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Emergency medicine administration management department

Nils Kunze-Szikszay, Lennart A Krack, Pauline Wildenauer, Saskia Wand, Tim Heyne, Karoline Walliser, Christopher Spering, Martin Bauer, Michael Quintel, Markus Roessler
BACKGROUND: Hyperfibrinolysis (HF) is a major contributor to coagulopathy and mortality in trauma patients. This study investigated (i) the rate of HF during the pre-hospital management of patients with multiple injuries and (ii) the effects of pre-hospital tranexamic acid (TxA) administration on the coagulation system. METHODS: From 27 trauma patients with pre-hospital an estimated injury severity score (ISS) ≥16 points blood was obtained at the scene and on admission to the emergency department (ED)...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Katherine Remick, Christopher Redgate, Daniel Ostermayer, Amy H Kaji, Marianne Gausche-Hill
OBJECTIVE: Many Emergency Medicine Services (EMS) protocols require point-of-care blood glucose testing (BGT) for any pediatric patient who presents with seizure or altered level of conscious. Few data describe the diagnostic yield of BGT when performed on all pediatric seizures regardless of presenting mental status. We analyzed a large single center dataset of pediatric patients presenting with prehospital seizures to determine the prevalence of hypoglycemic seizures and the utility of repeat BGT in the emergency department (ED)...
September 16, 2016: Prehospital Emergency Care
Grant D Innes, Frank Scheuermeyer, Mike Law, Andrew McRae, Bryce Weber, Heidi Boyda, Kevin Lonergan, James Andruchow
BACKGROUND: Sex-related differences occur in many areas of medicine. ED studies have suggested differences in access to care, diagnostic imaging use, pain management, and intervention. We investigated sex-based differences in the care and outcomes for ED patients with acute renal colic. METHODS: This was a multi-center population-based retrospective observational cohort study using administrative data and supplemented by structured chart review. All patients seen in Calgary Health Region (CHR) emergency departments between January 1, 2014 and December 31, 2014 with an ED diagnosis of renal colic based on the following ICD-10 codes were eligible for inclusion: calculus of kidney (N200), calculus of ureter (N201), calculus of kidney with calculus of ureter (N202), hydronephrosis with renal and ureteral calculous obstruction (N132), unspecified renal colic (N23), and unspecified urinary calculus (N209)...
June 30, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Mohammad Jalili, Ali Mozaffarpour Noori, Mojtaba Sedaghat, Arash Safaie
BACKGROUND: Efficient pain management is one of the most important components of care in the field of emergency medicine. OBJECTIVES: This study was conducted to compare intravenous paracetamol and intravenous morphine sulfate for acute pain reduction in patients with limb trauma. PATIENTS AND METHODS: In a randomized double-blinded clinical trial, all patients (aged 18 years and older) with acute limb trauma and a pain score of greater than 3/10 in the emergency department were recruited; they received either 1 g intravenous paracetamol or 0...
February 2016: Trauma Monthly
Stephanie Ruest, Angela Anderson
PURPOSE OF REVIEW: This article provides a summary of recommendations for the multimodal and multidisciplinary approach to acute pediatric pain management and highlights recent research on this topic. RECENT FINDINGS: Recent literature has focused on updating recommendations for the use of various analgesics in the pediatric population. While codeine is no longer recommended due to increasing evidence of adverse effects, the more liberal use of intranasal fentanyl is now encouraged because of the ease of administration and rapid delivery...
June 2016: Current Opinion in Pediatrics
Neil Roberts, Fabiana Lorencatto, Joanna Manson, Susan I Brundage, Jan O Jansen
BACKGROUND: Major Trauma Centers (MTCs), as part of a trauma system, improve survival and functional outcomes from injury. Developing such centers from current teaching hospitals is likely to generate diverse beliefs amongst staff. These may act as barriers or enablers. Prior identification of these may make the service development process more efficient. The importance of applying theory to systematically identify barriers and enablers to changing clinical practice in emergency medicine has been emphasized...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Geesje Van Woerden, Crispijn L Van Den Brand, Cornelis F Den Hartog, Floris J Idenburg, Diana C Grootendorst, M Christien Van Der Linden
BACKGROUND: The most common complaint of patients attending the emergency department (ED) is pain, caused by different diseases. Yet the treatment of pain at the ED is suboptimal, and oligoanalgesia remains common. The objective of this study is to determine whether the administration of analgesia at the ED increases by implementation of revised guidelines in pain management. METHODS: We conducted a prospective pre-post intervention cohort study with implementation of a revised guideline for pain management at our ED, in which nurses are allowed to administer analgesia (including low-dosage piritramid (opioid) intravenous) without doctor intervention...
December 2016: International Journal of Emergency Medicine
Matthew Wheatley, Christopher Baugh, Anwar Osborne, Carol Clark, Philip Shayne, Michael Ross
The role of observation services for emergency department patients has increased in recent years. Driven by changing health care practices and evolving payer policies, many hospitals in the United States currently have or are developing an observation unit (OU) and emergency physicians are most often expected to manage patients in this setting. Yet, few residency programs dedicate a portion of their clinical curriculum to observation medicine. This knowledge set should be integrated into the core training curriculum of emergency physicians...
April 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Johannes Prottengeier, Marlen Petzoldt, Nikola Jess, Andreas Moritz, Christine Gall, Joachim Schmidt, Georg Breuer
BACKGROUND: Dual-tasking, the need to divide attention between concurrent tasks, causes a severe increase in workload in emergency situations and yet there is no standardised training simulation scenario for this key difficulty. OBJECTIVES: We introduced and validated a quantifiable source of divided attention and investigated its effects on performance and workload in airway management. DESIGN: A randomised, crossover, interventional simulation study...
March 2016: European Journal of Anaesthesiology
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