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Emergency department operations

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https://www.readbyqxmd.com/read/29792051/predicting-suicide-attempts-and-suicide-deaths-following-outpatient-visits-using-electronic-health-records
#1
Gregory E Simon, Eric Johnson, Jean M Lawrence, Rebecca C Rossom, Brian Ahmedani, Frances L Lynch, Arne Beck, Beth Waitzfelder, Rebecca Ziebell, Robert B Penfold, Susan M Shortreed
OBJECTIVE: The authors sought to develop and validate models using electronic health records to predict suicide attempt and suicide death following an outpatient visit. METHOD: Across seven health systems, 2,960,929 patients age 13 or older (mean age, 46 years; 62% female) made 10,275,853 specialty mental health visits and 9,685,206 primary care visits with mental health diagnoses between Jan. 1, 2009, and June 30, 2015. Health system records and state death certificate data identified suicide attempts (N=24,133) and suicide deaths (N=1,240) over 90 days following each visit...
May 24, 2018: American Journal of Psychiatry
https://www.readbyqxmd.com/read/29790445/a-study-of-deficiencies-in-teamwork-skills-among-jordan-caregivers
#2
Omar Al-Araidah, Nader Al Theeb, Mariam Bader, Nabeel Mandahawi
Purpose The purpose of this paper is to present the deficiencies in teamwork skills at Jordan hospitals as seen by team members. The study aims to identify training needs to improve teamwork-related soft skills of caregivers to enhance staff satisfaction and improve quality of care. Moreover, the paper provides a methodology to identify the training needs in any healthcare workplace by repeating the same questionnaire. Design/methodology/approach A self-administrated questionnaire was designed to study deficiencies in teamwork and team leadership at Jordan hospitals as seen by team members...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29787558/a-new-weighted-injury-severity-scoring-system-better-predictive-power-for-pediatric-trauma-mortality
#3
Junxin Shi, Jiabin Shen, Sarah Caupp, Angela Wang, Kathryn E Nuss, Brian Kenney, Krista K Wheeler, Bo Lu, Henry Xiang
BACKGROUND: An accurate injury severity measurement is essential for the evaluation of pediatric trauma care and outcome research. The traditional Injury Severity Score (ISS) does not consider the differential risks of the Abbreviated Injury Scale (AIS) from different body regions nor is it pediatric specific. The objective of this study was to develop a weighted injury severity scoring (wISS) system for pediatric blunt trauma patients with better predictive power than ISS. METHODS: Based on the association between mortality and AIS from each of the six ISS body regions, we generated different weights for the component AIS scores used in the calculation of ISS...
May 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29786826/rare-case-of-bilateral-incarcerated-obturator-hernia-a-case-report
#4
Engin Hatipoğlu, Fatih Dal, Veysel Umman, Süleyman Demiryas, Oktay Demirkıran, Metin Ertem, Sabri Ergüney, Salih Pekmezci
Here, we report the case of an 84-year-old woman with acute mechanical intestinal obstruction (AMIO) who was admitted to our Emergency Department. Computed tomography (CT) scan revealed an incarcerated bilateral obturator hernia, and the defect was resolved using transabdominal preperitoneal (TAPP) technique with polypropylene mesh. The patient was administered an oral regimen two days after the operation. The patient stayed in the intensive care unit for 4 days and was uneventfully discharged on the 9th postoperative day...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29784718/opinion-and-special-articles-stress-when-performing-the-first-lumbar-puncture-may-compromise-patient-safety
#5
Mikael Johannes Vuokko Henriksen, Troels Wienecke, Jesper Kristiansen, Yoon Soo Park, Charlotte Ringsted, Lars Konge
OBJECTIVE: To quantify physician stress levels when performing lumbar puncture (LP) and explore operator stress effect on patient outcomes. METHODS: This was a cross-sectional, multicenter study. Novices, intermediates, and experts in performing LP were recruited from 4 departments of neurology and emergency medicine. Stress was measured before and during performance of the LP using cognitive appraisal (CA), State-Trait Anxiety Inventory-Short (STAI-S) questionnaire, and the heart rate variability measure low frequency/high frequency index (LF/HF ratio)...
May 22, 2018: Neurology
https://www.readbyqxmd.com/read/29784607/telestroke-adoption-among-community-hospitals-in-north-carolina-a-cross-sectional-study
#6
Christopher M Shea, Amir Alishahi Tabriz, Kea Turner, Steve North, Kristin L Reiter
OBJECTIVE: This study identifies community and hospital characteristics associated with adoption of telestroke among acute care hospitals in North Carolina (NC). METHODS: Our sample included 107 hospitals located in NC. Our analytic dataset included variables from the American Hospital Association (AHA) annual survey, AHA Health IT supplement, Healthcare Cost Report Information System, and Centers for Disease Control and Prevention's WONDER online database. We supplemented our secondary sources with data on telestroke adoption and market-level variables developed for NC...
May 18, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29782079/the-dipep-diagnosis-of-pe-in-pregnancy-study-an-observational-study-of-the-diagnostic-accuracy-of-clinical-assessment-d-dimer-and-chest-x-ray-for-suspected-pulmonary-embolism-in-pregnancy-and-postpartum
#7
Steve Goodacre, Kimberley Horspool, Catherine Nelson-Piercy, Marian Knight, Neil Shephard, Fiona Lecky, Steven Thomas, Beverley J Hunt, Gordon Fuller
OBJECTIVE: To identify clinical features associated with PE diagnosis and determine the accuracy of decision rules and D-dimer for diagnosing suspected PE in pregnant/postpartum women. DESIGN: Observational cohort study augmented with additional cases. SETTING: Emergency departments and maternity units at eleven prospectively recruiting sites and maternity units in the United Kingdom Obstetric Surveillance System (UKOSS). POPULATION: 324 pregnant/postpartum women with suspected PE and 198 pregnant/postpartum women with diagnosed PE...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29777436/fatigue-related-risk-management-in-the-emergency-department-a-focus-group-study
#8
Pierre Bérastégui, Mathieu Jaspar, Alexandre Ghuysen, Anne-Sophie Nyssen
Fatigue has major implications on both patient safety and healthcare practitioner's well-being. Traditionally, two approaches can be used to reduce fatigue-related risk: reducing the likelihood of a fatigued operator working (i.e. fatigue reduction), or reducing the likelihood that a fatigued operator will make an error (i.e. fatigue proofing). Recent progress mainly focussed on fatigue reduction strategies such as reducing work hours. Yet it has to be recognized that such approach has not wholly overcome the experience of fatigue...
May 18, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#9
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29774222/asymmetrical-traumatic-bilateral-hip-dislocations-with-hemodynamic-instability-and-an-unstable-pelvic-ring-case-report-and-review-of-literature
#10
Kai Huang, Grey Giddins, Jian-Fang Zhang, Jian-Wei Lu, Jun-Ming Wan, Peng-Li Zhang, Shao-Yu Zhu
Simultaneous anterior and posterior traumatic dislocations of both hips are very rare. Only 33 cases have been previously reported in the English language literature. Although they were all due to high-energy injuries, they were hemodynamically stable and had a stable pelvic ring. We report a unique case of asymmetrical hip dislocations with an unstable pelvic ring and hemodynamic instability. A 40-year-old man was injured in a high-energy motor vehicle accident. He was hemodynamically unstable when he presented in the emergency department...
May 16, 2018: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/29769491/management-of-traumatic-unstable-thoracolumbar-spine-conservative-versus-operative-treatment
#11
M M Rahman, N A Islam, M S Islam, M M Rahman, M A Islam, M K Alamgir, M H Sarker
Traumatic thoracolumbar spine injury result in significant instability of the spine and leads to an acute on delayed neurological deficit. Objective of the study is to find a better option in the management of unstable traumatic thoracolumbar spine with incomplete neurological lesion. This was quasi-experimental study. The study was carried out at National Institute of Traumatology & Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh from January 2006 to December 2008. A total number of 40 patients with traumatic thoracolumbar spine injuries with incomplete neurological lesion were selected purposively...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29769024/hems-inter-facility-transfer-a-case-mix-analysis
#12
Damien Di Rocco, Mathieu Pasquier, Eric Albrecht, Pierre-Nicolas Carron, Fabrice Dami
BACKGROUND: Helicopter emergency medical services (HEMS) are popular rescue systems despite inconsistent evidence in the scientific literature to support their use for primary interventions, as well as for inter-facility transfer (IFT). There is little research about IFT by HEMS, hence questions remain about the appropriateness of this method of transport. The aim of this study was to describe a case-mix of operational and medical characteristics for IFT activity of a sole HEMS base, and identify indicators of over-triage...
May 16, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29768927/ultrasonographic-optic-nerve-sheath-diameter-to-detect-increased-intracranial-pressure-in-adults-a-meta-analysis
#13
Sung-Eun Kim, Eun Pyo Hong, Heung Cheol Kim, Si Un Lee, Jin Pyeong Jeon
Background The optimal optic nerve sheath diameter (ONSD) cut-off for identifying increased intracranial pressure (IICP) remains unclear in adult patients. Purpose To validate the diagnostic accuracy of ultrasonographic (US) ONSD > 5.0 mm as a cut-off for detecting IICP by computed tomographic (CT) through a meta-analysis. Material and Methods A systemic literature review was performed of online databases from January 1990 to September 2017. A bivariate random-effects model was used to estimate pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence intervals (CIs)...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29768470/integrative-omics-to-detect-bacteremia-in-patients-with-febrile-neutropenia
#14
Rachel S Kelly, Jessica Lasky-Su, Sai-Ching J Yeung, Richard M Stone, Jeffrey M Caterino, Sean C Hagan, Gary H Lyman, Lindsey R Baden, Brett E Glotzbecker, Christopher J Coyne, Christopher W Baugh, Daniel J Pallin
BACKGROUND: Cancer chemotherapy-associated febrile neutropenia (FN) is a common condition that is deadly when bacteremia is present. Detection of bacteremia depends on culture, which takes days, and no accurate predictive tools applicable to the initial evaluation are available. We utilized metabolomics and transcriptomics to develop multivariable predictors of bacteremia among FN patients. METHODS: We classified emergency department patients with FN and no apparent infection at presentation as bacteremic (cases) or not (controls), according to blood culture results...
2018: PloS One
https://www.readbyqxmd.com/read/29768401/near-real-time-forecasting-for-cholera-decision-making-in-haiti-after-hurricane-matthew
#15
Damiano Pasetto, Flavio Finger, Anton Camacho, Francesco Grandesso, Sandra Cohuet, Joseph C Lemaitre, Andrew S Azman, Francisco J Luquero, Enrico Bertuzzo, Andrea Rinaldo
Computational models of cholera transmission can provide objective insights into the course of an ongoing epidemic and aid decision making on allocation of health care resources. However, models are typically designed, calibrated and interpreted post-hoc. Here, we report the efforts of a team from academia, field research and humanitarian organizations to model in near real-time the Haitian cholera outbreak after Hurricane Matthew in October 2016, to assess risk and to quantitatively estimate the efficacy of a then ongoing vaccination campaign...
May 16, 2018: PLoS Computational Biology
https://www.readbyqxmd.com/read/29766136/can-necrotizing-soft-tissue-infection-be-reliably-diagnosed-in-the-emergency-department
#16
Sharon M Henry, Kimberly A Davis, Jonathan J Morrison, Thomas M Scalea
Necrotizing soft tissue infections (NSTIs) are associated with a high mortality and require prompt recognition and treatment, consisting of aggressive surgical debridement and critical care support. Diagnosis is a key step, which is generally made in the operating room (OR), but the decision to debride requires guidance. This is frequently made on clinical grounds, but NSTI can be occult in presentation and several other infective processes can mimic NSTI. It is unknown whether the various scoring systems described in the literature can enable clinicians to reliably diagnose NSTI in the emergency department, rather than the OR...
2018: Trauma Surg Acute Care Open
https://www.readbyqxmd.com/read/29766127/grey-s-anatomy-effect-television-portrayal-of-patients-with-trauma-may-cultivate-unrealistic-patient-and-family-expectations-after-injury
#17
Rosemarie O Serrone, Jordan A Weinberg, Pamela W Goslar, Erin P Wilkinson, Terrell M Thompson, Jonathan L Dameworth, Shawna R Dempsey, Scott R Petersen
Background: Expectations of the healthcare experience may be influenced by television dramas set in the hospital workplace. It is our perception that the fictional television portrayal of hospitalization after injury in such dramas is misrepresentative. The purpose of this study was to compare trauma outcomes on television dramas versus reality. Methods: We screened 269 episodes of Grey's Anatomy , a popular medical drama. A television (TV) registry was constructed by collecting data for each fictional trauma portrayed in the television series...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29764844/second-look-laparostomy-for-perforated-gangrenous-gastric-volvulus-to-prevent-total-gastrectomy
#18
Paul K Okeny, Omar Abbassi, Ali Warsi
A 42-year-old Caucasian woman presented to the emergency department with severe upper abdominal pain and vomiting. Clinically, she was septic, and abdominal examination suggested peritonitis. Following immediate resuscitation, the patient was stabilised and underwent urgent contrast-enhanced CT of the abdomen and pelvis. This revealed a mesenteroaxial gastric volvulus with traction on the mesentery and a small volume of free fluid. She underwent laparotomy revealing gangrenous gastric fundus perforation complicated by persistent intraoperative hypotension...
May 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29764735/risk-factors-for-acute-pancreatitis-in-patients-with-accidental-hypothermia
#19
Hiroyuki Inoue, Shuji Uemura, Keisuke Harada, Hirotoshi Mizuno, Naofumi Bunya, Kazuhito Nomura, Ryuichiro Kakizaki, Eichi Narimatsu
BACKGROUND: Pancreatic damage is commonly observed as a consequence of accidental hypothermia (core body temperature below 35 °C). We aimed to investigate the risk factors for pancreatic damage and the causal relationship in patients with accidental hypothermia. METHODS: This retrospective, single-center, observational case-control study was conducted in the emergency department of a tertiary care medical center. We investigated patients who were admitted for accidental hypothermia over a course of ten years (January 2008 to December 2017)...
May 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29764553/-interposed-abdominal-pulling-pressing-cardiopulmonary-resuscitation-improve-the-resuscitation-effect-for-patients-with-cardiac-arrest
#20
Dabing Wang, Xiaonan Feng, Yujuan Han
OBJECTIVE: To study the impact of interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) for patients with cardiac arrest (CA). METHODS: A prospective study was conducted. A total of 122 CA patients admitted to Department of Emergency of Shandong Provincial Mining Industry Group Company Central Hospital from July 2013 to December 2017 were enrolled. They were divided into standard cardiopulmonary resuscitation (S-CPR) group (n = 62) and IAPP-CPR group (n = 60) according to order of admission...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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