extremity injuries are currently triaged to specialists and to assess the current opinion among hand and orthopedic trauma specialists as to how these injuries should be best triaged based on injury location and severity. METHODS: The American Association for Hand Surgery (AAHS) membership and Orthopaedic Trauma Association (OTA) membership were surveyed using a 28-item online questionnaire...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28717647/intracranial-hematoma-detection-by-near-infrared-spectroscopy-in-a-helicopter-emergency-medical-service-practical-experience
#6
Patrick Schober, Sebastiaan M Bossers, Lothar A Schwarte
In (helicopter) emergency medical services, (H)EMS, the prehospital detection of intracranial hematomas should improve patient care and the triage to specialized neurosurgical hospitals. Recently, noninvasive detection of intracranial hematomas became possible by applying transcranial near infrared spectroscopy (NIRS). Herein, second-generation devices are currently available, for example, the Infrascanner 2000 (Infrascan), that appear suited also for prehospital (H)EMS applications. Since (H)EMS operations are time-critical, we studied the Infrascanner 2000 as a "first-time-right" monitor in healthy volunteers (n = 17, hospital employees, no neurologic history)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28716152/development-of-a-theory-informed-implementation-intervention-to-improve-the-triage-treatment-and-transfer-of-stroke-patients-in-emergency-departments-using-the-theoretical-domains-framework-tdf-the-t-3-trial
#7
Louise E Craig, Natalie Taylor, Rohan Grimley, Dominique A Cadilhac, Elizabeth McInnes, Rosemary Phillips, Simeon Dale, Denise O'Connor, Chris Levi, Mark Fitzgerald, Julie Considine, Jeremy M Grimshaw, Richard Gerraty, N Wah Cheung, Jeanette Ward, Sandy Middleton
BACKGROUND: Theoretical frameworks and models based on behaviour change theories are increasingly used in the development of implementation interventions. Development of an implementation intervention is often based on the available evidence base and practical issues, i.e. feasibility and acceptability. The aim of this study was to describe the development of an implementation intervention for the T(3) Trial (Triage, Treatment and Transfer of patients with stroke in emergency departments (EDs)) using theory to recommend behaviour change techniques (BCTs) and drawing on the research evidence base and practical issues of feasibility and acceptability...
July 17, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28716050/working-for-patient-safety-a-qualitative-study-of-women-s-help-seeking-during-acute-perinatal-events
#8
Nicola Mackintosh, Susanna Rance, Wendy Carter, Jane Sandall
BACKGROUND: Women and their relatives can play an important role in early detection and help seeking for acute perinatal events. Recent UK reports indicate that patient-professional partnership in 'working for safety' can be difficult to achieve in practice, sometimes with catastrophic consequences. This research explored the experiences of women and relatives who had experienced early warning signs about their condition and sought help in escalating care. METHODS: Secondary analysis of case study data which included qualitative interviews with 22 women purposively sampled on account of experiencing a step up in care and 4 of their relatives from two NHS Trusts in England during 2010...
July 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28715794/an-introduction-to-the-emergency-department-adult-clinical-escalation-protocol-ed-ace
#9
Eoin Coughlan, Una Geary, Abel Wakai, Ronan O'Sullivan, John Browne, Eilish McAuliffe, Marie Ward, Fiona McDaid, Conor Deasy
PURPOSE OF THE STUDY: This study demonstrates how a participatory action research approach was used to address the challenge of the early and effective detection of the deteriorating patient in the ED setting. The approach enabled a systematic approach to patient monitoring and escalation of care to be developed to address the wide-ranging spectrum of undifferentiated presentations and the phases of ED care from triage to patient admission. This paper presents a longitudinal patient monitoring system, which aims to provide monitoring and escalation of care, where necessary, of adult patients from triage to admission to hospital in a manner that is feasible in the unique ED environment...
November 14, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28712683/-stratification-of-thoracic-pain-with-modified-heart-score-and-its-relationship-to-short-term-cardiovascular-events
#10
Manuel Chacón-Diaz, Jorge Salinas, Rafael Doig
OBJECTIVE: Chest pain is a major reason for emergency room care worldwide. The relationship between the Modified Heart Score and the presence of major cardiac events at 30 days after emergency admission was evaluated. METHODS: Retrospective, observational study in a single center. In patients older than 18 years old, who were treated for chest pain, in whom the Modified HEART Score was applied at admission and related to the presence of major cardiac events (myocardial infarction, death, hospitalization due to cardiac causes and percutaneous coronary revascularization Or surgical) at 30 days of follow-up...
July 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28710612/-diagnostic-quality-of-triage-algorithms-for-mass-casualty-incidents
#11
A R Heller, N Salvador, M Frank, J Schiffner, R Kipke, C Kleber
BACKGROUND: Regarding survival and quality of life, recent mass casualty incidents have once more emphasized the importance of early identification of the correct degree of injury or illness, to enable prioritizing treatment of patients and transportation to an appropriate hospital. The present study investigated international triage algorithms in terms of sensitivity (SE) and specificity (SP) as well as the process duration in a relevant emergency patient cohort. METHODS: A total of 500 consecutive air rescue missions were evaluated by means of standardized patient records...
July 14, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28705687/antecedents-and-precipitants-of-patient-related-violence-in-the-emergency-department-results-from-the-australian-vent-study-violence-in-emergency-nursing-and-triage
#12
Jacqueline V Pich, Ashley Kable, Mike Hazelton
INTRODUCTION: Workplace violence is one of the most significant and hazardous issues faced by nurses globally. It is a potentially life-threatening and life-affecting workplace hazard often downplayed as just "part of the job" for nurses. METHODS: A cross-sectional design was used and data were collected using a purpose developed survey tool. Surveys were distributed to all members of the College of Emergency Nurses' Australasia (CENA) in 2010 and 537 eligible responses were received (RR=51%)...
July 10, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28701576/estimated-impact-of-emergency-medical-service-triage-of-stroke-patients-on-comprehensive-stroke-centers-an-urban-population-based-study
#13
Brian S Katz, Opeolu Adeoye, Heidi Sucharew, Joseph P Broderick, Jason McMullan, Pooja Khatri, Michael Widener, Kathleen S Alwell, Charles J Moomaw, Brett M Kissela, Matthew L Flaherty, Daniel Woo, Simona Ferioli, Jason Mackey, Sharyl Martini, Felipe De Los Rios la Rosa, Dawn O Kleindorfer
BACKGROUND AND PURPOSE: The American Stroke Association recommends that Emergency Medical Service bypass acute stroke-ready hospital (ASRH)/primary stroke center (PSC) for comprehensive stroke centers (CSCs) when transporting appropriate stroke patients, if the additional travel time is ≤15 minutes. However, data on additional transport time and the effect on hospital census remain unknown. METHODS: Stroke patients ≥20 years old who were transported from home to an ASRH/PSC or CSC via Emergency Medical Service in 2010 were identified in the Greater Cincinnati area population of 1...
July 12, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28699093/evaluating-facility-based-decision-making-in-women-with-a-prior-cesarean-delivery-and-association-with-maternal-and-perinatal-outcomes
#14
Adeline Adwoa Boatin, Kwame Adu-Bonsaffoh, Blair Johnson Wylie, Samuel A Obed
Objective To describe facility-based decision-making for women with one prior cesarean delivery (CD) in a resource-limited setting and to characterize maternal and perinatal outcomes in these groups. Methods One year retrospective study of women with one prior CD delivering at Korle-Bu Teaching Hospital (KBTH), Ghana. Women were categorized into three groups based on initial plan of management on admission [trial of labor after cesarean (TOLAC), emergency repeat CD (EMCD) or non-emergent repeat CD (RCD)]. Characteristics and outcomes across these groups were then compared...
July 11, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28695610/anion-gap-can-differentiate-between-psychogenic-and-epileptic-seizures-in-the-emergency-setting
#15
Yi Li, Liesl Matzka, Louise Maranda, Daniel Weber
Differentiation between psychogenic nonepileptic seizures (PNES) and generalized convulsive epileptic seizures (ES) is important for appropriate triaging in the emergency department (ED). This can be difficult in the ED, as the event is often not witnessed by a medical professional. In the current study, we investigated whether anion gap (AG), bicarbonate, and the Denver Seizure Score (DSS) could differentiate between PNES and ES. Of a total of 1,354 subjects reviewed from a tertiary care medical center, 27 PNES and 27 ES patients were identified based on clinical description and subsequent electroencephalogram...
July 11, 2017: Epilepsia
https://www.readbyqxmd.com/read/28695351/robustness-and-effectiveness-of-the-triage-system-in-the-pediatric-context
#16
Marcello Montefiori, Enrico di Bella, Lucia Leporatti, Paolo Petralia
BACKGROUND: The increasing use of emergency departments (EDs) potentially compromises their effectiveness and quality. The evaluation of the performance of the triage code system in a pediatric context is important because waiting time affects the quality of care for acutely ill patients. OBJECTIVE: In this study, we aimed to assess the effectiveness and robustness of the triage code system in a pediatric context and identify the determinants of waiting times for urgent and non-urgent patients...
July 10, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28693524/national-consensus-on-communication-in-prehospital-trauma-care-the-denim-study
#17
Annelieke Maria Karien Harmsen, Leo Maria George Geeraedts, Georgios Fredericus Giannakopoulos, Maartje Terra, Herman M T Christiaans, Lidwine Brigitta Mokkink, Frank Willem Bloemers
BACKGROUND: In the Netherlands prehospital trauma care is provided by emergency medical services (EMS) nurses. This care is extended by Physician staffed Helicopter Emergency Medical Services (P-HEMS) for the more severely injured patient. Prehospital communication is a factor of influence on the identification of these patients and the dispatch of P-HEMS. Though prehospital communication it is often perceived to be incomplete and unstructured. To elucidated factors of influence on prehospital triage and the identification of the severely injured patient a Delphi study was performed...
July 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28693518/the-third-delay-understanding-waiting-time-for-obstetric-referrals-at-a-large-regional-hospital-in-ghana
#18
David M Goodman, Emmanuel K Srofenyoh, Adeyemi J Olufolabi, Sung Min Kim, Medge D Owen
BACKGROUND: Delay in receiving care significantly contributes to maternal morbidity and mortality. Much has been studied about reducing delays prior to arrival to referral facilities, but the delays incurred upon arrival to the hospital have not been described in many low- and middle-income countries. METHODS: We report on the obstetric referral process at Ridge Regional Hospital, Accra, Ghana, the largest referral hospital in the Ghana Health System. This study uses data from a prospectively-collected cohort of 1082 women presenting with pregnancy complications over a 10-week period...
July 11, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28692402/enhanced-influenza-surveillance-using-telephone-triage-and-electronic-syndromic-surveillance-in-the-department-of-veterans-affairs-2011-2015
#19
Cynthia Lucero-Obusan, Carla A Winston, Patricia L Schirmer, Gina Oda, Mark Holodniy
Telephone triage (TT) is a method whereby medical professionals speak by telephone to patients to assess their symptoms or health concerns and offer advice. These services are often administered through an electronic TT system, which guides TT professionals during the encounter through the use of structured protocols and algorithms to help determine the severity of the patients' health issue and refer them to appropriate care. TT is also an emerging data source for public health surveillance of infectious and noninfectious diseases, including influenza...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28692389/evaluation-of-the-components-of-the-north-carolina-syndromic-surveillance-system-heat-syndrome-case-definition
#20
Laurel Harduar Morano, Anna E Waller
OBJECTIVES: To improve heat-related illness surveillance, we evaluated and refined North Carolina's heat syndrome case definition. METHODS: We analyzed North Carolina emergency department (ED) visits during 2012-2014. We evaluated the current heat syndrome case definition (ie, keywords in chief complaint/triage notes or International Classification of Diseases, Ninth Revision, Clinical Modification [ ICD-9-CM] codes) and additional heat-related inclusion and exclusion keywords...
July 2017: Public Health Reports
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