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Emergency department operations

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https://www.readbyqxmd.com/read/28735594/facilitating-partnerships-with-community-and-faith-based-organizations-for-disaster-preparedness-and-response-results-of-a-national-survey-of-public-health-departments
#1
Rachel M Adams, Michael L Prelip, Deborah C Glik, Ian Donatello, David P Eisenman
OBJECTIVE: We identify characteristics of local health departments, which enhance collaborations with community- and faith-based organizations (CFBOs) for emergency preparedness and response. METHODS: Online survey data were collected from a sample of 273 disaster preparedness coordinators working at local health departments across the United States between August and December 2011. RESULTS: Using multiple linear regression models, we found that perceptions of CFBO trust were associated with more successful partnership planning (β=0...
July 24, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28734432/outbreak-of-middle-east-respiratory-syndrome-coronavirus-causes-high-fatality-after-cardiac-operations
#2
Rakan I Nazer
Middle East respiratory syndrome-coronavirus (MERS-CoV) resembles a severe form of community-acquired pneumonia initially reported in Saudi Arabia in 2012. The MERS-CoV epidemic poses a big challenge because of its high mortality. In January 2015, a patient who was potentially incubating MERS-CoV arrived from the emergency department of another hospital and was admitted with acute coronary syndrome. This resulted in an outbreak in the cardiac surgery ward that caused the deaths of 5 of 6 patients who had undergone cardiac operations...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28733688/predicting-pneumonia-in-acute-ischaemic-stroke-comparison-of-five-prediction-scoring-models
#3
Tian Ming Tu, Sheena Sh Phua, Sanchalika Acharyya, Wai May Ng, Daniel Ct Oh
INTRODUCTION: Although pneumonia is a major complication after acute ischaemic stroke (AIS), pneumonia prediction scores have not been extensively validated. This study aimed to compare the discrimination performance of 5 pneumonia prediction scores in AIS patients. MATERIALS AND METHODS: We retrospectively reviewed all consecutive adult AIS patients whom presented to our emergency department within 4.5 hours of symptom-onset between January 2012 and February 2015...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28729007/the-feasibility-of-point-of-care-ankle-ultrasound-examination-in-patients-with-recurrent-ankle-sprain-and-chronic-ankle-instability-comparison-with-magnetic-resonance-imaging
#4
Sun Hwa Lee, Seong Jong Yun
OBJECTIVE: To evaluate the feasibility of point-of-care ankle ultrasound compared with magnetic resonance imaging (MRI) for diagnosing major ligaments and Achilles tendon injuries in patients with recurrent ankle sprain and chronic instability, and to evaluate inter-observer reliability between an emergency physician and a musculoskeletal radiology fellow. MATERIAL AND METHODS: A prospective cross-sectional study was conducted in an emergency department. Patients with recurrent ankle sprain and chronic instability were recruited...
July 13, 2017: Injury
https://www.readbyqxmd.com/read/28727802/diagnostic-accuracy-of-procalcitonin-neutrophil-lymphocyte-count-ratio-c-reactive-protein-and-lactate-in-patients-with-suspected-bacterial-sepsis
#5
Lars Ljungström, Anna-Karin Pernestig, Gunnar Jacobsson, Rune Andersson, Barbara Usener, Diana Tilevik
BACKGROUND: Early recognition is a key factor to achieve improved outcomes for septic patients. Combinations of biomarkers, as opposed to single ones, may improve timely diagnosis and survival. We investigated the performance characteristics of sepsis biomarkers, alone and in combination, for diagnosis of verified bacterial sepsis using Sepsis-2 and Sepsis-3 criteria, respectively. METHODS: Procalcitonin (PCT), neutrophil-lymphocyte count ratio (NLCR), C-reactive protein (CRP), and lactate were determined in a total of 1,572 episodes of adult patients admitted to the emergency department on suspicion of sepsis...
2017: PloS One
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#6
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
July 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28721899/gaps-in-radiation-therapy-awareness-results-from-an-educational-multi-institutional-survey-of-us-internal-medicine-residents
#7
Narek Shaverdian, Sun Mi Yoo, Ryan Cook, Eric M Chang, Naomi Jiang, Ye Yuan, Kiri Sandler, Michael Steinberg, Percy Lee
PURPOSE: Internists and primary care providers play a growing role in cancer care. We therefore evaluated the awareness of radiation therapy in general and specifically the clinical utility of stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) among current US internal medicine residents. METHODS AND MATERIALS: A web-based institutional review board-approved multi-institutional survey was distributed to US internal medicine residency programs...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28720631/accrued-cost-savings-of-a-free-clinic-using-quality-adjusted-life-years-saved-and-return-on-investment
#8
Jim Sanders, Marcus Lacey, Clare E Guse
INTRODUCTION: Savings garnered through the provision of preventive services is a form of profit for health systems. Free clinics have been using this logic to demonstrate their cost-savings. The Community-Based Chronic Disease Management (CCDM) clinic treats hypertension using nurse-led teams, clinical protocols, and community-based settings. METHODS: We calculated CCDM's cost-effectiveness from 2007 to 2013 using 2 metrics: Quality-adjusted life years (QALYs) saved and return on investment (ROI)...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720000/differentiation-between-pyogenic-flexor-tenosynovitis-and-other-finger-infections
#9
Colin D Kennedy, Alexander S Lauder, Jonathan R Pribaz, Stephen A Kennedy
BACKGROUND: Hospital transfer decisions regarding pyogenic flexor tenosynovitis (PFT) are made difficult by emergency department presentations similar to other finger infections, with pain, redness, and functional limitation. Our objectives were to: (1) determine diagnostic sensitivity and specificity of Kanavel signs; and (2) identify existing factors most predictive of PFT during initial presentation. METHODS: Adult patients who underwent surgical consultation for concern of PFT over a 5-year period were identified retrospectively...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28714287/bacteremia-prediction-model-for-community-acquired-pneumonia-external-validation-in-a-multicenter-retrospective-cohort
#10
Byunghyun Kim, Jungho Choi, Kyuseok Kim, Sujin Jang, Tae Gun Shin, Won Young Kim, Jung-Youn Kim, Yoo Seok Park, Soo Hyun Kim, Hui Jai Lee, Jonghwan Shin, JeSung You, Kyung Su Kim, Sung Phil Chung
OBJECTIVE: Many studies have described constructing a prediction model for bacteremia in community-acquired pneumonia (CAP), but these studies were not validated in external heterogeneous groups. The objective of this study was to test the generalizability of a previous bacteremia prediction model for CAP by external validation. METHODS: This multicenter retrospective cohort analysis was performed in eight tertiary urban hospital emergency departments (ED). We reviewed adult patients who were hospitalized after presentation to the ED with CAP...
July 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28712608/a-custom-developed-emergency-department-provider-electronic-documentation-system-reduces-operational-efficiency
#11
Joshua Feblowitz, Sukhjit S Takhar, Michael J Ward, Ryan Ribeira, Adam B Landman
STUDY OBJECTIVE: Electronic health record implementation can improve care, but may also adversely affect emergency department (ED) efficiency. We examine how a custom, ED provider, electronic documentation system (eDoc), which replaced paper documentation, affects operational performance. METHODS: We analyzed retrospective operational data for 1-year periods before and after eDoc implementation in a single ED. We computed daily operational statistics, reflecting 60,870 pre- and 59,337 postimplementation patient encounters...
July 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28712196/small-gut-volvulus-a-rare-twist-in-the-setting-of-an-even-rarer-entity-multiple-giant-jejuno-ileal-diverticula
#12
Ayesha Khan, Faheem Khan, Kashif Rafique, Sarwar Khan, Anam Majid, Khalid Khan, Asad Ullah
Small gut volvulus with multiple Jejuno-ileal diverticulosis is an unusual pathology of the small intestine with a scarce number of cases reported so far. It usually goes unnoticed because it is often asymptomatic but complications like diverticulitis, perforation, bleeding or intestinal obstruction can occur in 10-30% of the cases. Mechanical obstruction, if it occurs, can be caused by adhesions or stenosis due to diverticulitis, intussusception at the site of the diverticulum and volvulus of the segment containing the diverticula...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28704554/trends-in-the-incidence-and-outcomes-of-bicycle-related-injury-in-the-emergency-department-a-nationwide-population-based-study-in-south-korea-2012-2014
#13
Youn-Jung Kim, Dong-Woo Seo, Jae-Ho Lee, Yoon-Seon Lee, Bum-Jin Oh, Kyoung-Soo Lim, Won Young Kim
OBJECTIVE: This study aimed to examine trends in the incidence and outcomes of bicycle-related injuries in emergency departments (ED) in South Korea. METHODS: We analysed data from the National Emergency Department Information System database for adult patients (≥20 years) with bicycle-related injuries presenting to EDs in South Korea between January 2012 and December 2014. Riders and bicycle passengers whose injuries were associated with bicycle use were included...
2017: PloS One
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#14
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation following cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28702136/chronic-cholecystitis-in-the-pediatric-population-an-underappreciated-disease-process
#15
Brian P Blackwood, Julia Grabowski
AIM: We hypothesize that chronic cholecystitis accounts for the majority of inflammatory diseases in the pediatric population and it is difficult to predict with preoperative ultrasound. BACKGROUND: Despite the increase in gallbladder disease, there is a paucity of data on pediatric cholecystitis. Most pediatric studies focus on cholelithiasis and biliary dyskinesia rather than inflammatory gallbladder disease. METHODS: We performed a single center retrospective review of all patients who underwent cholecystectomy from 1/1/10 - 1/1/15...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28698813/macroscopic-hematuria-due-to-placenta-percreta-report-of-two-cases-and-short-review
#16
Ourania Koukoura, George Lialios, Antonios Garas, George Sveronis, Asterios Nidimos, Irondiana Gkorezi, Zoi Alevra, Vassilios Tzortzis, Athanasios Oeconomou, Ioannis Zachos, Alexandros Daponte
Herein we present two cases of pregnant women with placenta percreta and severe hematuria during the 24th and 35th weeks of pregnancy, respectively. A timely sonographic diagnosis was feasible in the first case and cesarean section was performed during the 29th week. During the operation, the placenta was invading the bladder wall and concomitant hysterectomy with cystotomy and bladder wall reconstruction was performed. The second case presented in our emergency department with vaginal bleeding during the 35th weeks of pregnancy...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28698748/acute-postoperative-pain-in-trauma-patients-the-fifth-vital-sign
#17
Nikolina Farčić, Ivana Barać, Stana Pačarić, Ivana Lovrić, Vesna Ilakovac
AIM: To determine average pain intensity perceived by trauma patients at hospital admission, lowest and highest pain intensity during their hospitalisation and their satisfaction with provided pain treatment. PATIENTS AND METHODS: The research included 114 operated patients at the Clinical Department of Trauma Surgery. We used the standard Numerical Rating Scale (NRS) for a clinical measure of pain. RESULTS: The average pain intensity at hospital admission was NRS median 7 (range 4-10), the severest perceived rate of pain during hospitalisation was NRS median 5 (range 4-7)...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28695610/anion-gap-can-differentiate-between-psychogenic-and-epileptic-seizures-in-the-emergency-setting
#18
Yi Li, Liesl Matzka, Louise Maranda, Daniel Weber
Differentiation between psychogenic nonepileptic seizures (PNES) and generalized convulsive epileptic seizures (ES) is important for appropriate triaging in the emergency department (ED). This can be difficult in the ED, as the event is often not witnessed by a medical professional. In the current study, we investigated whether anion gap (AG), bicarbonate, and the Denver Seizure Score (DSS) could differentiate between PNES and ES. Of a total of 1,354 subjects reviewed from a tertiary care medical center, 27 PNES and 27 ES patients were identified based on clinical description and subsequent electroencephalogram...
July 11, 2017: Epilepsia
https://www.readbyqxmd.com/read/28692718/physician-reimbursement-in-medicare-advantage-compared-with-traditional-medicare-and-commercial-health-insurance
#19
Erin Trish, Paul Ginsburg, Laura Gascue, Geoffrey Joyce
Importance: Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear. Objective: To compare prices paid for physician and other health care services in MA, traditional Medicare, and commercial plans...
July 10, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28692011/far-forward-diagnostics-in-toxic-industrial-chemical-and-material-exposure-scenarios-and-biomarker-identification
#20
Charles C Young, Danielle L Ippolito
: This study describes key technical solutions for detecting environmental toxicants and diagnosing adverse health effects in military operational settings as outlined at a symposium cosponsored by the Department of Defense and the Johns Hopkins University-Applied Physics Laboratory (October 27 to 28, 2015). Such technologies are urgently needed in order to provide critical decision-aid tools and prognostic assessment of potential clinical sequelae. This review summarizes the state-of-the-science on (1) prioritization of adverse health effects, (2) existing technologies and diagnostic tools available for use in theater, (3) challenges to advancing diagnostic tools far-forward, and (4) the potential utility of anchoring diagnostic tools to adverse outcome pathways...
July 6, 2017: Journal of Occupational and Environmental Medicine
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