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Emergency department operations

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https://www.readbyqxmd.com/read/29141524/development-of-a-simple-sequential-organ-failure-assessment-score-for-risk-assessment-of-emergency-department-patients-with-sepsis
#1
Faheem W Guirgis, Michael A Puskarich, Carmen Smotherman, Sarah A Sterling, Shiva Gautam, Frederick A Moore, Alan E Jones
OBJECTIVES: Sepsis-3 recommends using the quick Sequential Organ Failure Assessment (qSOFA) score followed by SOFA score for sepsis evaluation. The SOFA is complex and unfamiliar to most emergency physicians, while qSOFA is insensitive for sepsis screening and may result in missed cases of sepsis. The objective of this study was to devise an easy-to-use simple SOFA score for use in the emergency department (ED). METHODS: Retrospective study of ED patients with sepsis with in-hospital mortality as the primary outcome...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29133324/effects-of-falls-prevention-interventions-on-falls-outcomes-for-hospitalised-adults-protocol-for-a-systematic-review-with-meta-analysis
#2
Susan C Slade, David L Carey, Anne-Marie Hill, Meg E Morris
INTRODUCTION: Falls are a major global public health problem and leading cause of accidental or unintentional injury and hospitalisation. Falls in hospital are associated with longer length of stay, readmissions and poor outcomes. Falls prevention is informed by knowledge of reversible falls risk factors and accurate risk identification. The extent to which hospital falls are prevented by evidence-based practice, patient self-management initiatives, environmental modifications and optimisation of falls prevention systems awaits confirmation...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132597/retrospective-review-of-pediatric-transport-where-do-our-patients-go-after-transport
#3
REVIEW
Emily Krennerich, Curtis G Sitler, Manish Shah, Fong Lam, Jeanine Graf
OBJECTIVE: This review describes disposition of transported children and identifies contributing factors affecting optimal patient placement. The study describes timing and patient placement indicators in transport patients to identify areas of improvement, re-education, and training. METHODS: A retrospective chart review for transports via our pediatric specialty transport team from January 1, 2012, to December 31, 2014, was performed. Patients were identified by the transport quality assurance performance improvement database, hospital electronic medical records, and transport medical records...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29131135/interhemispheric-and-infratentorial-subdural-empyema-with-preseptal-cellulitis-as-complications-of-sinusitis-a-case-report
#4
Muhammad Reza Arifianto, Achmad Zuhro Ma'ruf, Arie Ibrahim, Abdul Hafid Bajamal
Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency...
November 11, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29130608/impact-of-web-based-clinical-practice-guidelines-on-paediatric-fracture-clinics
#5
Mark W Camp, James R Barnes, Mohita Damany, Leo T Donnan
BACKGROUND: In an effort to standardize management and reduce over-treatment of uncomplicated paediatric fractures, the Victorian Pediatric Orthopaedic Network and the Royal Children's Hospital, Melbourne, created publically available web-based paediatric fracture pathways. The aim of this study was to determine the impact of web-based fracture pathways on the clinic volume at a tertiary-care paediatric fracture clinic. METHODS: A comparative retrospective review was performed at a large, urban, tertiary-care children's hospital...
November 12, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29123893/a-case-of-omental-herniation-through-the-esophageal-hiatus-successfully-treated-by-laparoscopic-surgery
#6
Koichiro Sueyoshi, Yoshiaki Inoue, Yuka Sumi, Ken Okamoto, Daisuke Azuma, Seiichiro Yoshikawa, Masaki Fukunaga, Hiroshi Tanaka
Case: We report a rare case of omental herniation through the esophageal hiatus. A 46-year-old man visited our emergency department complaining of epigastralgia. Abdominal examination revealed muscular defense and rebound tenderness in his upper abdomen. A computed tomography scan showed a fat density mass in the posterior mediastinum. A laparoscopic operation was carried out under the diagnosis of omental herniation through the esophageal hiatus. Outcome: Abdominal pain disappeared dramatically after the operation...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123605/evaluation-of-modified-alvarado-scoring-system-and-ripasa-scoring-system-as-diagnostic-tools-of-acute-appendicitis
#7
Abdullah Shuaib, Ali Shuaib, Zainab Fakhra, Bader Marafi, Khalid Alsharaf, Abdullah Behbehani
BACKGROUND: Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. Clinical scoring systems, such as the Alvarado and modified Alvarado scoring systems, were developed with the goal of reducing the negative appendectomy rate to 5%-10%. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system was established in 2008 specifically for Asian populations. The aim of this study was to compare the modified Alvarado with the RIPASA scoring system in Kuwait population...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29121051/process-evaluation-of-knowledge-transfer-across-industries-leveraging-coca-cola-s-supply-chain-expertise-for-medicine-availability-in-tanzania
#8
Erika Linnander, Christina T Yuan, Shirin Ahmed, Emily Cherlin, Kristina Talbert-Slagle, Leslie A Curry
Persistent gaps in the availability of essential medicines have slowed the achievement of global health targets. Despite the supply chain knowledge and expertise that ministries of health might glean from other industries, limited empirical research has examined the process of knowledge transfer from other industries into global public health. We examined a partnership designed to improve the availability of medical supplies in Tanzania by transferring knowledge from The Coca-Cola system to Tanzania's Medical Stores Department (MSD)...
2017: PloS One
https://www.readbyqxmd.com/read/29119470/failure-to-flow-an-exploration-of-learning-and-teaching-in-busy-multi-patient-environments-using-an-interpretive-description-method
#9
Teresa M Chan, Kenneth Van Dewark, Jonathan Sherbino, Alan Schwartz, Geoff Norman, Matthew Lineberry
INTRODUCTION: As patient volumes continue to increase, more attention must be paid to skills that foster efficiency without sacrificing patient safety. The emergency department is a fertile ground for examining leadership and management skills, especially those that concern prioritization in multi-patient environments. We sought to understand the needs of emergency physicians (EPs) and emergency medicine junior trainees with regards to teaching and learning about how best to handle busy, multi-patient environments...
November 8, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29117900/gestalt-for-shock-and-mortality-in-the-emergency-department-a-prospective-study
#10
Yan-Ling Li, Jun-Rong Mo, Nga-Man Cheng, Stewart S W Chan, Pei-Yi Lin, Xiao-Hui Chen, Colin A Graham, Timothy H Rainer
OBJECTIVE: The diagnosis of shock in patients presenting to the emergency department (ED) is often challenging. We aimed to compare the accuracy of experienced emergency physician gestalt against Li's pragmatic shock (LiPS) tool for predicting the likelihood of shock in the emergency department, using 30-day mortality as an objective standard. METHOD: In a prospective observational study conducted in an urban, academic ED in Hong Kong, adult patients aged 18years or older admitted to the resuscitation room or high dependency unit were recruited...
November 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29117650/sensitivity-and-specificity-of-feny%C3%A3-lindberg-and-teicher-scores-in-the-diagnosis-of-acute-appendicitis-in-women
#11
Zrinko Madžar, Mario Kopljar, Tomislav Madžar, Marko Mesić, Dubravka Mužina Mišić, Slaven Čiček, Mario Zovak
The aim of the study was to assess diagnostic accuracy (sensitivity and specificity) of Fenyö-Lindberg and Teicher scores for distinguishing patients that need immediate surgical treatment from the others, in a female population from an urban setting. The study prospectively included 130 female patients admitted to the emergency department with abdominal pain indicating acute appendicitis. The scores and parameters of validity were calculated and compared to definitive diagnosis. For Fenyö-Lindberg score of -17 or less, 84...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29116661/complying-with-the-emergency-medical-treatment-and-labor-act-emtala-challenges-and-solutions
#12
Charleen Hsuan, Jill R Horwitz, Ninez A Ponce, Renee Y Hsia, Jack Needleman
The Emergency Medical Treatment and Labor Act (EMTALA), which requires Medicare-participating hospitals to provide emergency care to patients regardless of their ability to pay, plays an important role in protecting the uninsured. Yet many hospitals do not comply. This study examines the reasons for noncompliance and proposes solutions. We conducted 11 semistructured key informant interviews with hospitals, hospital associations, and patient safety organizations in the Centers for Medicare and Medicaid Services region with the highest number of EMTALA complaints filed...
November 8, 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/29110733/sigmoid-volvulus-in-children-a-case-report
#13
Fayza Haider, Nabeel Al Asheeri, Barrak Ayoub, Eizat Abrar, Jawad Khamis, Hasan Isa, Husain Nasser, Fatima Al Hashimi
BACKGROUND: Sigmoid volvulus is frequently reported in the "volvulus belt" (Middle East, Africa, the Indian subcontinent, Turkey, and South America) and is the third leading cause of large bowel obstruction in North America. It is an uncommon problem in children and adolescents, and is rarely considered a diagnosis in this group. A high index of suspicion is necessary to diagnose sigmoid volvulus in children. CASE PRESENTATION: We present a 13-year-old Arabian girl who came with features suggestive of intestinal obstruction...
November 7, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29103779/is-outpatient-unicompartmental-knee-arthroplasty-safe-to-perform-at-an-ambulatory-surgery-center-a-comparative-study-of-early-post-operative-complications
#14
John P Cody, Kiel J Pfefferle, Deborah J Ammeen, Kevin B Fricka
BACKGROUND: Unicompartmental knee arthroplasty (UKA) lends itself to the outpatient surgical setting. Prior literature has established a low rate of readmission and post-operative complications when performed in a hospital outpatient setting (HOP). To our knowledge, there have been no studies comparing complications of UKA performed at an ambulatory surgery center (ASC) and those in a HOP. METHODS: We retrospectively reviewed all patients who underwent outpatient UKA by a single surgeon from 2012 to 2016...
October 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29101666/laparoscopic-appendectomy-vs-antibiotic-therapy-for-acute-appendicitis-a-propensity-score-matched-analysis-from-a-multicenter-cohort-study
#15
Gaetano Poillucci, Lorenzo Mortola, Mauro Podda, Salomone Di Saverio, Laura Casula, Chiara Gerardi, Nicola Cillara, Luigi Presenti
Acute appendicitis (AA) is among the most common causes of acute lower abdominal pain leading patients to the emergency department. Significant debate remains on whether AA should be operated or not. A propensity score-matched analysis was performed in seven Italian Hospitals, with the aim to assess safety and feasibility both nonoperative management with antibiotics (AT) and surgical therapy with appendectomy (ST) for patients with AA. Data regarding all patients discharged from the participating centers with a diagnosis of appendicitis from January 1st, 2014 to December 31st, 2014 were collected retrospectively...
November 3, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29100662/management-of-partial-fingertip-amputation-in-adults-operative-and-non-operative-treatment
#16
REVIEW
Kunal Sindhu, Steven F DeFroda, Andrew P Harris, Joseph A Gil
BACKGROUND: Hand and finger injuries account for approximately 4.8 million visits to emergency departments each year. These injuries can cause a great deal of distress for both patients and providers and are often initially encountered in urgent care clinics, community hospitals, and level one trauma centers. Tip amputation injuries vary widely in mechanism, ranging from sharp lacerations to crush injuries that present with varying degrees of contamination. The severity of damage to soft tissue, bone, arteries and nerves is dependent upon the mechanism and guides treatment decision-making...
October 31, 2017: Injury
https://www.readbyqxmd.com/read/29100592/peri-operative-emergency-department-utilization-in-inpatient-and-outpatient-medicare-laparoscopic-cholecystectomy
#17
Susan M Nedza, Donald E Fry, Michael Pine, Agnes M Reband, Pan Chen, Gregory Pine
BACKGROUND: Preoperative emergency department (ED) visits may reflect the patient's biliary disease, or may signal unstable comorbid conditions that have relevance following inpatient laparoscopic cholecystectomy (ILC) and outpatient laparoscopic cholecystectomy (OLC) in Medicare patients. METHODS: We used the Medicare inpatient and outpatient Limited Datasets to identify elective laparoscopic cholecystectomy patients from 2011 to 2014. ED visits for 30-days before the surgical event were identified and correlated with the probability of patients returning to the ED in the 30-days following the procedure...
October 24, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29099826/-governance-in-a-project-addressing-care-of-disabled-elderly-persons-within-the-regional-healthcare-system-of-tuscany-italy
#18
Claudio Pedace, Antonella Rosa, Paolo Francesconi, Anna Acampora, Walter Ricciardi, Gianfranco Damiani
Population aging and the concurrent increase of age-related chronic degenerative diseases and disability are associated with an increased proportion of elderly persons who are dependent in activities of daily living (ADL). ADL-dependent persons need continuous and long-term health and social care according to the "taking charge" rationale, in order to warrant access and continuity of care. A healthcare system needs to respond to the long-term and complex needs, such as those of disabled elderly people, by providing appropriate health and social care services in Primary Care...
July 2017: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/29099696/treatment-of-duodenal-injuries-and-complications-after-surgery-case-reports
#19
Z Beriashvili, M Gurgenidze
A 28-year-old male patient came to Surgical Department 15.07.2003 after a gunshot wound. An emergency operation was performed. Among the other damages of different part of intestinum damage of the anterior wall of the second anatomical part of the duodenum was diagnosed intraoperatively. The size of the damaged area was 3×1 sm. The doudenal wound was sutured with two layers after updating the edges. On the fifth postoperative day the wound leakage was detected. Later the giant sizes of duodenal fistula was formed...
October 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29098196/perirenal-abscess-after-partial-nephrectomy-because-of-migration-of-upper-calix-stone-and-urine-leakage-a-case-report
#20
Sheng-Chun Hung, Li-Wen Chang, Cheng-Kuang Yang
Background: Nephron-sparing surgery has been shown to achieve oncological results equivalent to those of radical nephrectomy in patients with compromised renal function who have renal tumors <4 cm. However, technical difficulties and potential surgical complications remain challenges to the surgeon. Various factors, such as tumor size and location, collecting system invasion, and patient's expectations, are major concerns that may affect the feasibility of performing an effective partial nephrectomy. We report a patient with renal cell carcinoma who underwent open partial nephrectomy and suffered from complications of perirenal abscess because of stone migration, obstruction, and subsequence urine leakage...
2017: Journal of Endourology Case Reports
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