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https://www.readbyqxmd.com/read/28812053/emergency-medical-service-personnel-recognize-pediatric-concussions
#1
Joshua N Speirs, Matthew I Lyons, Bert E Johansson
Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28807499/making-the-hard-decisions-ethical-care-decisions-in-wartime-nursing-practice
#2
Janice Agazio, Petra Goodman
BACKGROUND: Codes of ethics set forth standards of ethical conduct for nurses. However, nurses involved in wartime operations, or disasters, may often have their moral compass challenged by the patient care decisions necessary under adverse conditions. Reverse triage, resource allocation, and promotion of patient autonomy present multiple challenges to meeting commonly applied ethical principles. PURPOSE: The purpose of this study was to use the International Council of Nursing code of ethics as a framework to organize the ethical issues emerging from wartime nursing...
June 30, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28807080/a-descriptive-analysis-of-traction-splint-utilization-and-iv-analgesia-by-emergency-medical-services
#3
Joshua Nackenson, Amado A Baez, Jonathan P Meizoso
Study Objectives Traction splinting has been the prehospital treatment of midshaft femur fracture as early as the battlefield of the First World War (1914-1918). This study is the assessment of these injuries and the utilization of a traction splint (TS) in blunt and penetrating trauma, as well as intravenous (IV) analgesia utilization by Emergency Medical Services (EMS) in Miami, Florida (USA). METHODS: This is a retrospective study of patients who sustained a midshaft femur fracture in the absence of multiple other severe injuries or severe physiologic derangement, as defined by an injury severity score (ISS) <20 and a triage revised trauma score (T-RTS)≥10, who presented to an urban, Level 1 trauma center between September 2008 and September 2013...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28802404/enabling-faster-go-no-go-decisions-through-secondary-screens-in-anti-mycobacterial-drug-discovery
#4
REVIEW
Raju Mukherjee, Anup Chandra Pal, Mousumi Banerjee
Management of tuberculosis, already a global health emergency, is becoming increasingly challenging with extensive misuse of second line drugs and their inaccessibility to eighty percent of the eligible patients. Rising statistics of antimicrobial resistance underscores the need for a set of completely new and more effective class of compounds with novel mechanisms of action that can be administered in combination to replace and shorten the present intensive six months regimen. In this review, we stress on the importance and the successes of phenotypic screening for discovery of anti-mycobacterial compound and discuss the importance of performing secondary screens and counter screens to get early estimate on compound's potentials for a successful development...
September 2017: Tuberculosis
https://www.readbyqxmd.com/read/28801483/characteristics-of-youth-agreeing-to-electronic-sexually-transmitted-infection-risk-assessment-in-the-emergency-department
#5
Fahd A Ahmad, Donna B Jeffe, Katie Plax, Kenneth B Schechtman, Dwight E Doerhoff, Jane M Garbutt, David M Jaffe
OBJECTIVES: Adolescents and young adults are at high risk for sexually transmitted infections (STIs). We previously reported an increase in STI testing of adolescents in our ED by obtaining a sexual history using an Audio-enhanced Computer-Assisted Self-Interview (ACASI). We now examine associations among demographics, sexual behaviour, chief complaint and willingness to be tested. METHODS: This was a prospective study conducted in a paediatric ED between April and December 2011...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28798972/diagnostic-precision-of-triage-algorithms-for-mass-casualty-incidents-english-version
#6
A R Heller, N Salvador, M Frank, J Schiffner, R Kipke, C Kleber
BACKGROUND: Regarding survival and quality of life recent mass casualty incidents again emphasize the importance of early identification of the correct degree of injury/illness to enable prioritization of treatment amongst patients and their transportation to an appropriate hospital. The present study investigated existing triage algorithms in terms of sensitivity (SE) and specificity (SP) as well as its process duration in a relevant emergency patient cohort. METHODS: In this study 500 consecutive air rescue missions were evaluated by means of standardized patient records...
August 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28794660/a-renal-colic-fast-track-pathway-to-improve-waiting-times-and-outcomes-for-patients-presenting-to-the-emergency-department
#7
Omar Al Kadhi, Kate Manley, Madhavi Natarajan, Valmiki Lutchmedial, Abbi Forsyth, Kate Tabrett, Jonathan Betteridge, William Finch, Heinrich Hollis
INTRODUCTION: Renal colic is commonly encountered in the emergency department (ED). We validated a fast track renal colic (FTRC) initiative to decrease patient waiting times and streamline patient flow. METHOD: The FTRC pathway was devised according to the National Institute for Health and Care Excellence clinical summary criteria for the management of patients with suspected renal colic. ED triage nurses use the pathway to identify patients with likely renal colic suitable for fast track to analgesia, investigation and management...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28793384/factors-that-influence-care-priority-for-chest-pain-patients-using-the-manchester-triage-system
#8
Carine Lais Nonnenmacher, Ananda Ughini Bertoldo Pires, Vitor Monteiro Moraes, Amália de Fátima Lucena
AIMS AND OBJECTIVES: Analyze 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...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28793374/pain-assessment-by-emergency-nurses-at-triage-in-the-emergency-department-a-qualitative-study
#9
Marilène Vuille, Maryline Foerster, Eliane Foucault, Olivier Hugli
AIM: To investigate the assessment of pain intensity in the specific context of triage. BACKGROUND: Acute pain affects most patients admitted in emergency departments (ED) but pain relief in this setting remains insufficient. Evaluation of pain and its treatment at the time of patient triage expedites the administration of analgesia, but may be awkward at this time-pressured moment. The assessment of pain intensity by a validated pain scale is a critical initial step, and a patient's self-reporting is widely considered as the key to effective pain management...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28792256/triage-of-septic-patients-using-qsofa-criteria-at-the-samu-regulation-a-retrospective-analysis
#10
R Jouffroy, A Saade, A Carpentier, S Ellouze, P Philippe, R Idialisoa, P Carli, B Vivien
PURPOSE: One of the major prognostic factors in the management of sepsis is the early initiation of appropriate treatment. To serve this purpose, early identification and triage of patients are crucial steps, which are still not optimal. The objective of this study was to determine whether the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) score is an accurate method for prehospital triaging of septic patients. We evaluated whether the use of qSOFA criteria collected by the Service Mobile d'Urgence et de Réanimation 15 (SAMU 15) regulation call center during prehospital care would facilitate appropriate intensive care unit (ICU) admission of patients with septic syndromes...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28789607/assessing-the-validity-of-the-triage-risk-screening-tool-in-a-third-world-setting
#11
Ravi Lalla, Ian Sammy, Joanne Paul, Paula Nunes, Vidya Ramcharitar Maharaj, Paula Robertson
Background Social risk is rarely evaluated in older emergency department (ED) patients, although its identification can reduce re-attendance. Objectives This study assessed the diagnostic accuracy of the Triage Risk Screening Tool (TRST) in the ED of a developing country. Methods The diagnostic accuracy of the TRST to detect elderly adults in need of social service intervention was compared with routine clinical evaluation, using comprehensive evaluation by an experienced social worker as the "gold standard"...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28782193/resident-responses-to-after-hours-otolaryngology-patient-phone-calls-an-overlooked-aspect-of-residency-training
#12
Ashton E Lehmann, Elliott D Kozin, Rosh K V Sethi, Kevin Wong, Brian M Lin, Stacey T Gray, Michael J Cunningham
OBJECTIVES/HYPOTHESIS: Otolaryngology residents are often responsible for triaging after-hours patient calls. However, residents receive little training on this topic. Data are limited on the clinical content, reporting, and management of otolaryngology patient calls. This study aimed to characterize the patient concerns residents handle by phone and their subsequent management and reporting. STUDY DESIGN: Retrospective review. METHODS: Five hundred consecutive after-hours patient calls in a tertiary pediatric hospital were reviewed...
August 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28780982/validation-of-the-criteria-for-early-critical-care-resource-use-in-assessing-the-effectiveness-of-field-triage
#13
Ki Ok Ahn, Sang Chul Kim, Ju Ok Park, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong
BACKGROUND: This study aimed to validate the criteria for early critical care resource (CCR) use as an outcome predictor for seriously injured patients triaged in the field by comparing the effectiveness of the criteria for early CCR use with that of criteria defined by an Injury Severity Score (ISS) >15. METHODS: We analysed data from seriously injured trauma patients who were triaged using a field triage protocol by emergency medical service providers (EMS-ST patients)...
July 31, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28777159/icu-admission-after-surgery-who-benefits
#14
Sadia Ghaffar, Rupert M Pearse, Michael A Gillies
PURPOSE OF REVIEW: Death following surgery remains a major cause of death worldwide, and ICU admission following major surgery is considered a standard of care in many healthcare systems. However, ICU resources are finite and expensive, thus identifying those most likely to benefit is of great importance. RECENT FINDINGS: Advances in surgical and perioperative management have moved the focus of postoperative care to preventing complications and reducing duration of hospitalisation...
August 1, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28777117/delays-in-treatment-seeking-decisions-among-women-with-myocardial-infarction
#15
Cynthia Arslanian-Engoren, Linda D Scott
BACKGROUND: Minimizing the time from myocardial infarction (MI) symptom onset to the implementation of lifesaving interventions decreases morbidity and mortality of women who experience an MI. However, not all women seek timely evaluation and treatment for their MI symptoms. OBJECTIVES: The aim of this article is to describe reasons for decision treatment delays among women who experience an initial MI. METHOD: A secondary analysis of narrative data collected as part of a qualitative study examining the triage experiences of women (N = 14) who presented to the emergency department with symptoms of acute MI...
September 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28774995/consultant-triage-cuts-emergency-operations-by-a-third-report-finds
#16
Sophie Arie
No abstract text is available yet for this article.
August 3, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28774350/correlation-of-age-and-rurality-with-low-urgency-use-of-emergency-medical-services-luems-a-geographic-analysis
#17
Mikiko Terashima, Alix J E Carter
OBJECTIVES: Studies suggest that addressing the needs of the older population in rural areas may substantially reduce their low-urgency use of emergency medical services (LUEMS). It may ultimately also help improve the efficiency in our health system. There is, however, a dearth of evidence substantiating geographic patterns in LUEMS by different age cohorts. This exploratory study was aimed to clarify the understanding of emergency medical services (EMS) use in Nova Scotia through a geographic analysis...
August 4, 2017: CJEM
https://www.readbyqxmd.com/read/28774317/measuring-the-effect-of-nurse-practitioner-np-led-care-on-health-related-quality-of-life-in-adult-patients-with-atrial-fibrillation-study-protocol-for-a-randomized-controlled-trial
#18
Marcie J Smigorowsky, Colleen M Norris, Micheal Sean McMurtry, Ross T Tsuyuki
BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia associated with significant morbidity, mortality, and healthcare resource use. The prevalence of AF is increasing with a growing and aging population, and timely access to care for these patients is a concern. Nontraditional models of care delivery, such as nurse practitioner (NP)-led clinics, may improve access to care and quality of care, but they require formal assessment. The objective of this study is to assess the effect of NP-led care on the health-related quality of life (HRQoL) of adult patients with AF...
August 3, 2017: Trials
https://www.readbyqxmd.com/read/28771647/patients-with-access-and-functional-needs-in-a-disaster
#19
Sharon E Mace, Constance J Doyle
Individuals with special healthcare needs have some of the highest morbidity and mortality rates during disasters. Efforts to triage, transport, shelter, or treat vulnerable populations often fail to take into consideration disabilities and social situations, including caregiver availability. Communication, medical care, independence, supervision, and transportation needs should be considered in emergency preparedness planning. Inconsistencies with the definitions and scope of individuals with special healthcare needs exist...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28771567/muscle-oxygenation-as-an-indicator-of-shock-severity-in-patients-with-suspected-severe-sepsis-or-septic-shock
#20
Kenneth A Schenkman, David J Carlbom, Eileen M Bulger, Wayne A Ciesielski, Dana M Fisk, Kellie L Sheehan, Karin M Asplund, Jeremy M Shaver, Lorilee S L Arakaki
PURPOSE: The aim of this pilot study was to evaluate the potential of a new noninvasive optical measurement of muscle oxygenation (MOx) to identify shock severity in patients with suspected sepsis. METHODS: We enrolled 51 adult patients in the emergency department (ED) who presented with possible sepsis using traditional Systematic Inflammatory Response Syndrome criteria or who triggered a "Code Sepsis." Noninvasive MOx measurements were made from the first dorsal interosseous muscles of the hand once potential sepsis/septic shock was identified, as soon as possible after admission to the ED...
2017: PloS One
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