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https://www.readbyqxmd.com/read/28931198/older-siblings-are-at-increased-risk-for-foreign-bodies
#1
Laura H Swibel Rosenthal, Matthew R Bartindale, Zachary C Fridirici, Natalie A Papillon
A prospective, case-control study was performed to describe the role that siblings play in foreign bodies of the head and neck and to recognize situations in which children are most at risk for foreign bodies. Any child or adolescent (0 to 17 years old) with a foreign body removed from the head or neck was included. The data collected included location of the foreign body, location of acquisition (e.g., home), and the number of and ages of siblings. Controls were matched by age, sex, and location of removal (clinic, operating room, or emergency department)...
September 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28930956/implications-of-the-trauma-quality-improvement-project-inclusion-of-nonsurvivable-injuries-in-performance-benchmarking
#2
Jiselle Bock Heaney, Rebecca Schroll, Jennifer Turney, Lance Stuke, Alan B Marr, Patrick Greiffenstein, Rosemarie Robledo, Amanda Theriot, Juan Duchesne, John Hunt
BACKGROUND: The Trauma Quality Improvement Project (TQIP) uses an injury prediction model for performance benchmarking. We hypothesize that at a Level I high-volume penetrating trauma center, performance outcomes will be biased due to inclusion of patients with nonsurvivable injuries. METHODS: Retrospective chart review was conducted for all patients included in the institutional TQIP analysis from 2013 to 2014 with length of stay (LOS) less than 1 day to determine survivability of the injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#3
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28929478/defining-a-risk-informed-framework-for-whole-of-government-lessons-learned-a-canadian-perspective
#4
Shaye K Friesen, Shelley Kelsey, J A Jim Legere
Lessons learned play an important role in emergency management (EM) and organizational agility. Virtually all aspects of EM can derive benefit from a lessons learned program. From major security events to exercises, exploiting and applying lessons learned and "best practices" is critical to organizational resilience and adaptiveness. A robust lessons learned process and methodology provides an evidence base with which to inform decisions, guide plans, strengthen mitigation strategies, and assist in developing tools for operations...
July 2017: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/28929477/superstorm-sandy-emergency-management-staff-perceptions-of-impact-and-recommendations-for-future-preparedness-new-york-state
#5
Adam Yanson, Asante Shipp Hilts, Stephanie Mack, Millicent Eidson, Trang Nguyen, Guthrie Birkhead
OBJECTIVE: This study collected and summarized feedback from staff at the New York State (NYS) Office of Emergency Management (OEM) and three county OEMs within NYS to understand lessons learned from the 2012 Superstorm Sandy. DESIGN: Cross-sectional qualitative and quantitative analysis. SUBJECTS, PARTICIPANTS: One staff person from each identified critical role from the state and county OEMs who were still employed in the roles identified...
July 2017: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/28926505/do-all-clavicle-fractures-in-children-need-to-be-managed-by-orthopedic-surgeons
#6
John Adamich, Andrew Howard, Mark Camp
OBJECTIVES: Although many uncomplicated pediatric fractures do not require routine long-term follow-up with an orthopedic surgeon, practitioners with limited experience dealing with pediatric fractures will often defer to a strategy of frequent clinical and radiographic follow-up. Development of an evidence-based clinical care pathway can help unnecessary radiation exposure to this patient population and reduce costs to patient families and the health care system. METHODS: A retrospective analysis including patients who presented to the Hospital for Sick Children (SickKids) for management of clavicle fractures was performed...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28926210/clinical-relevance-of-retinal-structure-in-children-with-laser-treated-retinopathy-of-prematurity-versus-controls-using-optical-coherence-tomography
#7
Florina Stoica, Adela Chirita-Emandi, Nicoleta Andreescu, Alina Stanciu, Cristian G Zimbru, Maria Puiu
PURPOSE: We aimed to assess the macular anatomy using spectral domain optical coherence tomography (SD-OCT), in children born preterm who had laser-treated retinopathy of prematurity (ROP), and to investigate the relationship between structural changes in macula and visual function. METHODS: Thirty-seven 3-8 years old children were included in the study in two groups: 20 children born preterm [(<34 weeks of gestation, birthweight (BW) <2000 g)] who had laser-treated ROP in the Neonatology Department, Municipal Clinical Emergency Hospital of Timisoara, Romania; and 17 controls (children born at term, without eye disease, matched for age and gender)...
September 19, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#8
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVE: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28925587/lessons-learned-from-the-development-and-parameterization-of-a-computer-simulation-model-to-evaluate-task-modification-for-healthcare-providers
#9
Parastu Kasaie, W David Kelton, Rachel M Ancona, Michael J Ward, Craig M Froehle, Michael S Lyons
Computer simulation is a highly advantageous method for understanding and improving healthcare operations with a wide variety of possible applications. Most computer-simulation studies in emergency medicine have sought to improve allocation of resources to meet demand, or to assess the impact of hospital and other system policies on emergency department (ED) throughput. These models have enabled essential discoveries that can be used to improve the general structure and functioning of EDs. Theoretically, computer simulation could also be used to examine the impact of adding or modifying specific provider tasks...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28919522/the-incidence-of-ischemic-colitis-after-repair-of-ruptured-abdominal-aortic-aneurysms-is-decreasing-in-the-endovascular-era
#10
S K Desikan, N Singh, S R Steele, N Tran, E Quiroga, P Danaher, B T Garland, B W Starnes
OBJECTIVE: Ischemic colitis (IC) is a well-described complication of ruptured abdominal aortic aneurysms (rAAA). The purpose of this study was to compare the incidence of IC in patients with rAAA undergoing open (OR) vs. endovascular aneurysm repair (EVAR) at a single institution. In addition, we analyzed the incidence of ischemic colitis pre- and post- implementation of a formal rupture AAA protocol (rEVAR protocol). METHODS: A retrospective analysis of prospectively collected data on all patients presenting with rAAA to our institution between Jan 2002 and Oct 2013 was performed...
September 14, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28918905/raising-suspicion-of-mistreatment-from-burns-derivation-and-validation-of-the-burn-tool
#11
Alison M Kemp, Linda Hollén, Alan M Emond, Diane Nuttall, David Rea, Sabine Maguire
BACKGROUND: 10-25% of childhood burns arise from mistreatment. AIM: To derive and validate a clinical prediction tool to assist the recognition of suspected maltreatment. METHODS: Prospectively collected data from 1327 children with burns were analyzed using logistic regression. Regression coefficients for variables associated with 'referral for child maltreatment investigation' (112 cases) in multivariable analyses were converted to integers to derive the BuRN-Tool, scoring each child on a continuous scale...
September 14, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28918297/a-rare-case-of-spontaneous-rupture-of-an-aneurysm-of-the-right-gastric-artery
#12
Yu-Ki Takemoto, Nobuaki Fujikuni, Kazuaki Tanabe, Hironobu Amano, Toshio Noriyuki, Masahiro Nakahara
BACKGROUND: Visceral artery aneurysms at the origin of the gastric and gastroepiploic artery are uncommon. Raptured visceral aneurysms cause high mortality and require urgent and adequate intervention and treatment. PRESENTATION OF CASE: A 65-year-old woman was transferred to the emergency department with sudden abdominal and back pain. Radiographically, we diagnosed intra-abdominal bleeding due to a ruptured aneurysm of the right gastric artery. Although her vital signs were relatively stable, transcatheter arterial embolization (TAE) could not be performed due to thrombotic occlusion of her abdominal aorta, and bilateral axillary arteries...
September 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28916325/what-is-the-incidence-of-implant-malpositioning-and-revision-surgery-after-orbital-repair
#13
Fabian Schlittler, Andre Schmidli, Franca Wagner, Chantal Michel, Matthias Mottini, Olivier Lieger
PURPOSE: Postoperative radiographic examinations are the gold standard in maxillofacial surgery, except in orbital reconstruction. Therefore, the purpose of this study was to estimate the frequency of implant malposition and revision operation after orbital repair. MATERIALS AND METHODS: This retrospective cohort study was conducted in a level I trauma center at the University Hospital in Bern, Switzerland. To assess the incidence of malpositioning, a qualitative analysis of postoperative computed tomography scans, as well as comparative volumetric measurements of the orbits, was conducted...
August 23, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28915258/rapid-emergency-medicine-score-a-novel-prognostic-tool-for-predicting-the-outcomes-of-adult-patients-with-hepatic-portal-venous-gas-in-the-emergency-department
#14
Chen-June Seak, David Hung-Tsang Yen, Chip-Jin Ng, Yon-Cheong Wong, Kuang-Hung Hsu, Joanna Chen-Yeen Seak, Hsien-Yi Chen, Chen-Ken Seak
OBJECTIVE: This study aims to evaluate the performance of Rapid Emergency Medicine Score (REMS), Rapid Acute Physiology Score (RAPS), and Modified Early Warning Score (MEWS) in ascertaining the severity of illness and predicting the mortality of adult hepatic portal venous gas (HPVG) patients presenting to the emergency department (ED). This will assist emergency physicians (EPs) in risk stratification. METHODS: Data for 66 adult HPVG patients who visited the EDs of 2 research hospitals between October 1999 and April 2016 were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28911896/patient-selection-and-outcomes-of-transfemoral-transcatheter-aortic-valve-replacement-performed-with-monitored-anesthesia-care-versus-general-anesthesia
#15
Saroj Pani, John Cagino, Paul Feustel, Sridhar Reddy Musuku, Asim Raja, Natalie Bruno, Christopher Ursillo, Nathapong Arunakul, Constantine M Poulos, Michael Welljams-Dorof, Kevin Roberts, Mikhail Torosoff, Augustine Delago
OBJECTIVE: The aim of this study was to compare outcomes of monitored anesthesia care (MAC) versus general anesthesia (GA) for transfemoral transcatheter aortic valve replacement (TF-TAVR) and to describe a selection process for the administration of MAC. DESIGN: Retrospective analysis of patients who underwent TF-TAVR under MAC or GA. SETTING: Department of Cardiac Anesthesia, Albany Medical Center, a tertiary university hospital. PARTICIPANTS: Patients selected for TF-TAVR...
April 5, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28905252/human-and-equipment-resources-for-difficult-airway-management-airway-education-programs-and-capnometry-use-in-japanese-emergency-departments-a-nationwide-cross-sectional-study
#16
Yuko Ono, Koichi Tanigawa, Kazuaki Shinohara, Tetsuhiro Yano, Kotaro Sorimachi, Ryota Inokuchi, Jiro Shimada
BACKGROUND: Although human and equipment resources, proper training, and the verification of endotracheal intubation are vital elements of difficult airway management (DAM), their availability in Japanese emergency departments (EDs) has not been determined. How ED type and patient volume affect DAM preparation is also unclear. We conducted the present survey to address this knowledge gaps. METHODS: This nationwide cross-sectional study was conducted from April to September 2016...
September 13, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28903813/rebooting-healthcare-information-technology-downtime-management
#17
Julie Bulson, Mark Van Dyke, Nicole Skibinski
Healthcare, like many other industries, has become reliant on technology to manage daily operations. Often, technology downtimes are managed within the information technology departments to ensure the technical staff can return the hardware or software to the end users as quickly as possible. However, if managed strictly through IT departments, such incidents lack critical communication components and an understanding of the impact on end users. This paper argues that such technological incidents need to be managed not just rapidly but also in conjunction with the emergency preparedness department...
January 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28900999/-study-on-the-relationship-between-tumor-regression-grade-and-lymph-node-regression-grade
#18
Quanquan Zhao, Chuangang Fu, Enda Yu, Wei Zhang, Ronggui Meng, Hantao Wang, Liqiang Hao, Hao Wang
OBJECTIVE: To investigate the relationship between tumor regression grade (TRG) and lymph node regression grade (LRG) after neoadjuvant chemoradiotherapy (CRT) for rectal cancer and its clinical implication. METHODS: Clinicopathological data of 176 rectal cancer patients undergoing radical excision after neoadjuvant CRT from January 2005 to December 2013 in our department were retrospectively analyzed. INCLUSION CRITERIA: (1) Radiology indicated locally advanced low rectal cancer and patients had strong desire to preserve the sphincter before neoadjuvant CRT; (2) there was no definite metastatic lesion before neoadjuvant CRT; (3) patients received whole course of neoadjuvant CRT (regular radiotherapy plus synchronous fluorouracil-like drugs chemotherapy); (4) patients underwent radical operation after neoadjuvant CRT...
September 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28898799/rare-diagnosis-of-intestinal-lipomatosis-complicated-by-intussusception-in-an-adult-a-case-report
#19
Kaitlin Kumar, Mahboub R Noori, Kishan M Patel, William Yuen, Carlos Bello
INTRODUCTION: Intestinal Lipomatosis consists of diffuse lipomas in various regions from the small to large bowel. They can remain asymptomatic or present with complications such as Intussusception. DISCUSSION: Intestinal lipomatosis complicated by Intussusception is a rare occurrence that has not been well documented. Rare condition management is difficult to approach because of the customizability each scenario requires. We hope through sharing our approach this can serve as a rough template to physicians who find themselves in a similar scenario...
September 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28895038/a-retrospective-external-validation-study-of-the-heart-score-among-patients-presenting-to-the-emergency-department-with-chest-pain
#20
Matthew Jay Streitz, Joshua James Oliver, Jessica Marie Hyams, Richard Michael Wood, Yevgeniy Mikhaylovich Maksimenko, Brit Long, Robert Michael Barnwell, Michael David April
Emergency physicians must be able to effectively prognosticate outcomes for patients presenting to the Emergency Department (ED) with chest pain. The HEART score offers a prognostication tool, but external validation studies are limited. We conducted an external retrospective validation study of the HEART score among ED patients presenting to our ED with chest pain from 1 January 2014 to 9 June 2014. We utilized chart review methodology to abstract data from each patient's electronic medical record. We collected data relevant to each of the five elements of the HEART score: history, electrocardiogram (ECG) interpretation, patient age, patient risk factors, and troponin levels...
September 11, 2017: Internal and Emergency Medicine
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