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ED Observation unit

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https://www.readbyqxmd.com/read/27931303/a-comparison-of-seasonal-trends-in-asthma-exacerbations-among-children-from-geographic-regions-with-different-climates
#1
Julia A Wisniewski, Anne P McLaughlin, Philip J Stenger, James Patrie, Mark A Brown, Jane M El-Dahr, Thomas A E Platts-Mills, Nora J Byrd, Peter W Heymann
BACKGROUND: The fall peak in childhood asthma exacerbations is thought to be related to an increase in viral infections and allergen exposure when children return to school. Whether the seasonality of asthma attacks among children from different geographic regions follows similar trends is unclear. OBJECTIVE: To compare seasonal trends in asthma exacerbations among school-age children who lived in different geographic locations, with different climates, within the United States...
November 2016: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/27923148/patient-and-clinician-reported-outcome-in-eating-disorders
#2
Laura Al-Dakhiel Winkler, Jacob Stampe Frølich, Claire Gudex, Kirsten Hørder, Niels Bilenberg, René Klinkby Støving
Patient-reported outcome is increasingly applied in health sciences. Patients with eating disorders (EDs) characteristically have a different opinion of their needs to that of the health professionals, which can lead to ambivalence towards treatment and immense compliance difficulties. This cross-sectional study compared data assessed by the clinician to patient-reported measures in patients with a history of EDs. We included data from a cohort of patients with EDs (n=544) referred to a specialized ED unit in Denmark...
November 30, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27918377/utility-of-emergency-department-observation-units-for-neurologically-intact-children-with-head-ct-abnormalities-secondary-to-acute-closed-head-injury
#3
Roxanna Lefort, Jill V Hunter, Andrea T Cruz, A Chantal Caviness, Thomas G Luerssen, Aderonke Adekunle-Ojo
OBJECTIVE: The aim of the study was to evaluate the utility of the emergency department observation unit (EDOU) for neurologically intact children with closed head injuries (CHIs) and computed tomography (CT) abnormalities. METHODS: A retrospective cohort study of children aged 0 to 18 years with acute CHI, abnormal head CT, and a Glasgow Coma Scales score of 14 or higher admitted to the EDOU of a tertiary care children's hospital from 2007 to 2010. Children with multisystem trauma, nonaccidental trauma, and previous neurosurgical or coagulopathic conditions were excluded...
December 1, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27914661/statin-discontinuation-and-mortality-in-an-older-adult-population-with-traumatic-brain-injury-a-four-year-multi-centre-observational-cohort-study
#4
Alessandro Orlando, Christine Thomas, Matthew Carrick, D Sue Slone, Charles W Mains, David Bar-Or
INTRODUCTION: Statin discontinuation has been investigated in a wide range of diseases and injuries, but there is a paucity of data in the older adult population with traumatic brain injury (TBI). The purpose of this study was to re-examine the extent to which early discontinuation of pre-injury statin (PIS) therapy increases the risk of poor patient outcomes in older adult patients suffering a TBI. METHODS: This was a retrospective observational cohort study of adult trauma patients with a blunt TBI across three trauma centres over four years...
November 25, 2016: Injury
https://www.readbyqxmd.com/read/27903209/incidence-and-cost-of-stress-ulcer-prophylaxis-after-discharge-from-the-intensive-care-unit-a-retrospective-study
#5
Benedict Tan, Richard Norman, Ed Litton, Chloe Heath, David J Hawkins, Ravi Krishnamurthy, Ravikiran Sonawane, Matthew H Anstey
OBJECTIVE: To describe current patterns in initiation and cessation of proton pump inhibitors (PPIs) for stress ulcer prophylaxis (SUP) in intensive care units, and to assess the costs associated with inappropriate (non-evidence-based) SUP. DESIGN, SETTING AND PARTICIPANTS: Retrospective observational study in five ICUs in Western Australia. We assessed the medical records of consecutive patients admitted to the ICUs between September 2013 and January 2015. Patients aged < 18 years were excluded...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27902667/managing-skin-and-soft-tissue-infections-in-the-emergency-department-observation-unit
#6
Shabana Yusuf, Joseph L Hagan, Aderonke O Adenkule-Ojo
BACKGROUND: Skin and soft tissue infections (SSTIs) are a common reason for presentation to the emergency department (ED) and account for 3% of ED visits. Patients with a diagnosis of cellulitis requiring intravenous (IV) antibiotics have traditionally been admitted to the hospital. In our institution, these patients are placed in the ED Observation Unit (EDOU) for IV antibiotics. OBJECTIVES: The purpose of this study is to determine if 3 doses of IV antibiotics are adequate to document clinical improvement in children with uncomplicated SSTI...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27896320/influences-of-do-not-resuscitate-order-prohibition-on-cpr-outcomes
#7
Umut Gulacti, Ugur Lok
OBJECTIVES: The aim of the study is to determine factors affecting the return of spontaneous circulation (ROSC) ratios, neurological outcomes at discharge, the ratio of living patients discharged from the hospital and due to Do not attempt resuscitation (DNAR) prohibition. MATERIAL AND METHODS: This is a retrospective observational study conducted on patients of cardiopulmonary resuscitation (CPR) performed in emergency department (ED) and intensive care units between February 2010 and February 2012...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876328/best-clinical-practice-controversies-in-transient-ischemic-attack-evaluation-and-disposition-in-the-emergency-department
#8
Brit Long, Alex Koyfman
BACKGROUND: Transient ischemic attack (TIA) affects over 200,000 patients annually in the United States, and it precedes approximately 14% to 23% of strokes. Patients are typically admitted for evaluation and management. OBJECTIVE: This review investigates the controversies of emergency department (ED) evaluation of TIA, including imaging, clinical risk scores, rapid diagnostic protocols, and disposition. DISCUSSION: TIA is a common condition, with over 200,000 patients affected annually, and is associated with risk of stroke...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27823581/associations-between-energy-density-of-meals-and-snacks-and-overall-diet-quality-and-adiposity-measures-in-british-children-and-adolescents-the-national-diet-and-nutrition-survey
#9
Kentaro Murakami, M Barbara E Livingstone
This cross-sectional study examined how energy density (ED) of meals and snacks are associated with overall diet quality and adiposity measures in 1617 British children aged 4-18 years from the 1997 National Diet and Nutrition Survey. On the basis of data from 7-d weighed dietary record, all eating occasions were divided into meals or snacks on the basis of time (meals: 06.00-09.00, 12.00-14.00 and 17.00-20.00 hours; snacks: all others) or contribution to energy intake (EI) (meals: ≥15 %; snacks: <15 %)...
November 2016: British Journal of Nutrition
https://www.readbyqxmd.com/read/27814441/a-study-of-the-patients-admitted-to-the-clinical-decision-unit-over-one-year
#10
E O'Shea, S Cusack, I O'Sullivan
Clinical decision units (CDUs) are areas within an emergency department (ED) providing care for the patient who may benefit from an extended observation period, usually for a maximum of twenty-four hours. A retrospective patient record audit was performed to determine the characteristics of patients admitted to the Cork University Hospital (CUH) CDU over 12 months. The average length of stay of a patient in the CDU was 29 hours. The most common diagnoses admitted to the CDU were chest pain (9.5%) and headache (7...
June 10, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/27797873/skin-and-soft-tissue-infection-management-failure-in-the-emergency-department-observation-unit-a-systematic-review
#11
Jeremy W Abetz, Nicholas G Adams, Biswadev Mitra
INTRODUCTION: Skin and soft tissue infections (SSTIs) are commonly treated in ED observation units (EDOUs). The management failure rate in this setting is high, as evidenced by a large proportion of patients requiring inpatient admission. This systematic review sought to quantify the management failure rate and identify risk factors associated with management failure. METHODS: Searches of six databases and grey literature were conducted with no limits on publication year or language...
October 25, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27780380/a-web-based-educational-video-to-improve-asthma-knowledge-for-limited-english-proficiency-latino-caregivers
#12
Antonio Riera, Agueda Ocasio, Gunjan Tiyyagura, Anita Thomas, Patricia Goncalves, Lauren Krumeich, Kyle Ragins, Sandra Trevino, Federico E Vaca
OBJECTIVES: To evaluate limited English proficiency (LEP) Latino caregiver asthma knowledge after exposure to an educational video designed for this target group. METHODS: A cross-sectional, interventional study was performed. We aimed to evaluate the post-test impact on asthma knowledge from baseline after exposure to a patient-centered, evidence-based, and professionally produced Spanish asthma educational video. Participants included LEP Latino caregivers of children 2-12 years old with persistent asthma...
October 26, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27769999/cardiomyopathy-related-mutation-a30v-in-mouse-cardiac-troponin-t-divergently-alters-the-magnitude-of-stretch-activation-in-%C3%AE-and-%C3%AE-myosin-heavy-chain-fibers
#13
Alexis V Mickelson, Sampath K Gollapudi, Murali Chandra
The present study investigated the functional consequences of the human hypertrophic cardiomyopathy (HCM) mutation, A28V, in cardiac troponin T (TnT). The A28V mutation is located within the N-terminus of TnT, a region known to be important for full activation of cardiac thin filaments. The functional consequences of the A28V mutation in TnT remain unknown. Given how α- and β-myosin heavy chain (MHC) isoforms differently alter the effect of the N-terminus of TnT, we hypothesized that the A28V-induced effects would be differently modulated by α- and β-MHC isoforms...
October 21, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27743490/an-observational-study-of-dyspnoea-in-emergency-departments-the-asia-australia-and-new-zealand-dyspnoea-in-emergency-departments-study-aanzdem
#14
Anne Maree Kelly, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
OBJECTIVES: To describe the epidemiology of dyspnoea presenting to emergency departments (EDs) in the Asia-Pacific region, to understand how it is investigated and treated and its outcome. METHODS: Prospectiveinterrupted time series cohort study conducted at three time points in EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia of adult patients presenting to the ED with dyspnoea as a main symptom. Data were collected over three 72-hour periods and included demographics, co-morbidities, mode of arrival, usual medications, pre-hospital treatment, initial assessment, ED investigations, treatment in the ED, ED diagnosis, disposition from ED, in-hospital outcome and final hospital diagnosis...
October 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27742520/impact-of-delayed-admission-to-intensive-care-units-on-patients-with-acute-respiratory-failure
#15
Chih-Chia Hsieh, Ching-Chi Lee, Hsiang-Chin Hsu, Hsin-I Shih, Chien-Hsin Lu, Chih-Hao Lin
BACKGROUND/PURPOSE: To determine the impact of delayed admission to the intensive care unit (ICU) on the clinical outcomes of patients with acute respiratory failure (ARF) in the emergency department (ED). METHODS: This retrospective cohort study included non-traumatic adult patients with ARF and mechanical ventilation support in the ED of a tertiary university hospital in Taiwan from January 1, 2013, to August 31, 2013. Clinical data were extracted from chart records...
September 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27739128/observation-or-inpatient-impact-of-patient-disposition-on-outcomes-and-utilization-among-emergency-department-patients-with-chest-pain
#16
M Fernanda Bellolio, Lindsey R Sangaralingham, Stephanie R Schilz, Claire M Noel-Miller, Keith D Lind, Pamela Morin, Peter A Noseworthy, Nilay D Shah, Erik P Hess
OBJECTIVES: To compare healthcare utilization including coronary angiography, percutaneous coronary intervention (PCI), rehospitalization, and rate of subsequent acute myocardial infarction (AMI) within 30-days, among patients presenting to the Emergency Department (ED) with chest pain admitted as short-term inpatient (≤2 days) versus observation (in ED observation units combined with in-hospital observation). METHODS: We identified adults diagnosed with acute chest pain in the ED from 2010-2014 using administrative claims from privately insured and Medicare Advantage...
October 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27722910/niv-by-an-interdisciplinary-respiratory-care-team-in-severe-respiratory-failure-in-the-emergency-department-limited-to-day-time-hours
#17
Christian Michael Horvath, Martin Horvath Brutsche, Otto Dagobert Schoch, Bernarde Schillig, Florent Baty, Dieter vonOw, Jochen Julius Rüdiger
Non-invasive ventilatory support is frequently used in patients with severe respiratory failure (SRF), but is often limited to intensive care units (ICU). We hypothesized that an instantaneous short course of NIV (up to 2 h), limited to regular working hours as an additional therapy on the emergency department (ED) would be feasible and could improve patient´s dyspnoea measured by respiratory rate and Borg visual dyspnea scale. NIV was set up by an interdisciplinary respiratory care team. Outside these predefined hours NIV was performed in the ICU...
October 8, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27704018/insurance-status-and-the-risk-of-severe-respiratory-syncytial-virus-disease-in-united-states-preterm-infants-born-at-32-35-weeks-gestational-age
#18
Jeremy A Franklin, Evan J Anderson, Xionghua Wu, Christopher S Ambrose, Eric A F Simões
Background.  Database studies have identified that public health insurance status is associated with an increased risk of severe respiratory syncytial virus (RSV) disease in US infants. However, these studies did not adjust for the presence of other risk factors and did not evaluate the risk in preterm infants. Methods.  In this study, we evaluate the independent association between public insurance and severe RSV disease outcomes adjusting for other risk factors. The prospective, observational RSV Respiratory Events among Preterm Infants Outcomes and Risk Tracking (REPORT) study was conducted over 2 consecutive RSV seasons at 188 US clinical sites that enrolled preterm infants born at 32-35 wGA who had not received RSV immunoprophylaxis with palivizumab...
September 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27693280/emergency-department-point-of-care-ultrasound-in-out-of-hospital-and-in-ed-cardiac-arrest
#19
Romolo Gaspari, Anthony Weekes, Srikar Adhikari, Vicki E Noble, Jason T Nomura, Daniel Theodoro, Michael Woo, Paul Atkinson, David Blehar, Samuel M Brown, Terrell Caffery, Emily Douglass, Jacqueline Fraser, Christine Haines, Samuel Lam, Michael Lanspa, Margaret Lewis, Otto Liebmann, Alexander Limkakeng, Fernando Lopez, Elke Platz, Michelle Mendoza, Hal Minnigan, Christopher Moore, Joseph Novik, Louise Rang, Will Scruggs, Christopher Raio
BACKGROUND: Point-of-care ultrasound has been suggested to improve outcomes from advanced cardiac life support (ACLS), but no large studies have explored how it should be incorporated into ACLS. Our aim was to determine whether cardiac activity on ultrasound during ACLS is associated with improved survival. METHODS: We conducted a non-randomized, prospective, protocol-driven observational study at 20 hospitals across United States and Canada. Patients presenting with out-of-hospital arrest or in-ED arrest with pulseless electrical activity or asystole were included...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27687168/effect-of-a-multi-diagnosis-observation-unit-on-emergency-department-length-of-stay-and-inpatient-admission-rate-at-two%C3%A2-canadian-hospitals
#20
Amy H Y Cheng, Neil G Barclay, Riyad B Abu-Laban
BACKGROUND: Observation units (OUs) have been shown to reduce emergency department (ED) lengths of stay (LOS) and admissions. Most published studies have been on OUs managing single complaints. OBJECTIVE: Our aim was to determine whether an OU reduces ED LOS and hospital admission rates for adults with a variety of presenting complaints. METHODS: We comparatively evaluated two hospitals in British Columbia, Canada (hereafter ED A and ED B) using a pre-post design...
December 2016: Journal of Emergency Medicine
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