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Emergency Triage

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https://www.readbyqxmd.com/read/28214474/emergency-department-utilisation-by-older-people-in-metropolitan-melbourne-2008-12-findings-from-the-reducing-older-patient
#1
Danielle Mazza, Christopher Pearce, Angela Joe, Lyle R Turner, Bianca Brijnath, Colette Browning, Marianne Shearer, Judy Lowthian
Objective Older patients are over-represented in emergency departments (ED), with many presenting for conditions that could potentially be managed in general practice. The aims of the present study were to examine the characteristics of ED presentations by older patients and to identify patient factors contributing to potentially avoidable general practitioner (PAGP)-type presentations.Methods A retrospective analysis was performed of routinely collected data comprising ED presentations by patients aged ≥70 years at public hospitals across metropolitan Melbourne from January 2008 to December 2012...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28211119/cross-sectional-study-of-emergency-department-presentation-triage-categories-at-goondiwindi-hospital-and-their-effect-on-the-treatment-of-acute-emergencies
#2
Ashraf Saleh
OBJECTIVE: The objective of this study was to investigate the number and proportion of non-acute presentations to a district hospital emergency department in Goondiwindi, a rural Queensland town, both in the treatment of emergency cases and potential barriers patients have in seeing a medical practitioner in the general practice setting. DESIGN: Occasions of service to Goondiwindi Hospital were collated from administrative records according to Australasian Triage Scale categories and analysed by Student's t-test for monthly variations in triage category presentations...
February 17, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28210350/use-of-physician-in-triage-model-in-the-management-of-abdominal-pain-in-an-emergency-department-observation-unit
#3
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/28207968/mri-vs-ultrasound-as-the-initial-imaging-modality-for-pediatric-and-young-adult-patients-with-suspected-appendicitis
#4
Daniel Imler, Christine Keller, Shyam Sivasankar, Nancy Ewen Wang, Shreyas Vasanawala, Matias Bruzoni, James Quinn
BACKGROUND: While ultrasound (US), given its lack of ionizing radiation is currently the recommended initial imaging study of choice for the diagnosis of appendicitis in pediatric and young adult patients, it does have significant shortcomings. US is time intensive, operator dependent, and results in frequent inconclusive studies, thus necessitating further imaging, and admission for observation or repeat clinical visits. A rapid focused Magnetic Resonance Imaging (MRI) for appendicitis has been shown to have definitive sensitivity and specificity, similar to Computed tomography (CT) but without radiation and offers a potential alternative to US...
February 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28192583/erratum-for-emergency-department-triage-of-the-incessantly-crying-baby
#5
(no author information available yet)
No abstract text is available yet for this article.
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192477/impact-of-early-in-hospital-medication-review-by-clinical-pharmacists-on-health-services-utilization
#6
Corinne M Hohl, Nilu Partovi, Isabella Ghement, Maeve E Wickham, Kimberlyn McGrail, Lisa N Reddekopp, Boris Sobolev
BACKGROUND: Adverse drug events are a leading cause of emergency department visits and unplanned admissions, and prolong hospital stays. Medication review interventions aim to identify adverse drug events and optimize medication use. Previous evaluations of in-hospital medication reviews have focused on interventions at discharge, with an unclear effect on health outcomes. We assessed the effect of early in-hospital pharmacist-led medication review on the health outcomes of high-risk patients...
2017: PloS One
https://www.readbyqxmd.com/read/28192440/helicopter-emergency-medical-services-in-major-incident-management-a-national-norwegian-cross-sectional-survey
#7
Anne Siri Johnsen, Stephen J M Sollid, Trond Vigerust, Morten Jystad, Marius Rehn
OBJECTIVE: Helicopter Emergency Medical Services (HEMS) aim to bring a highly specialised crew to the scene of major incidents for triage, treatment and transport. We aim to describe experiences made by HEMS in Norway in the management of major incidents. DESIGN: Doctors, rescue paramedics and pilots working in Norwegian HEMS and Search and Rescue Helicopters (SAR) January 1st 2015 were invited to a cross-sectional study on experiences, preparedness and training in major incident management...
2017: PloS One
https://www.readbyqxmd.com/read/28188059/validity-of-emergency-department-triage-tools-addressing-heterogeneous-definitions-of-over-triage-and-under-triage
#8
Brian A Lentz, Alexander Jenson, Jeremiah S Hinson, Scott Levin, Stephanie Cabral, Kevin George, Edbert B Hsu, Gabor Kelen, Bhakti Hansoti
No abstract text is available yet for this article.
February 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28187803/management-of-acute-traumatic-spinal-cord-injuries
#9
C D Shank, B C Walters, M N Hadley
Acute traumatic spinal cord injury (SCI) is a devastating disease process affecting tens of thousands of people across the USA each year. Despite the increase in primary prevention measures, such as educational programs, motor vehicle speed limits, automobile running lights, and safety technology that includes automobile passive restraint systems and airbags, SCIs continue to carry substantial permanent morbidity and mortality. Medical measures implemented following the initial injury are designed to limit secondary insult to the spinal cord and to stabilize the spinal column in an attempt to decrease devastating sequelae...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187101/how-nurse-gender-influences-patient-priority-assignments-in-us-emergency-departments
#10
Jacob Miguel Vigil, Patrick Coulombe, Joe Alcock, Sarah See Stith, Eric Kruger, Sara Cichowski
The goals of this study were to compare whether emergency department (ED) patients' pain intensity (PI) is measured differently by male and female nurses and to determine whether PI, heart rate (HR), and respiratory rate (RR) were used to prioritize patient urgency differently by male and female nurses. The associations between patients' PI|HR|RR and the Emergency Severity Index (ESI) scores they were assigned by attending nurses were analyzed using a national database of electronic medical records of US Veterans Affairs ED patients from 2008 to 2012...
March 2017: Pain
https://www.readbyqxmd.com/read/28186825/balancing-safety-and-harm-for-older-adults-with-dementia-in-rural-emergency-departments-healthcare-professionals-perspectives
#11
Kathleen F Hunter, Belinda Parke, Maureen Babb, Dorothy Forbes, Laurel Strain
INTRODUCTION: The emergency department (ED) is a potentially harmful environment for older adults with dementia, and rural EDs face unique challenges in providing care to this population. The purpose of this study was to understand safety and harm in rural ED transitional care for community dwelling older adults with dementia from the perspective of healthcare professionals (HCPs). METHODS: An interpretive, descriptive exploratory design from a social ecological perspective was used...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28185509/developing-an-advanced-nurse-practitioner-approach-to-clinical-assessments
#12
Caroline Prescott, Nick Stackhouse
Emergency departments (EDs) often experience reduced patient flow, which results in low capacity, increased congestion and delays in patient care. Advanced nurse practitioners (ANPs) possess the skills required to relieve these pressures and enhance care delivery. This article describes how introducing ANP-led rapid assessment triage in an ED has enabled these practitioners to use advanced practice skills in assessment and intervention, and to request early diagnostic processes to improve patient flow. The system enables the ANPs to identify high-acuity patients who can be cared for in the ED without the need for admission, while ensuring their safety, rapid assessment and timely interventions...
February 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28185499/improving-patient-safety-through-the-introduction-of-a-formal-triage-process
#13
Cliff Evans, Clare Hughes, John Ferguson
Emergency departments (EDs) in the UK are facing unprecedented increases in attendance, and the ability to safely assess, diagnose, treat, refer or discharge patients is a national challenge. This article discusses one component of a comprehensive ED strategy created to address serious concerns identified by regulators and develop and improve services in the department at Medway NHS Foundation Trust, Kent.
February 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28180119/nonemergent-patients-in-the-emergency-department-an-ethnographic-study
#14
Amir Mirhaghi, Abbas Heydari, Mohsen Ebrahimi, Mohsen Noghani Dokht Bahmani
BACKGROUND: Triage in the interactive atmosphere of the emergency department (ED) has been described as complex and challenging. Nonemergent ED visits have been accompanied by ethical and legal conflicts. OBJECTIVES: The aim of this study was to gain an understanding of ED nurses' practice regarding triage of nonemergent patients. PATIENTS AND METHODS: Focused micro-ethnography based on Spradley's developmental research sequence (DRS) was used...
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28177940/emergency-department-pain-management-in-children-with-appendicitis-in-a-bi-ethnic-population
#15
Ron Jacob, Baruch Krauss, Gal Twito, Ronit Leiba, Itai Shavit
OBJECTIVES: Our goal was to examine factors associated with the administration of ED analgesia (any analgesia, opioid analgesia) in patients with acute appendicitis in a tertiary children's hospital in Israel, and to examine ethnic differences. METHODS: A retrospective cohort study of children evaluated in the ED, who had ICD-9 diagnosis of acute appendicitis. Regression analysis was used to test the effect of multiple variables on the provision of analgesia. Medications were administered according to a nurse-driven pain protocol...
February 7, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28177169/emergency-department-triage-of-traumatic-head-injury-using-brain-electrical-activity-biomarkers-a-multisite-prospective-observational-validation-trial
#16
Daniel Hanley, Leslie S Prichep, Jeffrey Bazarian, J Stephen Huff, Rosanne Naunheim, John Garrett, Elizabeth Jones, David Wright, John O'Neill, Neeraj Badjatia, Dheeraj Gandhi, Kenneth C Curley, Richard Chiacchierini, Brian O'Neil, Dallas C Hack
OBJECTIVES: A brain electrical activity biomarker for identifying traumatic brain injury (TBI) in Emergency Department (ED) patients presenting with high GCS after sustaining a head injury has shown promise for objective, rapid, triage. The main objective of this study was to prospectively evaluate the efficacy of an automated classification algorithm to determine the likelihood of being CT positive, in high functioning TBI patients in the acute state. METHODS: Adult patients admitted to the ED for evaluation within 72 hours of sustaining a closed head injury with GCS 12-15were candidates for study...
February 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28174362/most-frequent-oral-lesions-in-patients-with-type-2-diabetes-mellitus
#17
Micheline S Trentin, Georgia Verardi, Michele De C Ferreira, João P de Carli, Soluete O da Silva, Igor Fp Lima, Luiz R Paranhos
AIM: Type 2 diabetes mellitus (DM2) is a chronic disease caused by the underproduction of insulin in the organism and it is considered a risk factor to periodontal disease. MATERIALS AND METHODS: This study performed a cross-sectional research on the main oral changes in patients with DM2 and nondiabetics, in Passo Fundo, Rio Grande do Sul, Brazil. The sample included 116 patients examined at the Diabetes Outpatient Clinic of the School of Medicine of the University of Passo Fundo (UPF) and 134 nondiabetic patients examined at the Examinations, Triage, and Emergency Sector of the School of Dentistry of UPF...
February 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/28173749/testing-a-systematic-approach-to-identify-and-prioritise-barriers-to-successful-implementation-of-a-complex-healthcare-intervention
#18
Louise E Craig, Leonid Churilov, Liudmyla Olenko, Dominique A Cadilhac, Rohan Grimley, Simeon Dale, Cintia Martinez-Garduno, Elizabeth McInnes, Julie Considine, Jeremy M Grimshaw, Sandy Middleton
BACKGROUND: Multiple barriers may inhibit the adoption of clinical interventions and impede successful implementation. Use of standardised methods to prioritise barriers to target when selecting implementation interventions is an understudied area of implementation research. The aim of this study was to describe a method to identify and prioritise barriers to the implementation of clinical practice elements which were used to inform the development of the T(3) trial implementation intervention (Triage, Treatment [thrombolysis administration; monitoring and management of temperature, blood glucose levels, and swallowing difficulties] and Transfer of stroke patients from Emergency Departments [ED])...
February 7, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28168774/when-i-get-like-that-put-a-gun-to-my-head
#19
Nancy Lutwak, Curt Dill
Yesterday a 95 year old man with prostate carcinoma and widespread bone metastases was brought to the emergency department because of blood in his urine after he pulled on his foley. At triage he was febrile and hypotensive, moaning incoherently which was not a change in mental status. Despite IV fluid hydration and pressors his blood pressure remained low. This article is protected by copyright. All rights reserved.
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28164367/the-association-of-admission-hyperglycaemia-and-adverse-clinical-outcome-in-medical-emergencies-the-multinational-prospective-observational-triage-study
#20
A Kutz, T Struja, P Hausfater, D Amin, A Amin, S Haubitz, M Bernard, A Huber, B Mueller, P Schuetz
AIMS: The clinical relevance of hyperglycaemia in an emergency department population remains incompletely understood. We investigated the association between admission blood glucose levels and adverse clinical outcomes in a large emergency department cohort. METHODS: We prospectively enrolled 7132 adult medical patients seeking emergency department care in three tertiary care hospitals in Switzerland, France and the USA. We used adjusted multivariable logistic regression models to examine the association between admission blood glucose levels and 30-day mortality, as well as adverse clinical course stratified by pre-existing diabetes and principal medical diagnoses...
February 6, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
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