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https://www.readbyqxmd.com/read/28108319/how-the-changes-in-the-system-affect-trauma-care-provision-the-assessment-of-and-implications-for-lithuanian-trauma-service-performance-in-2007-2012
#1
Žilvinas Dambrauskas, Vytautas Aukštakalnis, Aurika Karbonskienė, Dmitrijus Kačiurinas, Jolanta Vokietienė, Robertas Lapka, Algimantas Pamerneckas, Narūnas Porvaneckas, Kęstutis Stašaitis, Nedas Jasinskas, Paulius Dobožinskas, Dinas Vaitkaitis, Raimundas Lunevičius
OBJECTIVE: The aim of this study was to identify and assess the effects of changes in the Lithuanian trauma service from 2007 to 2012. We postulate that the implications derived from this study will be of importance to trauma policy planners and makers in Lithuania and throughout other countries of Eastern and Central Europe. MATERIALS AND METHODS: Out of 10,390 trauma admissions to four trauma centers in 2007, 294 patients (2.8%) were randomly selected for the first arm of a representative study sample...
January 6, 2017: Medicina
https://www.readbyqxmd.com/read/28107293/the-age-of-value-navigating-the-transition-from-volume-to-value
#2
Renée M Glanzman
The healthcare industry has historically rewarded providers on the basis of the volume of services rendered, rather than the value of those services. Through the commitment of the Department of Health and Human Services, new programs and legislation have been created to tie provider payment based on the achievement of the Triple Aim: improve the patient experience, reduce cost, and improve overall health. As a result, new programs and legislation have emerged, resulting in the need for cultural shifts, new skills, and new technology for health systems, providers, and patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28106673/outcomes-of-pediatric-fractures-managed-with-closed-reduction-by-orthopaedic-residents-in-the-emergency-department
#3
Vivek Natarajan, Ermias Abebe, James Dunlap, Patrick Bosch, Ozgur Dede, W Timothy Ward, James Roach
BACKGROUND: Closed reduction of pediatric fractures is commonly performed by orthopaedic residents using conscious sedation in the emergency department (ED). The purpose of this study was to determine the rate of satisfactory reductions as performed by residents, and to determine the outcomes of these procedures. METHODS: A retrospective review was performed of all fractures that underwent closed reduction under conscious sedation in the ED of a level 1 pediatric trauma center between January 1, 2010 and November 30, 2014...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28102994/at-a-glance-emergency-department-surveillance-of-thermal-burns-and-scalds-electronic-canadian-hospitals-injury-reporting-and-prevention-program-2013
#4
J Crain, S McFaull, D P Rao, M T Do, W Thompson
INTRODUCTION: Although fatality and hospitalization rates for burns in Canada have declined over time, less serious cases still commonly present to the emergency department (ED). METHODS: The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an injury and poisoning surveillance system administered by the Public Health Agency of Canada, operating in emergency departments of 17 hospitals. RESULTS: Overall, cases reported in 2013 were scalds and contact burns from hot objects...
January 2017: Health Promotion and Chronic Disease Prevention in Canada
https://www.readbyqxmd.com/read/28099293/validating-a-clinical-prediction-rule-for-ventricular-shunt-malfunction
#5
Tehnaz P Boyle, Amir A Kimia, Lise E Nigrovic
OBJECTIVE: This study aims to validate a published ventricular shunt clinical prediction rule for the identification of children at low risk for ventricular shunt malfunction based on the absence of 3 high-risk clinical predictors (irritability, nausea or vomiting, and headache). METHODS: We identified children aged 21 years and younger with a ventricular shunt who presented between 2010 and 2013 to a single pediatric emergency department (ED) for evaluation of potential shunt malfunction...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28089112/predictive-utility-of-the-total-glasgow-coma-scale-versus-the-motor-component-of-the-glasgow-coma-scale-for-identification-of-patients-with-serious-traumatic-injuries
#6
REVIEW
Roger Chou, Annette M Totten, Nancy Carney, Spencer Dandy, Rongwei Fu, Sara Grusing, Miranda Pappas, Ngoc Wasson, Craig D Newgard
STUDY OBJECTIVE: The motor component of the Glasgow Coma Scale (mGCS) has been proposed as an easier-to-use alternative to the total GCS (tGCS) for field assessment of trauma patients by emergency medical services. We perform a systematic review and meta-analysis to compare the predictive utility of the tGCS versus the mGCS or Simplified Motor Scale in field triage of trauma for identifying patients with adverse outcomes (inhospital mortality or severe brain injury) or who underwent procedures (neurosurgical intervention or emergency intubation) indicating need for high-level trauma care...
January 11, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28088941/fracture-union-in-percutaneous-kirschner-wire-fixation-in-paediatric-tibial-shaft-fractures
#7
Ramji Lal Sahu, Rajni Ranjan
PURPOSE: To evaluate the efficacy of intramedullary Kirschner wires for the treatment of unstable tibial shaft fractures in children. METHODS: This prospective study was conducted at the Department of Orthopaedic Surgery in Maharishi Markandeshwar Medical College from June 2005 to June 2010. Sixty-six children having closed fracture of the tibial shaft with a mean age of 7.7 years (range, 2-14 years) were recruited from emergency and outpatient department. They were treated with percutaneous intramedullary Kirschner wires...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28087496/digital-pills-to-measure-opioid-ingestion-patterns-in-emergency-department-patients-with-acute-fracture-pain-a-pilot-study
#8
Peter R Chai, Stephanie Carreiro, Brendan J Innes, Rochelle K Rosen, Conall O'Cleirigh, Kenneth H Mayer, Edward W Boyer
BACKGROUND: Nonadherence to prescribed regimens for opioid analgesic agents contributes to increasing opioid abuse and overdose death. Opioids are frequently prescribed on an as-needed basis, placing the responsibility to determine opioid dose and frequency with the patient. There is wide variability in physician prescribing patterns because of the lack of data describing how patients actually use as-needed opioid analgesics. Digital pill systems have a radiofrequency emitter that directly measures medication ingestion events, and they provide an opportunity to discover the dose, timing, and duration of opioid therapy...
January 13, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28069418/splenic-artery-aneurysm-rupture-in-pregnancy
#9
Joshua Jacobson, Chad Gorbatkin, Stacey Good, Scott Sullivan
CASE PRESENTATION: A pregnant woman at 22+5/7weeks gestation presented to the emergency department (ED) from an outpatient clinic, hypotensive after experiencing a syncopal episode. On arrival to the ER she was tachycardic, tachypneic and complaining of abdominal pain. A bedside FAST was performed and noted free fluid in the abdomen. Subsequent CT obtained noted the rare but life-threatening diagnosis of ruptured splenic artery aneurysm that resulted in emergent transfer to the operating room with OB/GYN and general surgery...
December 15, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28069402/predictive-capacity-of-a-multimarker-strategy-to-determine-short-term-mortality-in-patients-attending-a-hospital-emergency-department-for-acute-heart-failure-bio-eahfe-study
#10
Pablo Herrero-Puente, Belén Prieto-García, María García-García, Javier Jacob, F Javier Martín-Sánchez, Domingo Pascual-Figal, Héctor Bueno, Victor Gil, Pere Llorens, Joaquin Vázquez-Alvarez, Rodolfo Romero-Pareja, Marta Sanchez-Gonzalez, Òscar Miró
OBJECTIVE: A multimarker strategy may help determine the prognosis of patients with acute heart failure (AHF). The aim of this study was to evaluate the capacity of mid-regional pro-adrenomedullin (MRproADM), copeptin and interleukin-6 (IL-6) combined with conventional clinical and biochemical markers to predict the 30-day mortality of patients with AHF. METHODS: We performed an observational, multicenter, prospective study of patients attended in the emergency department (ED) for AHF...
January 6, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28065773/using-the-electronic-medical-record-to-identify-patients-at-high-risk-for-frequent-ed-visits-and-high-system-costs
#11
David W Frost, Shankar Vembu, Jiayi Wang, Karen Tu, Quaid Morris, Howard B Abrams
BACKGROUND: A small proportion of patients accounts for a very high proportion of healthcare utilization. Accurate pre-emptive identification may facilitate tailored intervention. We sought to determine whether Machine Learning techniques using text from a family practice Electronic Medical Record (EMR) can be used to predict future high Emergency Department (ED) use and total costs by patients who are not yet high ED users or high cost to the healthcare system. METHODS: Text from fields of the Cumulative Patient Profile within an EMR (PS Suite) of 43,111 patients was indexed...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28065392/mapping-the-process-of-emergency-care-at-a-teaching-hospital-in-ghana
#12
Emily Aaronson, Elizabeth Mort, Samara Soghoian
Emergency Department (ED) overcrowding has become a global concern as the number of countries with formalized emergency care systems has expanded, and the burden of trauma and non-communicable diseases in low and middle-income countries increased. In light of this, the international Emergency Medicine literature has outlined the need for operational projects in low and middle income countries which focus on the process of care. Despite this, there is limited published literature describing these types of projects...
January 3, 2017: Healthcare
https://www.readbyqxmd.com/read/28056150/trends-in-otolaryngology-consultation-patterns-at-an-academic-quaternary-care-center
#13
Kevin J Choi, Russel R Kahmke, Matthew G Crowson, Liana Puscas, Richard L Scher, Seth M Cohen
Importance: The consultation patterns of an otolaryngology-head and neck surgery service have not previously been reported. The time, resources, and attention required to operate such a consultation service are unknown. Objective: To assess trends in otolaryngology-head and neck surgery consultations conducted in emergency departments (EDs) and inpatient services. Design, Setting, and Participants: A retrospective analysis was conducted of the medical records of patients at a quaternary care center receiving inpatient otolaryngology consultations from January 1 to December 31, 2014...
January 5, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28053659/a-web-based-information-system-for-a-regional-public-mental-healthcare-service-network-in-brazil
#14
Vinicius Tohoru Yoshiura, João Mazzoncini de Azevedo-Marques, Magdalena Rzewuska, André Luiz Teixeira Vinci, Ariane Morassi Sasso, Newton Shydeo Brandão Miyoshi, Antonia Regina Ferreira Furegato, Rui Pedro Charters Lopes Rijo, Cristina Marta Del-Ben, Domingos Alves
BACKGROUND: Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28053261/the-epidemiology-and-trends-in-management-of-acute-achilles-tendon-ruptures-in-ontario-canada-a-population-based-study-of-27-607-patients
#15
U Sheth, D Wasserstein, R Jenkinson, R Moineddin, H Kreder, S B Jaglal
AIMS: The aims of this study were to establish the incidence of acute Achilles tendon rupture (AATR) in a North American population, to select demographic subgroups and to examine trends in the management of this injury in the province of Ontario, Canada. PATIENTS AND METHODS: Patients ≥ 18 years of age who presented with an AATR to an emergency department in Ontario, Canada between 1 January 2003 and 31 December 2013 were identified using administrative databases...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28051054/appendicular-bilharzioma-an-unusual-cause-of-acute-intestinal-obstruction-in-childhood-a-case-report-at-charles-de-gaulle-paediatric-teaching-hospital-of-ouagadougou
#16
Albert Wandaogo, Isso Ouédraogo, Toussaint Wendlamita Tapsoba, Emile Bandré, Francis Somkieta Ouédraogo, Bernadette Béré, Balima Elie
The authors report the case of a 12-year-old boy admitted to the surgical emergency department of Charles de Gaulle Paediatric Teaching Hospital of Ouagadougou for acute abdominal pain. A strangulation of the terminal ileum by a tumour-like appendix wound around the bowel loop was seen during operation. The histological examination of the removed appendix disclosed eggs of Schistosoma haematobium and concluded to bilharzian appendicitis. A course of praziquantel treatment was instituted, and the patient underwent an event-free recovery...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28050802/the-effectiveness-of-apneic-oxygenation-during-tracheal-intubation-in-various-clinical-settings-a-narrative-review
#17
David T Wong, Amanda J Yee, Siaw May Leong, Frances Chung
PURPOSE: During the process of tracheal intubation, patients are apneic or hypoventilating and are at risk of becoming hypoxemic. This risk is especially high in patients with acute or chronic respiratory failure and accompanying compromised respiratory reserve. To address this concern, apneic oxygenation can be administered during tracheal intubation to aid in maintaining arterial oxygen saturation. The objective of this narrative review is to examine the utilization of apneic oxygenation within the operating room, intensive care unit (ICU), emergency department, and pre-hospital settings and to determine its efficacy compared with controls...
January 3, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28045846/lung-ultrasound-as-first-line-examination-for-the-diagnosis-of-community-acquired-pneumonia-in-children
#18
Contantinia Boursiani, Maria Tsolia, Chrysoula Koumanidou, Aikaterini Malagari, Marina Vakaki, Georgios Karapostolakis, Argyro Mazioti, Efthymia Alexopoulou
OBJECTIVES: The diagnosis of pediatric community-acquired pneumonia (CAP) is based on clinical criteria. Even though chest x-ray (CXR) is only recommended in severe cases, it is often requested from physicians in mild cases, thus increasing radiation exposure. Lung ultrasound (LUS) is not included in the diagnostic workup. The objective of this study was to evaluate the diagnostic performance of LUS against CXR. METHODS: Children who presented to the emergency department with clinical signs suggesting CAP and had already been evaluated with a CXR were included in the study...
January 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28041612/evaluation-of-a-routine-follow-up-visit-after-an-internal-fixation-of-proximal-femoral-fracture
#19
Joonas Mm Kuorikoski, Tim P Söderlund
BACKGROUND AND PURPOSE: Post-operative follow-up after internal fixation of fractures is a common practice. The goal of this study was to evaluate the necessity of a routine follow-up visit after internal fixation of a proximal femoral fracture. Our hypothesis is that these follow-up visits do not result in a change in the treatment plan, but add an extra cost to the health care system and lead to the purposeless utilisation of limited resources. PATIENTS AND METHODS: A retrospective study of 428 consecutive patients (431 fractures) with a scheduled outpatient clinic visit after internal fixation of proximal femoral fractures in a single hospital during years 2012-2013...
December 23, 2016: Injury
https://www.readbyqxmd.com/read/28040285/diagnostic-performance-of-a-high-sensitive-troponin-t-assay-and-a-troponin-t-point-of-care-assay-in-the-clinical-routine-of-an-emergency-department-a-clinical-cohort-study
#20
Anna Slagman, Johannes von Recum, Martin Möckel, Fabian Holert, Dirk Meyer Zum Büschenfelde, Christian Müller, Julia Searle
BACKGROUND: A point of care test (POCT) for troponin T (TnT) in the Emergency Department (ED) was compared to a high-sensitivity TnT (hsTnT) central laboratory test (CLT) to determine the influence of test system and different cut-off values on the diagnostic performance in patients with suspected acute coronary syndrome (ACS) under routine conditions. METHODS: All patients with routine TnT testing in the ED were enrolled. Only internal medicine patients without STEMI and with both troponin values were analyzed...
December 21, 2016: International Journal of Cardiology
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