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ED Observation unit

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https://www.readbyqxmd.com/read/29420459/vital-signs-asthma-in-children-united-states-2001-2016
#1
Hatice S Zahran, Cathy M Bailey, Scott A Damon, Paul L Garbe, Patrick N Breysse
BACKGROUND: Asthma is the most common chronic lung disease of childhood, affecting approximately 6 million children in the United States. Although asthma cannot be cured, most of the time, asthma symptoms can be controlled by avoiding or reducing exposure to asthma triggers (allergens and irritants) and by following recommendations for asthma education and appropriate medical care. METHODS: CDC analyzed asthma data from the 2001-2016 National Health Interview Survey for children aged 0-17 years to examine trends and demographic differences in health outcomes and health care use...
February 9, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29395945/pattern-of-non-trauma-emergency-department-resource-utilization-in-older-adults-an-8-year-experience-in-taiwan
#2
Julia Chia-Yu Chang, Zih-Han Yuan, I-Hsin Lee, Teh-Fu Hsu, Chorng-Kuang How, David Hung-Tsang Yen
BACKGROUND: To describe the patterns of non-trauma emergency department (ED) resource utilization, cost of visit, acuity level, and admission rate in older adult patients in Taiwan. METHODS: This is a retrospective observational cohort study conducted at the Taipei Veterans General Hospital with an annual ED population of 80,000 patients. Patients aged ≥20 years with non-trauma ED visits from 2005 to 2012 were included in the study. RESULTS: We analyzed 441,665 ED visits...
January 25, 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29395173/the-sensitivity-of-clinician-diagnosis-of-sepsis-in-tertiary-and-community-based-emergency-settings
#3
Halden F Scott, Emily E Greenwald, Lalit Bajaj, Sara J Deakyne Davies, Lina Brou, Allison Kempe
OBJECTIVES: To assess whether the risk of missed clinician diagnosis of pediatric sepsis requiring care in the intensive care unit (ICU) was greater in community vs tertiary pediatric emergency care settings with sepsis pathways. STUDY DESIGN: An observational cohort study in a tertiary pediatric emergency department (ED) staffed by pediatric emergency physicians and 4 affiliated community pediatric ED/urgent care sites staffed by general pediatricians. Use of an institutional sepsis order set or pathway was considered clinician diagnosis of sepsis...
January 25, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29386309/increased-serum-lactate-in-peritoneal-dialysis-patients-presenting-with-intercurrent-illness
#4
Emilie Trinh, Joanne M Bargman, Nalinee Saiprasertkit
BACKGROUND: Lactate is the most commonly used buffer in peritoneal dialysis (PD) solutions. While previous studies have shown that serum lactate is normal in stable PD patients, the purpose of our study was to evaluate whether abnormal lactate values are more common in PD patients presenting to the emergency department (ED) and have the same significance as in the general population. METHODS: This observational cohort study assessed the prevalence of elevated serum lactate in PD patients presenting to the ED and evaluated clinical factors associated with an abnormal lactate value...
January 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29382680/are-trends-in-billing-for-high-intensity-emergency-care-explained-by-changes-in-services-provided-in-the-emergency-department-an-observational-study-among-us-medicare-beneficiaries
#5
Laura G Burke, Robert C Wild, E John Orav, Renee Y Hsia
OBJECTIVE: There has been concern that an increase in billing for high-intensity emergency care is due to changes in coding practices facilitated by electronic health records. We sought to characterise the trends in billing for high-intensity emergency care among Medicare beneficiaries and to examine the degree to which trends in high-intensity billing are explained by changes in patient characteristics and services provided in the emergency department (ED). DESIGN, SETTING AND PARTICIPANTS: Observational study using traditional Medicare claims to identify ED visits at non-federal acute care hospitals for elderly beneficiaries in 2006, 2009 and 2012...
January 30, 2018: BMJ Open
https://www.readbyqxmd.com/read/29379974/prevalence-of-homelessness-by-gender-in-an-emergency-department-population-in-pennsylvania
#6
Brett J Feldman, Alexandra M Craen, Joshua Enyart, Timothy Batchelor, Timothy J Friel, Stephen W Dusza, Marna Rayl Greenberg
Context: According to the US Department of Housing and Urban Development, nearly 1.5 million people spend at least 1 night in an emergency shelter or transitional housing each year, and more than 500,000 people are homeless on a given night in the United States. To our knowledge, limited data exist regarding the prevalence of homelessness in ED patients by gender (male, female, and transgender). Objective: To assess the prevalence of homelessness by gender in 3 EDs in Pennsylvania...
February 1, 2018: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/29379959/prevalence-of-pulmonary-embolism-in-patients-with-syncope
#7
Giorgio Costantino, Martin H Ruwald, James Quinn, Carlos A Camargo, Frederik Dalgaard, Gunnar Gislason, Tadahiro Goto, Kohei Hasegawa, Padma Kaul, Nicola Montano, Anna-Karin Numé, Antonio Russo, Robert Sheldon, Monica Solbiati, Benjamin Sun, Giovanni Casazza
Importance: Sparse data and conflicting evidence exist on the prevalence of pulmonary embolism (PE) in patients with syncope. Objective: To estimate the prevalence of PE among patients presenting to the emergency department (ED) for evaluation of syncope. Design, Setting, and Participants: This retrospective, observational study analyzed longitudinal administrative data from 5 databases in 4 different countries (Canada, Denmark, Italy, and the United States)...
January 29, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29373155/emergency-department-contribution-to-the-prescription-opioid-epidemic
#8
Sarah Axeen, Seth A Seabury, Michael Menchine
STUDY OBJECTIVE: We characterize the relative contribution of emergency departments (EDs) to national opioid prescribing, estimate trends in opioid prescribing by site of care (ED, office-based, and inpatient), and examine whether higher-risk opioid users receive a disproportionate quantity of their opioids from ED settings. METHODS: This was a retrospective analysis of the nationally representative Medical Expenditure Panel Survey from 1996 to 2012. Individuals younger than 18 years and with malignancy diagnoses were excluded...
January 10, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29350674/takotsubo-cardiomyopathy-in-an-ultra-centenarian-woman
#9
Laura Bonfanti, Silvia Buratti, Luigi Vignali, Giuseppe Lippi, Franco Masini, Michele Bianconcini, Gianfranco Cervellin
A 101 years-old woman was admitted to our Emergency Department (ED) for acute dyspnea which onset nearly two hours before presentation. She had been on hydrochlorothyazyde-amiloride therapy due to mild hypertension. No other relevant features were present in the clinical history. The old lady had never been admitted to the hospital, and she was still living alone. A few days before hospital admission, one of the daughters became ill, so that a caregiver was paid for assisting her 12/24. This new circumstance was reluctantly accepted by the old lady...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29347982/emergency-department-hyperoxia-is-associated-with-increased-mortality-in-mechanically-ventilated-patients-a-cohort-study
#10
David Page, Enyo Ablordeppey, Brian T Wessman, Nicholas M Mohr, Stephen Trzeciak, Marin H Kollef, Brian W Roberts, Brian M Fuller
BACKGROUND: Providing supplemental oxygen is fundamental in the management of mechanically ventilated patients. Increasing amounts of data show worse clinical outcomes associated with hyperoxia. However, these previous data in the critically ill have not focused on outcomes associated with brief hyperoxia exposure immediately after endotracheal intubation. Therefore, the objectives of this study were to evaluate the impact of isolated early hyperoxia exposure in the emergency department (ED) on clinical outcomes among mechanically ventilated patients with subsequent normoxia in the intensive care unit (ICU)...
January 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29346028/biophysics-model-of-heavy-ion-degradation-of-neuron-morphology-in-mouse-hippocampal-granular-cell-layer-neurons
#11
Murat Alp, Francis A Cucinotta
Exposure to heavy-ion radiation during cancer treatment or space travel may cause cognitive detriments that have been associated with changes in neuron morphology and plasticity. Observations in mice of reduced neuronal dendritic complexity have revealed a dependence on radiation quality and absorbed dose, suggesting that microscopic energy deposition plays an important role. In this work we used morphological data for mouse dentate granular cell layer (GCL) neurons and a stochastic model of particle track structure and microscopic energy deposition (ED) to develop a predictive model of high-charge and energy (HZE) particle-induced morphological changes to the complex structures of dendritic arbors...
January 18, 2018: Radiation Research
https://www.readbyqxmd.com/read/29336989/are-geriatric-patients-placed-in-an-emergency-department-observation-unit-on-a-chest-pain-pathway-more-likely-than-non-geriatric-patients-to-re-present-to-the-hospital-within-30%C3%A2-days
#12
Christopher C Gruenberg, Alan H Breaud, James H Liu, Patricia M Mitchell, James A Feldman, Kerrie P Nelson, Joseph H Kahn
BACKGROUND: Emergency department observation units (EDOUs) are used frequently for low-risk chest pain evaluations. OBJECTIVE: The purpose of this study was to determine whether geriatric compared to non-geriatric patients evaluated in an EDOU for chest pain have differences in unscheduled 30-day re-presentation, length of stay (LOS), and use of stress testing. METHODS: We conducted an exploratory, retrospective, cohort study at a single academic, urban ED of all adult patients placed in an EDOU chest pain protocol from June 1, 2014 to May 31, 2015...
January 11, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29335822/emergency-department-throughput-an-intervention
#13
Nowreen Haq, Rona Stewart-Corral, Eric Hamrock, Jamie Perin, Waseem Khaliq
Shortening emergency department (ED) boarding time and managing hospital bed capacity by expediting the inpatient discharge process have been challenging for hospitals nationwide. The objective of this study is was to explore the effect of an innovative prospective intervention on hospital workflow, specifically on early inpatient discharges and the ED boarding time. The intervention consisted of a structured nursing "admission discharge transfer" (ADT) protocol receiving new admissions from the ED and helping out floor nursing with early discharges...
January 15, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29321107/can-i-send-this-patient-with-stroke-home-strategies-managing-transient-ischemic-attack-and-minor-stroke-in-the-emergency-department
#14
Bernard P Chang, Sara Rostanski, Joshua Willey, Benjamin Kummer, Eliza Miller, Mitchell Elkind
BACKGROUND: While transient ischemic attack and minor stroke (TIAMS) are common conditions evaluated in the emergency department (ED), there is controversy regarding the most effective and efficient strategies for managing them in the ED. Some patients are discharged after evaluation in the ED and cared for in the outpatient setting, while others remain in an observation unit without being admitted or discharged, and others experience prolonged and potentially costly inpatient admissions...
January 8, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29306267/role-of-emergency-department-observation-units-in-the-management-of-patients-with-unexplained-syncope-a-critical-review-and-meta-analysis
#15
REVIEW
Filippo Numeroso, Gianluigi Mossini, Giuseppe Lippi, Gianfranco Cervellin
This meta-analysis aimed to establish the role of standardized emergency department (ED) observation protocols in the management of syncopal patients as an alternative to ordinary admission. A systematic electronic literature search was performed to identify randomized controlled trials or observational studies evaluating syncopal patients managed in ED observation units. Data regarding mean length of stay, rate of etiological diagnosis, admission rate, and incidence of short-term serious outcomes were extracted...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29279631/a-clinical-study-on-the-initial-assessment-of-arterial-lactate-and-base-deficit-as-predictors-of-outcome-in-trauma-patients
#16
Rameshbabu Homanna Javali, Prithvishree Ravindra, Akkamahadevi Patil, Madhu Srinivasarangan, Harshit Mundada, S B Adarsh, S Nisarg
Background: Trauma is a leading cause of mortality in India. Outcomes can be improved by early recognition of hemorrhagic shock and expedited management. At present, we rely on traditional vital signs, which are not sensitive measures. Point of care biochemical markers have been emerging as prognostic markers in trauma, but have not been studied in Indian setting. Aims: This study aims to study the association between arterial lactate and base deficit (BD) at emergency department (ED) admission and 24 h outcome in trauma patients at risk of hemodynamic compromise...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29277163/criterion-validity-and-inter-rater-reliability-of-a-palliative-care-screening-tool-for-patients-admitted-to-an-emergency-department-intensive-care-unit
#17
Sabrina Corrêa da Costa Ribeiro, Ricardo Tavares de Carvalho, Juraci Aparecida Rocha, Roger Daglius Dias
OBJECTIVE: The use of palliative care (PC) screening criteria to trigger PC consultations may optimize the utilization of PC services, improve patient comfort, and reduce invasive and futile end-of-life care. The aim of the present study was to assess the criterion validity and inter-rater reliability of a PC screening tool for patients admitted to an emergency department intensive care unit (ED-ICU). METHOD: Observational retrospective study evaluating PC screening criteria based on the presence of advanced diagnosis and the use of two "surprise questions" (traditional and modified)...
December 26, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29275423/alcohol-screening-in-a-national-referral-hospital-an-observational-study-from-qatar
#18
Ayman El-Menyar, Rafael Consunji, Ahammed Mekkodathil, Ruben Peralta, Hassan Al-Thani
BACKGROUND Alcohol consumption is a high-risk factor for several medical disorders and traffic accidents and poses a burden on outpatient clinics and emergency units. We aimed to assess the pattern of alcohol screening among patients in a multicultural setting in a national referral hospital in an Arab Middle-Eastern country. MATERIAL AND METHODS A retrospective analysis was conducted for patients who were screened with blood alcohol concentration (BAC) in the Emergency Department (ED) in the period from January 2009 to December 2012...
December 24, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29274930/immediate-stress-echocardiography-for-low-risk-chest-pain-patients-in-the-emergency-department-a-prospective-observational-cohort-study
#19
Gregory Jasani, Mia Papas, Avkash J Patel, Neil Jasani, Brian Levine, Yuanyuan Zhang, Erik S Marshall
BACKGROUND: Evaluation and disposition of low-risk chest pain (CP) patients in the emergency department (ED) is time consuming and expensive. Low-risk CP often results in hospital admission to rule out myocardial infarction, which leads to additional costs and delays. OBJECTIVE: Our aim was to assess whether an immediate exercise stress echocardiogram (IESE) in the ED will allow safe, efficient, and cost-effective evaluation and discharge of patients with low-risk CP...
December 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29250027/derivation-of-a-three-biomarker-panel-to-improve-diagnosis-in-patients-with-mild-traumatic-brain-injury
#20
W Frank Peacock, Timothy E Van Meter, Nazanin Mirshahi, Kyle Ferber, Robert Gerwien, Vani Rao, Haris Iqbal Sair, Ramon Diaz-Arrastia, Frederick K Korley
Background: Nearly 5 million emergency department (ED) visits for head injury occur each year in the United States, of which <10% of patients show abnormal computed tomography (CT) findings. CT negative patients frequently suffer protracted somatic, behavioral, and neurocognitive dysfunction. Our goal was to evaluate biomarkers to identify mild TBI (mTBI) in patients with suspected head injury. Methods: An observational ED study of head-injured and control patients was conducted at Johns Hopkins University (HeadSMART)...
2017: Frontiers in Neurology
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