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Field triage

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https://www.readbyqxmd.com/read/28422541/evaluation-of-the-implementation-of-the-trauma-triage-and-destination-plan-on-the-field-triage-of-injured-patients-in-north-carolina
#1
Jane H Brice, Frances S Shofer, Christopher Cowden, E Brooke Lerner, Matthew Psioda, Meredith Arasaratanam, N Clay Mann, Antonio R Fernandez, Anna Waller, Chailee Moss, Michael Mian
OBJECTIVE: Timely triage and appropriate destination decision making for injured patients are central challenges faced by emergency medical services (EMS) systems. In 2010, North Carolina (NC) adopted a statewide Trauma Triage and Destination Plan (TTDP) based on the CDC's Field Triage Guidelines to better address these challenges. We sought to characterize the implementation of these guidelines by quantifying their effect on multiple metrics of patient care. METHODS: We employed a retrospective pre-post study design utilizing a statewide EMS medical record database...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28411260/the-fast-ed-app-a-smartphone-platform-for-the-field-triage-of-patients-with-stroke
#2
Raul G Nogueira, Gisele S Silva, Fabricio O Lima, Yu-Chih Yeh, Carol Fleming, Daniel Branco, Arthur H Yancey, Jonathan J Ratcliff, Robert Keith Wages, Earnest Doss, Mehdi Bouslama, Jonathan A Grossberg, Diogo C Haussen, Teppei Sakano, Michael R Frankel
BACKGROUND AND PURPOSE: The Emergency Medical Services field triage to stroke centers has gained considerable complexity with the recent demonstration of clinical benefit of endovascular treatment for acute ischemic stroke. We sought to describe a new smartphone freeware application designed to assist Emergency Medical Services professionals with the field assessment and destination triage of patients with acute ischemic stroke. METHODS: Review of the application's platform and its development as well as the different variables, assessments, algorithms, and assumptions involved...
April 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28376091/participant-referral-rate-in-the-national-eye-health-survey-nehs
#3
Stuart Keel, Pei Ying Lee, Joshua Foreman, Peter van Wijngaarden, Hugh R Taylor, Mohamed Dirani
PURPOSE: To present the rates of referral of participants in the National Eye Health Survey (NEHS) for further eye care. MATERIALS & METHODS: A national sample of 3098 non-Indigenous Australians aged 50-98 and 1738 Indigenous Australians aged 40-92 years living in 30 randomly selected sites was recruited using a door-to-door approach. Participants completed a general questionnaire and a series of eye tests, including vision and anterior segment assessment, intra-ocular pressure measurement, visual field testing and fundus photography...
2017: PloS One
https://www.readbyqxmd.com/read/28375009/sustainable-practices-in-medicinal-chemistry-part-2-green-by-design
#4
Ignacio Aliagas, Raphaelle Berger, Kristin Goldberg, Rachel T Nishimura, John Reilly, Paul F Richardson, Daniel Tyler Richter, Edward C Sherer, Brian Andrew Sparling, Marian C Bryan
With the development of ever-expanding synthetic methodologies, a medicinal chemist's toolkit continues to swell. However, with finite time and resources as well as a growing understanding of our field's environment impact, it is critical to refine what can be made to what should be made. This Perspective seeks to highlight multiple cheminformatic approaches in drug discovery that can influence and triage design and execution impacting the likelihood of rapidly generating high-value molecules in a more sustainable manner...
April 4, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28374428/ethical-considerations-of-triage-following-natural-disasters-the-idf-experience-in-haiti-as-a-case-study
#5
Efrat Ram-Tiktin
Natural disasters in populated areas may result in massive casualties and extensive destruction of infrastructure. Humanitarian aid delegations may have to cope with the complicated issue of patient prioritization under conditions of severe resource scarcity. A triage model, consisting of five principles, is proposed for the prioritization of patients, and it is argued that rational and reasonable agents would agree upon them. The Israel Defense Force's humanitarian mission to Haiti following the 2010 earthquake serves as a case study for the various considerations taken into account when designing the ethical-clinical policy of field hospitals...
April 3, 2017: Bioethics
https://www.readbyqxmd.com/read/28362937/diagnostic-performance-of-tuberculosis-specific-igg-antibody-profiles-in-patients-with-presumptive-tuberculosis-from-two-continents
#6
Tobias Broger, Robindra Basu Roy, Angela Filomena, Charles H Greef, Stefanie Rimmele, Joshua Havumaki, David Danks, Nicole Schneiderhan-Marra, Christen M Gray, Mahavir Singh, Ida Rosenkrands, Peter Andersen, Gregory M Husar, Thomas O Joos, Maria L Gennaro, Michael J Lochhead, Claudia M Denkinger, Mark D Perkins
Background: Development of rapid diagnostic tests for tuberculosis is a global priority. A whole proteome screen identified Mycobacterium tuberculosis antigens associated with serological responses in tuberculosis patients. We used World Health Organization (WHO) target product profile (TPP) criteria for a detection test and triage test to evaluate these antigens. Methods: Consecutive patients presenting to microscopy centers and district hospitals in Peru and to outpatient clinics at a tuberculosis reference center in Vietnam were recruited...
April 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28356162/blood-transfusion-and-coagulopathy-in-geriatric-trauma-patients
#7
Brett Mador, Bartolomeu Nascimento, Simon Hollands, Sandro Rizoli
BACKGROUND: Trauma resuscitation has undergone a paradigm shift with new emphasis on the early use of blood products and increased proportions of plasma and platelets. However, it is unclear how this strategy is applied or how effective it is in the elderly population. The study aim is to identify differences in transfusion practices and the coagulopathy of trauma in the elderly. METHODS: Data was prospectively collected on all consecutive patients that met trauma activation criteria at a Level I trauma centre...
March 29, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28328670/the-trauma-ecosystem-the-impact-and-economics-of-new-trauma-centers-on-a-mature-statewide-trauma-system
#8
David J Ciesla, Etienne E Pracht, Pablo T Leitz, David A Spain, Joseph J Tepas, Kristan L Staudenmayer
INTRODUCTION: Florida serves as a model for the study of trauma system performance. Between 2010 and 2104, 5 new trauma centers were opened along side 20 existing centers. The purpose of this study was to explore the impact of trauma system expansion on system triage performance and trauma center patient profiles. METHODS: A statewide dataset was queried for all injury related discharges from adult acute care hospitals using ICD-9 codes for 2010 and 2014. The dataset, inclusion criteria, and definitions of high-risk injury were chosen to match those used by the Florida department of health in its trauma registry...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28322534/indicators-for-monitoring-screening-programs-with-primary-hpv-test
#9
Manuel Zorzi, Paolo Giorgi Rossi
BACKGROUND: following scientific evidence produced in numerous studies, as well as national and international guidelines, organized cervical cancer screening programs in Italy have gradually introduced the HPV test as primary screening test, replacing cytology. As public health interventions, screening programs must ensure equity, improvement in quality of life, and adequate information for the population involved with regards to benefits and possible risks; therefore, it is essential for quality to be constantly checked at every phase of the project...
January 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/28314417/an-algorithmic-approach-to-triaging-facial-trauma-on-the-sidelines
#10
REVIEW
Kristi Colbenson
On-the-field evaluation of facial trauma requires a focused initial assessment of the patient's airway and breathing with a knowledge of the critical associated injuries. The initial triage in facial trauma involves assessing and protecting the athlete's airway, breathing, and cervical spine. The algorithm then requires a repeat evaluation for subtle causes of airway obstruction and aspiration risks. Final steps include control of hemorrhage, recognition of neurologic and ophthalmologic disability, and complete exposure of the athlete to examine for other associated injury...
April 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28266033/first-international-consensus-report-on-adnexal-masses-management-recommendations
#11
Phyllis Glanc, Beryl Benacerraf, Tom Bourne, Douglas Brown, Beverly G Coleman, Christopher Crum, Jason Dodge, Deborah Levine, Edward Pavlik, Dirk Timmerman, Frederick R Ueland, Wendy Wolfman, Steven R Goldstein
The First International Consensus Conference on Adnexal Masses was convened to thoroughly examine the state of the science and to formulate recommendations for clinical assessment and management. The panel included representatives of societies in the fields of gynecology, gynecologic oncology, radiology, and pathology and clinicians from Europe, Canada, and the United States. In the United States, there are approximately 9.1 surgeries per malignancy compared to the European International Ovarian Tumor Analysis center trials, with only 2...
May 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28264831/head-to-head-comparison-of-procalcitonin-and-presepsin-for-the-diagnosis-of-sepsis-in-critically-ill-adult-patients-a-protocol-for-a-systematic-review-and-meta-analysis
#12
Kei Hayashida, Yutaka Kondo, Yoshitaka Hara, Morio Aihara, Kazuma Yamakawa
INTRODUCTION: Early diagnosis and immediate therapeutic intervention, including appropriate antibiotic therapy and goal-directed resuscitation, are necessary to reduce mortality in patients with sepsis. However, a single clinical or biological marker indicative of sepsis has not been adopted unanimously. Although procalcitonin and presepsin are promising biomarkers that can effectively differentiate between sepsis/infection and systemic inflammatory response syndrome of non-infectious origin, little is known about which marker is superior...
March 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28238499/out-of-hospital-triage-of-older-adults-with-head-injury-a-retrospective-study-of-the-effect-of-adding-anticoagulation-or-antiplatelet-medication-use-as-a-criterion
#13
Daniel K Nishijima, Samuel D Gaona, Trent Waechter, Ric Maloney, Troy Bair, Adam Blitz, Andrew R Elms, Roel D Farrales, Calvin Howard, James Montoya, Jeneita M Bell, Mark Faul, David R Vinson, Hernando Garzon, James F Holmes, Dustin W Ballard
STUDY OBJECTIVE: Field triage guidelines recommend that emergency medical services (EMS) providers consider transport of head-injured older adults with anticoagulation use to trauma centers. However, the triage patterns and the incidence of intracranial hemorrhage or neurosurgery in these patients are unknown. Our objective is to describe the characteristics and outcomes of older adults with head trauma who are transported by EMS, particularly for patients who do not meet physiologic, anatomic, or mechanism-of-injury (steps 1 to 3) field triage criteria but are receiving anticoagulant or antiplatelet medications...
February 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28195686/diagnosis-of-anaplastic-lymphoma-kinase-rearrangement-in-cytological-samples-through-a-fluorescence-in-situ-hybridization-based-assay-cytological-smears-versus-cell-blocks
#14
Federica Zito Marino, Giulio Rossi, Matteo Brunelli, Maria Gabriella Malzone, Giuseppina Liguori, Giuseppe Bogina, Alessandro Morabito, Gaetano Rocco, Renato Franco, Gerardo Botti
Anaplastic lymphoma kinase (ALK) status analysis of lung cytological specimens should be successfully encouraged in routine practice because biopsy specimens are not always available. To date, the US Food and Drug Administration has approved both fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) as diagnostic tests for identifying ALK-positive patients eligible for treatment with crizotinib. Although ALK IHC is an optimal diagnostic tool, FISH becomes mandatory in equivocal cases. ALK FISH of paraffin-embedded tissue material is still the gold standard, whereas the cytological specimen assay has not yet been completely standardized...
February 14, 2017: Cancer
https://www.readbyqxmd.com/read/28156460/developing-and-piloting-an-electronic-telephone-triage-application
#15
Christine Carlisle, Colleen F Ford, Jan Hartman, Peggy Nikolajski, Carol Reidmiller, Justin S Rushford, Leslie Stewart, Amanda Barry, Melinda Krebs
68 Background: Telephone triage is a vital part of today's oncology practice and is often not standardized and measured to allow for quality improvement. UPMC CancerCenter (UPMC) has 31 outpatient clinics and is in need of a tool to streamline the current telephone triage process. UPMC and Via Oncology collaborated to develop and pilot a prototype of an electronic telephone triage application. The key components of the prototype were defined as decision support, EHR integration, reporting and workflow management...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28089112/predictive-utility-of-the-total-glasgow-coma-scale-versus-the-motor-component-of-the-glasgow-coma-scale-for-identification-of-patients-with-serious-traumatic-injuries
#16
REVIEW
Roger Chou, Annette M Totten, Nancy Carney, Spencer Dandy, Rongwei Fu, Sara Grusing, Miranda Pappas, Ngoc Wasson, Craig D Newgard
STUDY OBJECTIVE: The motor component of the Glasgow Coma Scale (mGCS) has been proposed as an easier-to-use alternative to the total GCS (tGCS) for field assessment of trauma patients by emergency medical services. We perform a systematic review and meta-analysis to compare the predictive utility of the tGCS versus the mGCS or Simplified Motor Scale in field triage of trauma for identifying patients with adverse outcomes (inhospital mortality or severe brain injury) or who underwent procedures (neurosurgical intervention or emergency intubation) indicating need for high-level trauma care...
January 11, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28055239/the-evolving-role-of-pathology-in-new-developments-classification-terminology-and-diagnosis-of-pancreatobiliary-neoplasms
#17
REVIEW
Michelle D Reid, Melinda M Lewis, Field F Willingham, N Volkan Adsay
Pancreatobiliary tract lesions are increasingly being discovered because of more sensitive imaging modalities. Magnetic resonance imaging has identified incidental pancreatic cysts in 13.5% of patients of progressively increasing age. Pancreatobiliary tissue is more accessible through endoscopic ultrasound and magnetic resonance imaging-guided biopsy procedures, and is now an integral part of pathologists' routine practice. Accordingly, several new tumor categories have been recently recognized, including intraductal tubulopapillary neoplasm, a new addition to tumoral intraepithelial neoplasms...
March 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28041758/emergency-medical-services-ems-versus-non-ems-transport-among-injured-children-in-the-united-states
#18
Michelle M Corrado, Junxin Shi, Krista K Wheeler, Jin Peng, Brian Kenney, Sarah Johnson, Huiyun Xiang
OBJECTIVES: This study aimed to assess the proportions of injured children transported to trauma centers by different transportation modes and evaluate the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. METHODS: We analyzed data from the 2007-2012 National Trauma Data Bank (NTDB) to study trends of EMS versus non-EMS transport. Multivariable logistic regression was used to evaluate the association between transport mode and inter-facility transfer...
March 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27992953/age-related-disparities-in-trauma-center-access-for-severe-head-injuries-following-the-release-of-the-updated-field-triage-guidelines
#19
Thomas J Flottemesch, Susan Raetzman, Kevin C Heslin, Katie Fingar, Rosanna Coffey, Marguerite Barrett, Ernest Moy
OBJECTIVE: In 2006, the American College of Surgeons' Committee on Trauma and the Centers for Disease Control and Prevention released field triage guidelines with special consideration for older adults. Additional considerations for direct transport to a Level I or II trauma center (TC) were added in 2011, reflecting perceived undertriage to TCs for older adults. We examined whether age-based disparities in TC care for severe head injury decreased following introduction of the 2011 revisions...
December 19, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27982665/building-health-it-capacity-to-improve-hiv-infection-health-outcomes
#20
Hannah Rettler, Monina Klevens, Gillian Haney, Liisa Randall, Alfred DeMaria, Johanna Goderre
Eighty-six percent of those engaged in HIV medical care in Massachusetts achieved viral suppression, making Massachusetts's long-term goal of eliminating new infections of HIV a real possibility. In order to achieve this goal, Massachusetts is working to engage all individuals living with HIV/AIDS in HIV medical care, keep them retained in care, and render their viral load non-detectable. Currently, in Massachusetts, the data elements necessary to monitor the HIV care continuum are documented in siloed health information systems that do not communicate with each other...
December 2016: American Journal of Managed Care
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