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https://www.readbyqxmd.com/read/29166203/temporal-profile-of-care-following-mild-traumatic-brain-injury-predictors-of-hospital-admission-follow-up-referral-and-six-month-outcome
#1
John K Yue, Ethan A Winkler, Sourabh Sharma, Mary J Vassar, Jonathan J Ratcliff, Frederick K Korley, Seth A Seabury, Adam R Ferguson, Hester F Lingsma, Sacha Meeuws, Opeolu M Adeoye, Jonathan W Rick, Caitlin K Robinson, Siena M Duarte, Esther L Yuh, Pratik Mukherjee, Sureyya S Dikmen, Thomas W McAllister, Ramon Diaz-Arrastia, Alex B Valadka, Wayne A Gordon, David O Okonkwo, Geoffrey T Manley
OBJECTIVE: To investigate the clinical management and medical follow-up of patients with mild traumatic brain injury (mTBI) presenting to emergency departments (EDs). METHODS: Overall, 168 adult patients with mTBI from the prospective, multicentre Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Pilot study with Glasgow Coma Scale (GCS) 13-15, no polytrauma and alive at six months were included. Predictors for hospital admission, three-month follow-up referral and six-month functional disability (Glasgow Outcome Scale-Extended (GOSE) ≤ 6) were analysed using multivariable regression...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29165853/past-year-prescription-drug-monitoring-program-opioid-prescriptions-and-self-reported-opioid-use-in-an-emergency-department-population-with-opioid-use-disorder
#2
Kathryn Hawk, Gail D'Onofrio, David A Fiellin, Marek C Chawarski, Patrick G O'Connor, Patricia H Owens, Michael V Pantalon, Steven L Bernstein
BACKGROUND: Despite increasing reliance on Prescription Drug Monitoring Programs (PDMPs) as a response to the opioid epidemic, the relationship between aberrant drug-related behaviors captured by the PDMP and opioid use disorder is incompletely understood. How PDMP data should guide Emergency Department (ED) assessment has not been studied. STUDY OBJECTIVE: To evaluate a relationship between PDMP opioid prescription records and self-reported non-medical opioid use of prescription opioids in a cohort of opioid dependent ED patients enrolled in a treatment trial...
November 22, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29165600/missed-opportunities-to-identify-occupational-asthma-in-acute-secondary-care
#3
P R Ellis, G I Walters
Background: Occupational asthma (OA) accounts for one in six cases of new-onset adult asthma. Despite this it remains under-recognized in the UK. Delayed and missed diagnoses of OA lead to poor health outcomes for workers at significant cost to the UK economy. The burden of occupational aetiology on hospital admissions with asthma is not known. Aims: To measure how frequently medical professionals consider occupational aetiology in patients presenting to secondary care with acute asthma symptoms...
November 18, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/29162145/reducing-hospital-admissions-in-remote-australia-through-the-establishment-of-a-palliative-and-chronic-disease-respite-facility
#4
Timothy A Carey, Mick Arundell, Kellie Schouten, John S Humphreys, Fred Miegel, Simon Murphy, John Wakerman
BACKGROUND: There are limited respite services for palliative care patients and their families in the Northern Territory (NT). The high prevalence of complex chronic diseases, limited access to primary care services, and the poor living situations of many Aboriginal and Torres Strait Islander Australians result in high hospitalisation rates and pressure on tertiary health services. Palliative Care NT identified a need for a flexible, community based, culturally appropriate respite service in Alice Springs...
November 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#5
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the Institutional Review Board. Study subjects were patients ≥18 years of age with an International Classification of Diseases (ICD) code corresponding to a traumatic IC, and admitted to an ED observation unit (EDOU) of an urban, academic level 1 trauma center between February 1, 2015 and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29159184/acute-asthma-in-the-pediatric-emergency-department-infections-are-the-main-triggers-of-exacerbations
#6
Arianna Dondi, Elisabetta Calamelli, Valentina Piccinno, Giampaolo Ricci, Ilaria Corsini, Carlotta Biagi, Marcello Lanari
Background: Asthma exacerbations are a common reason for Emergency Department (ED) visits in children. Aim: To analyze differences among age groups in terms of triggering factors and seasonality and to identify those with higher risk of severe exacerbations. Methods: We retrospectively revised the files of children admitted for acute asthma in 2016 in our Pediatric ED. Results: Visits for acute asthma were 603/23197 (2...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29157798/euglycemic-diabetic-ketoacidosis-secondary-to-dapagliflozin-use-a-case-report
#7
Felicity Brown, Tamara McColl
BACKGROUND: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a novel class of oral antihyperglycemic agents. They are associated with rare cases of euglycemic diabetic ketoacidosis (DKA), which presents a diagnostic challenge in the emergency department (ED) and potentially severe consequences if missed. CASE REPORT: A 53-year-old man with type 2 diabetes mellitus and a recent Roux-en-Y gastric bypass surgery presented to the ED with nausea, vomiting, and generalized abdominal pain...
November 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29157787/a-consultation-phone-service-for-patients-with-total-joint-arthroplasty-may-reduce-unnecessary-emergency-department-visits
#8
Eerik Hällfors, Sami A Saku, Tatu J Mäkinen, Rami Madanat
BACKGROUND: Different measures for reducing costs after total joint arthroplasty (TJA) have gained attention lately. At our institution, a free-of-charge consultation phone service was initiated that targeted patients with TJA. This service aimed at reducing unnecessary emergency department (ED) visits and, thus, potentially improving the cost-effectiveness of TJAs. To our knowledge, a similar consultation service had not been described previously. We aimed at examining the rates and reasons for early postdischarge phone calls and evaluating the efficacy of this consultation service...
October 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29157510/euthanasia-requests-in-a-canadian-psychiatric-emergency-room-a-case-series-part-1-of-the-mcgill-university-euthanasia-in-psychiatry-case-series
#9
David Benrimoh, Antoine Perreault, Frederique Van Den Eynde
Euthanasia was decriminalized in Quebec in December 2015, and Canada-wide in June 2016. Both the Provincial and Federal legislation have limited the right to medical assistance in dying (MAID) to end-of-life cases; which makes MAID inaccessible to most patients solely suffering from psychiatric illness. While some end-stage anorexia nervosa or elderly patients may meet the end-of-life criterion because of their medical comorbidities or their age (Kelly et al., 2003), repeated suicide attempts or psychotic disorganization would not qualify since they would not be seen as elements of an illness leading to a foreseeable "natural death" (Canada, 2016)...
November 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29155471/alcohol-related-harm-in-emergency-departments-a-prospective-multicentre-study
#10
Assoc Prof Diana Egerton-Warburton, Andrew Gosbell, Katie Moore, Angela Wadsworth, Drew Richardson, Daniel M Fatovich
BACKGROUND: Emergency department alcohol-related presentation data are not routinely collected. It is likely that previous research has underestimated the numbers of patients presenting with alcohol-related conditions. DESIGN: Multicentre, prospective study. Patients were prospectively screened for alcohol-related presentations over a seven-day period in December 2014. Part one involved screening to determine alcohol positive ED presentations, and data collection of patient demographic and clinical information...
November 20, 2017: Addiction
https://www.readbyqxmd.com/read/29153919/patient-and-health-care-provider-responses-from-a-prospective-double-blind-randomized-controlled-trial-comparing-vapocoolant-spray-versus-placebo-spray-in-adults-undergoing-venipuncture-in-the-emergency-department
#11
Tracy Barbour, Sharon O'Keefe, Sharon E Mace
Painful medical procedures are common. Topical anesthetics are easily applied, rapid onset, inexpensive, and avoid injection pain and needlestick injury. The aims of this study, using patient and health care provider questionnaires, were to answer the following questions: (1) Does vapocoolant spray decrease venipuncture pain? (2) Would patients be satisfied with and use a vapocoolant spray in the future? (3) Would providers be satisfied with and use a vapocoolant spray in the future? Adults (18-80 years) in a hospital emergency department (ED) were randomly assigned to sterile water placebo spray (S) (N = 50) or vapocoolant spray (V) (N = 50) before venipuncture...
November 16, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29153580/effectiveness-and-safety-of-oro-dispersible-sildenafil-in-a-new-film-formulation-for-the-treatment-of-erectile-dysfunction-comparison-between-sildenafil-100-mg-film-coated-tablet-and-75-mg-oro-dispersible-film
#12
Andrea Cocci, Marco Capece, Gianmartin Cito, Giorgio Ivan Russo, Marco Falcone, Massimiliano Timpano, Michele Rizzo, Pier Andrea Della Camera, Simone Morselli, Riccardo Campi, Francesco Sessa, Giovanni Cacciamani, Andrea Minervini, Mauro Gacci, Vincenzo Mirone, Girolamo Morelli, Nicola Mondaini, Gaia Polloni, Sergio Serni, Alessandro Natali
BACKGROUND: A new oro-dispersible film (ODF) formulation of sildenafil has been developed for the treatment of erectile dysfunction (ED) to overcome the drawbacks that some patients experience when taking the conventional film-coated tablet (FCT). AIM: To assess the effectiveness and safety of sildenafil ODF formulation in patients with ED who were using the conventional FCT. METHODS: From May 2017 through July 2017, 139 patients with ED were enrolled...
November 16, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29151053/protocol-of-the-sepsivit-study-a-prospective-observational-study-to-determine-whether-continuous-heart-rate-variability-measurement-during-the-first-48-hours-of-hospitalisation-provides-an-early-warning-for-deterioration-in-patients-presenting-with-infection
#13
Vincent M Quinten, Matijs van Meurs, Maurits H Renes, Jack J M Ligtenberg, Jan C Ter Maaten
INTRODUCTION: One in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an early warning for deterioration in patients presenting with suspected infection or sepsis to the emergency department (ED). METHODS AND ANALYSIS: The protocol of a prospective observational study in the ED...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29145728/understanding-how-emergency-medicine-physicians-survive-and-thrive-in-rural-practice-a-theoretical-model
#14
Ashra Kolhatkar, Andrea Keesey, Bob Bluman, Brenna Lynn, Tandi Wilkinson
INTRODUCTION: The challenges facing emergency medicine (EM) services in Canada reflect the limitations of the entire healthcare system. The emergency department (ED) is uniquely situated in the healthcare system such that shortcomings in hospital- and community-based services are often first revealed there. This is especially true in rural settings, where there are additional site-specific barriers to the provision of EM care. Existing studies look at the factors that influence rural EM physicians in isolation...
November 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29145510/out-of-hospital-cardiac-arrests-in-switzerland-predictors-for-emergency-department-mortality-in-patients-with-rosc-or-on-going-cpr-on-admission-to-the-emergency-department
#15
Thomas C Sauter, Nora Iten, Patrik R Schwab, Wolf E Hautz, Meret E Ricklin, Aristomenis K Exadaktylos
BACKGROUND: One of the leading causes of death is out-of-hospital cardiac arrest (OHCA) with an in-hospital mortality of about 70%. To identify predictors for the high mortality of OHCA patients and especially for women, that are considered at high risk for in-hospital mortality, we evaluated one specific setting of in-hospital treatment after OHCA: the emergency department (ED). METHODS: Retrospective analysis of consecutive ED admissions with OHCA at the Inselspital Bern, Switzerland from 1st June 2012 to 31th Mai 2015...
2017: PloS One
https://www.readbyqxmd.com/read/29143331/implicit-review-instrument-to-evaluate-quality-of-care-delivered-by-physicians-to-children-in-emergency-departments
#16
James P Marcin, Patrick S Romano, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, Charlie Casper, Jonathan Michael Dean, Nathan Kuppermann
OBJECTIVE: To evaluate the consistency, reliability, and validity of an implicit review instrument that measures the quality of care provided to children in the emergency department (ED). DATA SOURCES/STUDY SETTING: Medical records of randomly selected children from 12 EDs in the Pediatric Emergency Care Applied Research Network (PECARN). STUDY DESIGN: Eight pediatric emergency medicine physicians applied the instrument to 620 medical records...
November 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/29142581/an-unexpected-reason-for-isolated-foot-drop-acute-stroke
#17
Eylem Kuday Kaykisiz, Erden Erol Unluer
The differential diagnosis of acute weakness (AW) in emergency departments (ED) is broad and includes both neurological and medical reasons. We describe an 81-year-old female patient with cortical infarct presenting with sudden onset isolated foot drop, which to the best of our knowledge, was the third case in English literature. An 81-year-old female was admitted to our ED with a 12-hour history of left-sided foot drop. Her motor strength was normal throughout the upper and lower extremities, except for weakness in the left ankle and toe dorsiflexors...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29140748/paramedic-initiated-home-care-referrals-and-use-of-home-care-and-emergency-medical-services
#18
Amol A Verma, John Klich, Adam Thurston, Jordan Scantlebury, Alex Kiss, Gayle Seddon, Samir K Sinha
OBJECTIVE: We examined the association between paramedic-initiated home care referrals and utilization of home care, 9-1-1, and Emergency Department (ED) services. METHODS: This was a retrospective cohort study of individuals who received a paramedic-initiated home care referral after a 9-1-1 call between January 1, 2011 and December 31, 2012 in Toronto, Ontario, Canada. Home care, 9-1-1, and ED utilization were compared in the 6 months before and after home care referral...
November 15, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29137904/implications-of-iodinated-contrast-media-extravasation-in-the-emergency-department
#19
Jonathan D Sonis, Ravi V Gottumukkala, McKinley Glover, Brian J Yun, Benjamin A White, Mannudeep K Kalra, Alexi Otrakji, Ali S Raja, Anand M Prabhakar
PURPOSE: To characterize the management, outcomes, and emergency department (ED) length of stay (LOS) following iodinated contrast media extravasation events in the ED. METHODS: All ED patients who developed iodinated contrast media extravasation following contrast-enhanced CT (CECT) from October 2007-December 2016 were retrospectively identified. Medical records were reviewed and management, complications, frequency of surgical consultation, and ED LOS were quantified using descriptive statistics...
November 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137902/effects-of-opioid-medications-on-cognitive-skills-among-emergency-department-patients
#20
Catherine A Marco, Dennis Mann, Jordan Rasp, Michael Ballester, Oswald Perkins, Michael B Holbrook, Kyle Rako
INTRODUCTION: Treatment for pain and related conditions has been identified as the most common reason for Emergency Department (ED) visits. Concerns exist regarding the effects of opioid pain medications on cognition and patient ability to consent for procedures, hospital admission, or to refuse recommended medical interventions. This study was undertaken to identify cognitive skills before and after opioid pain medication in the ED setting. METHODS: This was a prospective study comparing performance on the Mini-Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) before and after administration of opioid pain medications...
November 8, 2017: American Journal of Emergency Medicine
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