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medical emergency

Tom G Moreels
Medical publishing has become a pivotal aspect of all stages of career development in medicine in Belgium. Publication pressure is therefore present from the stage of the medical student to the level of the head of an academic medical service. This pressure represents a real danger to commit scientific misconduct, ranging from minor missteps to severe fraud. Recent surveys have shown that scientific misconduct and publication fraud represent an important problem in medical publishing, more than in other scientific fields, also in Belgium...
January 2018: Acta Gastro-enterologica Belgica
Andres Canales, Seongjun Park, Antje Kilias, Polina Anikeeva
Multifunctional devices for modulation and probing of neuronal activity during free behavior facilitate studies of functions and pathologies of the nervous system. Probes composed of stiff materials, such as metals and semiconductors, exhibit elastic and chemical mismatch with the neural tissue, which is hypothesized to contribute to sustained tissue damage and gliosis. Dense glial scars have been found to encapsulate implanted devices, corrode their surfaces, and often yield poor recording quality in long-term experiments...
March 21, 2018: Accounts of Chemical Research
Matt Luther, Fergus Gardiner, Shane Lenson, David Caldicott, Ryan Harris, Ryan Sabet, Mark Malloy, Jo Perkins
Specific Event Identifiers a. Event type: Outdoor music festival. b. Event onset date: December 3, 2016. c. Location of event: Regatta Point, Commonwealth Park. d. Geographical coordinates: Canberra, Australian Capital Territory (ACT), Australia (-35.289002, 149.131957, 600m). e. Dates and times of observation in latitude, longitude, and elevation: December 3, 2016, 11:00-23:00. f. Response type: Event medical support. Abstract Introduction Young adult patrons are vulnerable to risk-taking behavior, including drug taking, at outdoor music festivals...
March 21, 2018: Prehospital and Disaster Medicine
Mary Lavelle, Jennifer Abthorpe, Thomas Simpson, Gabriel Reedy, Fiona Little, Anita Banerjee
The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions, known as 'indirect deaths'. The MBRRACE report identified serious gaps in clinicians' human factors skills, including communication, leadership and teamwork, which contributed to maternal death. In response, we developed the first multi-disciplinary simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Employing a mixed methods design, this study evaluated the educational impact of this training programme on the healthcare staff (n = 140), including the medical doctors (n = 91) and the midwives (n = 49)...
March 21, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Ariel M Brettholz, Sabrina Opiola Mccauley
Mucormycosis is a rare invasive fungal infection that affects immunocompromised patients and is fatal when not identified and treated early. Diagnosis is often delayed as the symptoms are nonspecific and frequently mimic other common diseases. Pediatric patients with cancer are at risk for the infection; however, there is limited research that applies directly to the pediatric population. An understanding of the risk factors and clinical presentation of mucormycosis is crucial for the pediatric oncology provider to initiate the workup and provide prompt treatment...
March 1, 2018: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
Amir Emami Zeydi, Hossein Karimi Moonaghi, Abbas Heydari
Background: Despite the clinical importance of adherence to treatment in β-Thalassemia Major (β-TM) patients, poor adherence remains a prevalent and persistent problem in these patients. Objective: The aim of this study was to explore Iranian β-TM patients' perception regarding the barriers and facilitators of adherence to their treatments. Methods: In this qualitative study, data were collected using purposeful sampling and semi-structured interviews with 18 β-TM patients, 3 family members and 5 healthcare professionals (total=26) in Sari, northern Iran, between August 2015 and May 2017...
December 2017: Electronic Physician
Jamal Seidi, Fatemeh Alhani, Farasat Ardalan
Background: Clinical judgment of nurses to conduct medication orders is based on patient assessment, medication knowledge, observation, and interpretation of the data collected. This process is influenced by many factors. Objective: This study aims to explore nurses' experience about facilitating factors in medication administration based on clinical judgment of nurses. Methods: This qualitative study was part of an approved project research of the Iranian National Institute of Health Research, which was conducted in Kurdistan University of Medical Sciences in 2015...
December 2017: Electronic Physician
Zinat Mohebbi, Farkhondeh Sharif, Hamid Peyrovi, Mahnaz Rakhshan, Mahvash Alizade Naini, Ladan Zarshenas
Background: Irritable bowel syndrome (IBS), as a chronic digestive disorder, impacts extensively on the quality of life, emotional well-being and self-identity. Chronic illness disrupts taken-for-granted notions about self. No qualitative study was found regarding patients' experience of life with irritable bowel syndrome (IBS) in Iran. Objective: To explore the self-perception of lived experience of IBS patients. Methods: A qualitative study with hermeneutic phenomenological approach was conducted on 12 IBS patients who had been referred to three central clinics (2 governmental and 1 private) affiliated to Shiraz University of Medical Sciences...
December 2017: Electronic Physician
Maya S Iyer, Raymond D Pitetti, Melissa Vitale
Introduction: Procedural sedation and analgesia (PSA) is used by non-anesthesiologists (NAs) outside of the operating room for several types of procedures. Adverse events during pediatric PSA that pose the most risk to patient safety involve airway compromise. Higher Mallampati scores may indirectly indicate children at risk for airway compromise. Medical governing bodies have proposed guidelines for PSA performed by NAs, but these recommendations rarely suggest using Mallampati scores in pre-PSA evaluations...
March 2018: Western Journal of Emergency Medicine
Kimberly N Means, Amanda E Gentry, Tammy T Nguyen
Introduction: Atrial fibrillation (AF) is a common diagnosis of patients presenting to the emergency department (ED). Intravenous (IV) diltiazem bolus is often the initial drug of choice for acute management of AF with rapid ventricular response (RVR). The route of diltiazem after the initial IV loading dose may influence the disposition of the patient from the ED. However, no studies exist comparing oral (PO) immediate release and IV continuous infusion diltiazem in the emergency setting...
March 2018: Western Journal of Emergency Medicine
Lauren R Klein, Marc L Martel, Brian E Driver, Mackenzie Reing, Jon B Cole
Introduction: A subset of frequent users of emergency services are those who use the emergency department (ED) for acute alcohol intoxication. This population and their ED encounters have not been previously described. Methods: This was a retrospective, observational, cohort study of patients presenting to the ED for acute alcohol intoxication between 2012 and 2016. We collected all data from the electronic medical record. Frequent users for alcohol intoxication were defined as those with greater than 20 visits for acute intoxication without additional medical chief complaints in the previous 12 months...
March 2018: Western Journal of Emergency Medicine
Jamie R Santistevan, Brian R Sharp, Azita G Hamedani, Scott Fruhan, Andrew W Lee, Brian W Patterson
Introduction: Opioid prescribing patterns have come under increasing scrutiny with the recent rise in opioid prescriptions, opioid misuse and abuse, and opioid-related adverse events. To date, there have been limited studies on the effect of default tablet quantities as part of emergency department (ED) electronic order entry. Our goal was to evaluate opioid prescribing patterns before and after the removal of a default quantity of 20 tablets from ED electronic order entry. Methods: We performed a retrospective observational study at a single academic, urban ED with 58,000 annual visits...
March 2018: Western Journal of Emergency Medicine
Jeff Lapoint, Seth Meyer, Charles K Yu, Kristi L Koenig, Roneet Lev, Sayone Thihalolipavan, Katherine Staats, Christopher A Kahn
Introduction: Cannabinoid hyperemesis syndrome (CHS) is an entity associated with cannabinoid overuse. CHS typically presents with cyclical vomiting, diffuse abdominal pain, and relief with hot showers. Patients often present to the emergency department (ED) repeatedly and undergo extensive evaluations including laboratory examination, advanced imaging, and in some cases unnecessary procedures. They are exposed to an array of pharmacologic interventions including opioids that not only lack evidence, but may also be harmful...
March 2018: Western Journal of Emergency Medicine
Fareen Zaver, Nicole Battaglioli, William Denq, Anne Messman, Arlene Chung, Michelle Lin, Emberlynn L Liu
Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs...
March 2018: Western Journal of Emergency Medicine
Jacob Arnold, Jennifer Tango, Ian Walker, Chris Waranch, Joshua McKamie, Zafrina Poonja, Anne Messman
Introduction: Physicians are at much higher risk for burnout, depression, and suicide than their non-medical peers. One of the working groups from the May 2017 Resident Wellness Consensus Summit (RWCS) addressed this issue through the development of a longitudinal residency curriculum to address resident wellness and burnout. Methods: A 30-person (27 residents, three attending physicians) Wellness Curriculum Development workgroup developed the curriculum in two phases...
March 2018: Western Journal of Emergency Medicine
Daniel G Miller, Priyanka Vakkalanka, Mark L Moubarek, Sangil Lee, Nicholas M Mohr
Introduction: This study investigated whether a 9.6% decrease in the use of head computed tomography (HCT) for patients presenting to the emergency department (ED) with a chief complaint of headache was followed by an increase in proportions of death or missed intracranial diagnosis during the 22.5-month period following each index ED visit. Methods: We reviewed the electronic medical records of all patients sampled during a quality improvement effort in which the aforementioned decrease in HCT use had been observed...
March 2018: Western Journal of Emergency Medicine
Andrew W Artenstein, Jennifer Friderici, Paul Visintainer
Introduction: Spinal epidural abscess (SEA), a highly morbid and potentially lethal deep tissue infection of the central nervous system has more than tripled in incidence over the past decade. Early recognition at the point of initial clinical presentation may prevent irreversible neurologic injury or other serious, adverse outcomes. To facilitate early recognition of SEA, we developed a predictive scoring model. Methods: Using data from a 10-year, retrospective, case-control study of adults presenting for care at a tertiary-care, regional, academic medical center, we used the Integrated Discrimination Improvement Index (IDI) to identify candidate discriminators and created a multivariable logistic regression model, refined based on p-value significance...
March 2018: Western Journal of Emergency Medicine
Sattha Riyapan, Phanthanee Thitichai, Wansiri Chaisirin, Tanyaporn Nakornchai, Tipa Chakorn
Introduction: Thailand has the highest mortality from road traffic injury (RTI) in the world. There are usually higher incident rates of RTI in Thailand over long holidays such as New Year and Songkran. To our knowledge, there have been no studies that describe the impact of emergency medical service (EMS) utilization by RTI patients in Thailand. We sought to determine the outcomes of EMS utilization in severe RTIs during the holidays. Methods: We conducted a retrospective review study by using a nationwide registry that collected RTI data from all hospitals in Thailand during the New Year holidays in 2008-2015 and Songkran holidays in 2008-2014...
March 2018: Western Journal of Emergency Medicine
Ashley C Rider, Chad S Kessler, Whitney W Schwarz, Gillian R Schmitz, Laura Oh, Michael D Smith, Eric A Gross, Hans House, Michael C Wadman, Bruce M Lo
Introduction: The goal of this study was to characterize current practices in the transition of care between the emergency department and primary care setting, with an emphasis on the use of the electronic medical record (EMR). Methods: Using literature review and modified Delphi technique, we created and tested a pilot survey to evaluate for face and content validity. The final survey was then administered face-to-face at eight different clinical sites across the country...
March 2018: Western Journal of Emergency Medicine
Marc L Martel, Lauren R Klein, Kurt A Hager, Diana B Cutts
Introduction: Food insecurity is a significant issue in the United States and is prevalent in emergency department (ED) patients. The purpose of this study was to report the novel use of an integrated electronic medical record (EMR) order for food resources, and to describe our initial institutional referral patterns after focused education and implementation of the order. Methods: This was a retrospective, observational study, describing food-bank referral patterns before and after the implementation of dedicated ED education on the novel EMR order for food resources...
March 2018: Western Journal of Emergency Medicine
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