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https://www.readbyqxmd.com/read/28930950/increased-mortality-in-trauma-patients-who-develop-postintubation-hypotension
#1
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Postintubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada, between 2000 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28929860/adolescent-perspectives-on-patient-provider-sexual-health-communication-a-qualitative-study
#2
Andrea J Hoopes, Samantha K Benson, Heather B Howard, Diane M Morrison, Linda K Ko, Taraneh Shafii
BACKGROUND: Adolescents in the United States are disproportionately affected by sexually transmitted infections and unintended pregnancy. Adolescent-centered health services may reduce barriers to health care; yet, limited research has focused on adolescents' own perspectives on patient-provider communication during a sexual health visit. METHODS: Twenty-four adolescents (14-19 years old) seeking care in a public health clinic in Washington State participated in one-on-one qualitative interviews...
September 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28929609/benchmarking-against-the-national-emergency-laparotomy-audit-recommendations
#3
Yiu Ming Ho, Julie Cappello, Ramin Kousary, Brian McGowan, Arkadiusz P Wysocki
BACKGROUND: The Royal College of Anaesthetists published the National Emergency Laparotomy Audit (NELA) to describe and compare inpatient care and outcomes of major emergency abdominal surgery in England and Wales in 2015 and 2016. The purpose of this article is to compare emergency abdominal surgical care and mortality in a regional hospital (Logan Hospital, Queensland, Australia) with NELA results. METHODS: Data were extracted from two databases. All deaths from May 2010 to April 2015 were reviewed and patients who had an emergency abdominal operation within 30 days of death were identified...
September 19, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28928227/community-based-noncommunicable-disease-care-for-syrian-refugees-in-lebanon
#4
Stephen Sethi, Rebecka Jonsson, Rony Skaff, Frank Tyler
In the sixth year of the Syrian conflict, 11 million people have been displaced, including more than 1.1 million seeking refuge in Lebanon. Prior to the crisis, noncommunicable diseases (NCDs) accounted for 80% of all deaths in Syria, and the underlying health behaviors such as tobacco use, obesity, and physical inactivity are still prevalent among Syrian refugees in Lebanon. Humanitarian agencies initially responded to the acute health care needs of refugees by delivering services to informal settlements via mobile medical clinics...
September 19, 2017: Global Health, Science and Practice
https://www.readbyqxmd.com/read/28925418/mhealth-application-areas-and-technology-combinations-a-comparison-of-literature-from-high-and-low-middle-income-countries
#5
Haitham Abaza, Michael Marschollek
BACKGROUND: With the continuous and enormous spread of mobile technologies, mHealth has evolved as a new subfield of eHealth. While eHealth is broadly focused on information and communication technologies, mHealth seeks to explore more into mobile devices and wireless communication. Since mobile phone penetration has exceeded other infrastructure in low and middle-income countries (LMICs), mHealth is seen as a promising component to provide pervasive and patient-centered care. OBJECTIVES: The aim of our research work for this paper is to examine the mHealth literature to identify application areas, target diseases, and mHealth service and technology types that are most appropriate for LMICs...
August 8, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28925344/prehospital-response-time-delays-for-emergency-patients-in-events-of-concurrent-mass-casualty-incidents
#6
Jungeun Kim, Chu Hyun Kim, Sang Do Shin, Ju Ok Park
OBJECTIVE: We investigated the extent of delays in the response time of emergency medical services (EMS) as an impact of mass casualty incidences (MCIs) in the same area. METHODS: We defined an MCI case as an event that resulted in 6 or more patients being transported by EMS, and prehospital response time as the time from the call to arrival at the scene. We matched patients before and after MCIs by dividing them into categories of 3 hours before, 0-1 hour after, 1-2 hours after, and 2-3 hours after the MCIs...
September 19, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28924623/the-effectiveness-of-pharmacist-provided-telephonic-medication-therapy-management-on-emergency-department-utilization-in-home-health-patients
#7
Stephanie A Gernant, Margie E Snyder, Heather Jaynes, Jason M Sutherland, Alan J Zillich
BACKGROUND: Preventable emergency department (ED) use may be targeted with interventions for improving the medication use process, as medication misadventures and non-adherence frequently cause preventable ED utilization. One intervention that could prevent ED visits is Medication Therapy Management (MTM). OBJECTIVE: To evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing emergency department utilization within a Medicare insured home health population...
October 1, 2016: Journal of Pharmacy Technology: JPT: Official Publication of the Association of Pharmacy Technicians
https://www.readbyqxmd.com/read/28922992/policy-maker-attitudes-to-the-ageing-of-the-hiv-cohort-in-botswana
#8
Kabo Matlho, Refelwetswe Lebelonyane, Tim Driscoll, Joel Negin
BACKGROUND: The roll out of antiretroviral therapy in Botswana, as in many countries with near universal access to treatment, has transformed HIV into a complex yet manageable chronic condition and has led to the emergence of a population aging with HIV. Although there has been some realization of this development at international level, no clear defined intervention strategy has been established in many highly affected countries. Therefore we explored attitudes of policy-makers and service providers towards HIV among older adults (50 years or older) in Botswana...
December 2017: SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance
https://www.readbyqxmd.com/read/28922625/living-and-dying-with-advanced-dementia-a-prospective-cohort-study-of-symptoms-service-use-and-care-at-the-end-of-life
#9
Elizabeth L Sampson, Bridget Candy, Sarah Davis, Anna Buylova Gola, Jane Harrington, Michael King, Nuriye Kupeli, Gerry Leavey, Kirsten Moore, Irwin Nazareth, Rumana Z Omar, Victoria Vickerstaff, Louise Jones
BACKGROUND: Increasing number of people are dying with advanced dementia. Comfort and quality of life are key goals of care. AIMS: To describe (1) physical and psychological symptoms, (2) health and social care service utilisation and (3) care at end of life in people with advanced dementia. DESIGN: 9-month prospective cohort study. SETTING AND PARTICIPANTS: Greater London, England, people with advanced dementia (Functional Assessment Staging Scale 6e and above) from 14 nursing homes or their own homes...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28921763/implementation-and-preliminary-clinical-outcomes-of-a-pharmacist-managed-venous-thromboembolism-clinic-for-patients-treated-with-rivaroxaban-post-emergency-department-discharge
#10
Baely M DiRenzo, Daren M Beam, Jeffrey A Kline, Karishma S Deodhar, Christina M Davis, Zachary A Weber, Todd A Walroth
OBJECTIVE: To describe the implementation, work flow, and differences in outcomes between a pharmacist-managed clinic for the outpatient treatment of venous thromboembolism (VTE) using rivaroxaban versus care by a primary care provider. INTERVENTIONS: Patients in the studied health system that are diagnosed with low-risk VTE in the emergency department are often discharged without hospital admission. These patients are treated with rivaroxban and follow up either in a pharmacist-managed VTE clinic or with their primary care provider...
September 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28921731/inter-observer-agreement-in-pediatric-cervical-spine-injury-assessment-between-prehospital-and-emergency-department-providers
#11
Lorin R Browne, Hamilton Schwartz, Fahd A Ahmad, Michael Wallendorf, Nathan Kuppermann, E Brooke Lerner, Julie C Leonard
BACKGROUND: Investigators have derived cervical spine injury (CSI) decision support tools from physician observations. There is a need to demonstrate that prehospital emergency medical services (EMS) providers can use these tools to appropriately determine the need for spinal motion restrictions and make field disposition decisions. OBJECTIVE: To determine the inter-observer agreement between EMS and emergency department (ED) providers for CSI risk assessment variables and overall gestalt for CSI in children after blunt trauma...
September 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28919592/the-study-on-the-lives-and-health-conditions-of-internees-in-santo-thomas-camp-of-philippines-based-on-mcanlis-s-the-war-in-manila-1941-1945
#12
Jueyeon Lee, Youngsoo Cho
When Japan invaded the Philippines, two missionary dentists (Dr. McAnlis and Dr. Boots) who were forced to leave Korea were captured and interned in the Santo Thomas camp in Manila. Japan continued to bombard and plunder the Philippines in the wake of the Pacific War following the Great East Asia policy, leading to serious inflation and material deficiency. More than 4,000 Allied citizens held in Santo Thomas camp without basic food and shelter. Santo Thomas Camp was equipped with the systems of the Japanese military medical officers and Western doctors of captivity based on the Geneva Conventions(1929)...
August 2017: Ŭi Sahak
https://www.readbyqxmd.com/read/28919404/emergency-in-the-clinic-a-simulation-curriculum-to-improve-outpatient-safety
#13
Eve Espey, Gillian Baty, John Rask, Michelle Chungtuyco, Brenda Pereda, Lawrence Leeman
BACKGROUND: Emergency response skills are essential when events such as seizure, anaphylaxis or hemorrhage occur in the outpatient setting. As services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. OBJECTIVE: The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy...
September 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28917169/short-term-associations-of-ambient-air-pollution-and-cause-specific-emergency-department-visits-in-guangzhou-china
#14
Pi Guo, Wenru Feng, Murui Zheng, Jiayun Lv, Li Wang, Ju Liu, Yanhong Zhang, Gangfeng Luo, Yanting Zhang, Changyu Deng, Tongxing Shi, Pengda Liu, Lin Zhang
BACKGROUND: Evidence of association of ambient air pollution with cause-specific emergency department visits in China is still limited. This study aimed to investigate short-term associations between exposures to air pollutants and daily cause-specific emergency department visits using a large-scale multicenter database involving a total of 65 sentinel hospitals in Guangzhou, the most densely-populated city in south China, during 2013-2015. MATERIAL AND METHODS: We obtained data on 162,771 emergency department visits from 65 hospitals from the Emergency Medical Command Center in Guangzhou between January 1, 2013 and December 31, 2015...
September 13, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28916666/regional-evaluation-of-the-severity-based-stroke-triage-algorithm-for-emergency-medical-services-using-discrete-event-simulation
#15
Brittany M Bogle, Andrew W Asimos, Wayne D Rosamond
BACKGROUND AND PURPOSE: The Severity-Based Stroke Triage Algorithm for Emergency Medical Services endorses routing patients with suspected large vessel occlusion acute ischemic strokes directly to endovascular stroke centers (ESCs). We sought to evaluate different specifications of this algorithm within a region. METHODS: We developed a discrete event simulation environment to model patients with suspected stroke transported according to algorithm specifications, which varied by stroke severity screen and permissible additional transport time for routing patients to ESCs...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28916174/evaluation-of-beat-to-beat-ventricular-repolarization-lability-from-standard-12-lead-ecg-during-acute-myocardial-ischemia
#16
Salah S Al-Zaiti, Mohammad Alrawashdeh, Christian Martin-Gill, Clifton Callaway, David Mortara, Jan Nemec
BACKGROUND: Acute myocardial ischemia is a common cause of ventricular arrhythmias, yet recent ECG methods predicting susceptibility to ventricular tachyarrhythmia have not been fully evaluated during spontaneous ischemia. We sought to evaluate the clinical utility of alternans and non-alternans components of repolarization variability from the standard 10-second 12-lead ECG signals to risk stratify patients with acute chest pain. METHODS: We enrolled consecutive, non-traumatic, chest pain patients transported through Emergency Medical Services (EMS) to three tertiary care hospitals with cardiac catheterization lab capabilities in Pittsburgh, PA...
August 10, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28915898/physician-staffed-helicopter-emergency-medical-service-has-a-beneficial-impact-on-the-incidence-of-prehospital-hypoxia-and-secured-airways-on-patients-with-severe-traumatic-brain-injury
#17
Toni Pakkanen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Jouni Nurmi, Ilkka Virkkunen, Arvi Yli-Hankala
BACKGROUND: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. METHODS: This was a retrospective cohort study...
September 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28915212/22-cases-of-bia-alcl-awareness-and-outcome-tracking-from-the-italian-ministry-of-health
#18
Campanale Antonella, Boldrini Rosaria, Marletta Marcella
BACKGROUND: To date, 359 cases of anaplastic large cell lymphoma in women with breast implants (BIA-ALCL) worldwide have been reported out of more than 10 million implanted patients but Health Care Authorities suspect this is a possible underestimation and the limited number of cases makes it difficult to clarify its etiology. The General Directorate of Medical Devices and Pharmaceutical Services of the Italian Ministry of Health (IMoH) has examined and studied the Italian BIA-ALCL cases, and the aim of this study is to report on the knowledge and experience gained on this new emerging disease...
September 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28914683/primum-non-nocere-and-the-5-rights
#19
Gabriele Popp, Dick Clarke, Stephen Rothstein
Overutilization of hyperbaric oxygen therapy (HBOT) is commonplace and primarily associated with outpatient wound care. While the number of hospitals providing HBOT is at an all-time high, the number of those willing to treat patients in immediate need is at an all-time low. Huge areas of the country, including major population areas, are now completely devoid of 24/7 HBOT availability and inpatient access. Purchasers of healthcare, including the Centers for Medicare and Medicaid Services, have become increasingly concerned to the point that several strategies have been introduced to constructively deal with this issue...
October 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28913974/impact-of-ladder-related-falls-on-the-emergency-department-and-recommendations-for-ladder-safety
#20
C J Cabilan, Kirsten Vallmuur, Rob Eley, Chantelle Judge, Sarah Cochrane, Connie Reed, Jessica Riordan, Kym Roberts, Ogilvie Thom, Gabriella Wood
OBJECTIVES: To describe the characteristics of patients who presented to the ED from a ladder-related fall and their injuries, highlight the impact of ladder-related falls on the ED, identify contributing factors of ladder falls and draw recommendations to improve ladder safety. METHODS: A prospective observational study was conducted in two EDs. Patients' demographics and ED services used were obtained from medical records. A 53-item questionnaire was used to gather information about the type of ladder used, ladder activity, circumstances of the fall, contributing factors and future recommendations...
September 14, 2017: Emergency Medicine Australasia: EMA
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