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https://www.readbyqxmd.com/read/28222456/nausea-vomiting-%C3%A2-tachycardia-%C3%A2-unintentional-weight-loss-%C3%A2-dx
#1
Daryl J Selen, Matthew P Gilbert
A 22-year-old woman presented to the emergency department (ED) with a 24-hour history of nausea, vomiting, diarrhea, generalized abdominal pain, and mild headache. She denied shortness of breath, chest pain, or anxiety, and didn't have a history of cardiac problems. The physical examination revealed tachycardia (heart rate, 135 beats/min) and a respiratory rate of 24 breaths per minute.
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28222019/practical-motives-are-prominent-in-test-ordering-in-the-emergency-department
#2
Armando van der Horst, Dennis J van de Wijngaart, Jolanda Scherrenburg, Nadine van Dijk, Pim M W Janssens
BACKGROUND: Laboratory test ordering under time pressure may impact test-ordering behavior. METHODS: To investigate the test-ordering behavior of doctors working under such pressure, we designed a questionnaire for trainees and staff in the Emergency Department (ED). This questionnaire addressed topics such as necessity of requested tests, time spent on ordering, costs and availability of tests, and the time of the day. We hypothesized that ordering behavior would be guided predominantly by the medical need of tests and aimed at identifying practical motives that also have an effect...
February 21, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28221820/risks-benefits-and-importance-of-collecting-sexual-orientation-and-gender-identity-data-in-healthcare-settings-a-multi-method-analysis-of-patient-and-provider-perspectives
#3
Allysha C Maragh-Bass, Maya Torain, Rachel Adler, Eric Schneider, Anju Ranjit, Lisa M Kodadek, Ryan Shields, Danielle German, Claire Snyder, Susan Peterson, Jeremiah Schuur, Brandyn Lau, Adil H Haider
PURPOSE: Research suggests that LGBT populations experience barriers to healthcare. Organizations such as the Institute of Medicine recommend routine documentation of sexual orientation (SO) and gender identity (GI) in healthcare, to reduce LGBT disparities. We explore patient views regarding the importance of SO/GI collection, and patient and provider views on risks and benefits of routine SO/GI collection in various settings. METHODS: We surveyed LGBT/non-LGBT patients and providers on their views on SO/GI collection...
February 21, 2017: LGBT Health
https://www.readbyqxmd.com/read/28221282/characteristics-and-triage-of-children-presenting-in-mental-health-crisis-to-emergency-departments-at-detroit-regional-hospitals
#4
Kristen Williams, Amanda R Levine, David M Ledgerwood, Alireza Amirsadri, Leslie H Lundahl
OBJECTIVES: The number of children in the United States utilizing emergency department (ED) services for psychiatric crises is increasing, and psychiatric-related ED visits disproportionately burden hospital resources. Yet, there is limited available information on the epidemiology and outcomes of pediatric mental health emergencies. The present study sought to characterize pediatric mental health-related ED presentations in a large urban center and identify factors predictive of inpatient hospitalization...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221281/first-attempt-success-longevity-and-complication-rates-of-ultrasound-guided-peripheral-intravenous-catheters-in-children
#5
Alexandra M Vinograd, Joseph J Zorc, Anthony J Dean, Mary Kate F Abbadessa, Aaron E Chen
OBJECTIVE: The aim of this study was to examine the success rates, longevity, and complications of ultrasound-guided peripheral intravenous lines (USgPIVs) placed in a pediatric emergency department. METHODS: The study analyzed 300 USgPIV attempts in an urban tertiary-care pediatric emergency department. Data regarding USgPIV placement were collected from a 1-page form completed by the clinician placing the USgPIV. The time and reason for USgPIV removal were extracted from the medical record for patients with USgPIVs admitted to the hospital...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221280/the-elusive-diagnosis-of-adolescent-systemic-lupus-erythematosus
#6
Michelino Mancini
Systemic lupus erythematosus (SLE) is an autoimmune disease affecting multiple systems, and its various symptoms are often mistaken for other diseases. This case report describes a 15-year-old girl who presented to the emergency department with complaints of diffuse abdominal pain, facial swelling, joint pain, low-grade fever, and rash. An initial autoimmune process was suspected, and, with prompt referral, a diagnosis of SLE was confirmed. This case report and discussion review the difficulty of diagnosing SLE and the importance of maintaining autoimmune diseases, such as SLE, on an emergency physician's differential...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221279/risk-factors-for-recurrent-intussusception-after-fluoroscopy-guided-air-enema
#7
Jung Heon Kim, Jong Seung Lee, Jeong Min Ryu, Kyoung Soo Lim, Won Young Kim
OBJECTIVES: The aim of this study was to identify risk factors for recurrent intussusception after a successful reduction by fluoroscopy-guided air enema, the time required for recurrence, and the association between delayed reduction and the recurrence. METHODS: Medical records of 479 consecutive children with intussusception who underwent fluoroscopy-guided air enema between January 2004 and September 2014 were reviewed. Recurrent intussusception was defined as a recurrence within 48 hours of a reduction...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28221275/changes-in-emergency-department-utilization-after-early-medicaid-expansion-in-california
#8
Lindsay M Sabik, Peter J Cunningham, Ali Bonakdar Tehrani
BACKGROUND: Medicaid expansions aim to improve access to primary care, which could reduce nonemergent (NE) use of the emergency department (ED). In contrast, Medicaid enrollees use the ED more than other groups, including the uninsured. Thus, the expected impact of Medicaid expansion on ED use is unclear. OBJECTIVES: To estimate changes in total and NE ED visits as a result of California's early Medicaid expansion under the Affordable Care Act. In addition to overall changes in the number of visits, changes by payer and safety net hospital status are examined...
February 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28221242/disseminated-intravascular-coagulation-in-emergency-department-patients-with-primary-postpartum-hemorrhage
#9
Chang Hwan Sohn, So Ra Kim, Youn-Jung Kim, Dong Woo Seo, Shin Ahn, Yoon-Seon Lee, Jae Ho Lee, Bum Jin Oh, Hye-Sung Won, Jae-Yoon Shim, Kyoung-Soo Lim, Won Young Kim
The aim of this study was to evaluate the prevalence of disseminated intravascular coagulation and to determine whether the presence of disseminated intravascular coagulation is associated with major adverse events in patients with primary postpartum hemorrhage who present to the emergency department.This retrospective case-control study was conducted in the emergency department of a university-affiliated, tertiary referral center between January 1, 2004 and December 31, 2013. Patients were classified into disseminated intravascular coagulation (disseminated intravascular coagulation score ≥ 5) and non-disseminated intravascular coagulation groups...
February 17, 2017: Shock
https://www.readbyqxmd.com/read/28221204/frequency-and-risk-factors-for-malnutrition-in-children-undergoing-general-anaesthesia-in-a-french-university-hospital
#10
Louis Gerbaud-Morlaes, Eric Frison, Florence Babre, Arnaud De Luca, Anne Didier, Maryline Borde, Brigitte Zaghet, Hélène Batoz, François Semjen, Karine Nouette-Gaulain, Raphael Enaud, Régis Hankard, Thierry Lamireau
BACKGROUND: Malnutrition is often underdiagnosed in hospitalised children, although it is associated with postoperative complications, longer hospital lengths of stay and increased healthcare-related costs. OBJECTIVE: We aimed to estimate the frequency of, and identify factors associated with, malnutrition in children undergoing anaesthesia. DESIGN: Cross-sectional observational study. SETTING: Paediatric anaesthesia department at the University Children's Hospital, Bordeaux, France...
February 17, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28220740/the-spectrum-and-outcome-of-surgical-sepsis-in-pietermaritzburg-south-africa
#11
S Green, V Y Kong, D L Clarke, B Sartorius, J Odendaal, J L Bruce, G L Laing, P Brysiewicz, W Bekker, E Harknett
BACKGROUND: Sepsis is a leading cause of morbidity and mortality worldwide, and the incidence appears to be increasing. In the resource-limited environment in low- and middle-income countries, the management of surgical sepsis (SS) continues to represent a significant portion of the workload for most general surgeons. OBJECTIVE: To describe the spectrum of SS seen at a busy emergency department, and categorise the outcomes. METHODS: The Pietermaritzburg Metropolitan Trauma Service (PMTS) and Pietermaritzburg Metropolitan Surgical Service (PMSS) in KwaZulu-Natal Province, South Africa (SA), maintain a prospective electronic registry...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28220486/cetuximab-plus-irinotecan-versus-panitumumab-in-patients-with-refractory-metastatic-colorectal-cancer-in-ontario-canada
#12
Katarzyna J Jerzak, Scott Berry, Yoo-Joung Ko, Craig Earle, Kelvin K W Chan
The addition of irinotecan to an EGFR antibody has previously been shown to improve tumor response rate and time to progression but not overall survival (OS) for refractory metastatic colorectal cancer (mCRC). We assessed the "real world" effectiveness and toxicity of the combination versus monotherapy. In Ontario, Canada universal public funding is available for either cetuximab plus irinotecan (Cmab+I) combination therapy or panitumumab (Pmab) monotherapy, only in patients with refractory non-mutated RAS mCRC...
February 21, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28220246/treatment-of-open-fractures-of-the-hand-in-the-emergency-department
#13
Nofar Ben Basat, Raviv Allon, Ahmad Nagmi, Ronit Wollstein
Current guidelines suggest early surgical treatment of open fractures. This rule in open hand fractures is not well supported and may be unpractical. Furthermore, desirable debridement and washout can be obtained in the emergency department (ED). The purpose of this study was to evaluate the relationship between the level of contamination, quality of washout in the emergency room, and the development of infection. Sixty-one patients with open fractures of the hand were retrospectively reviewed for demographic and fracture characteristics, and other complications...
February 20, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28219802/marijuana-use-trajectories-among-drug-using-youth-presenting-to-an-urban-emergency-department-violence-and-social-influences
#14
Maureen A Walton, Quyen Epstein-Ngo, Patrick M Carter, Marc A Zimmerman, Frederic C Blow, Anne Buu, Jason Goldstick, Rebecca M Cunningham
AIMS: This paper examined longitudinal marijuana use trajectories among drug-using youth presenting to the ED to inform intervention development. METHODS: Given interest in substance use and violence, this study oversampled those presenting with assault injuries. Assault-injured youth (ages 14-24) endorsing past 6-month drug use (n=349), and a sex and age proportionally-sampled comparison group (n=250) endorsing drug use, completed a baseline assessment and follow-ups at 6, 12, 18, and 24 months...
February 3, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28219617/techniques-and-outcomes-of-emergency-airway-management-in-japan-an-analysis-of-two-multicentre-prospective-observational-studies-2010-2016
#15
Yukari Goto, Tadahiro Goto, Yusuke Hagiwara, Yusuke Tsugawa, Hiroko Watase, Hiroshi Okamoto, Kohei Hasegawa
OBJECTIVES: Continuous surveillance of emergency airway management practice is imperative in improving quality of care and patient safety. We aimed to investigate the changes in the practice of emergency airway management and the related outcomes in the emergency departments (EDs) in Japan. METHODS: We conducted an analysis of the data from two prospective, observational, multicentre registries of emergency airway management-the Japanese Emergency Airway Network (JEAN)-1 and -2 Registries from April 2010 through May 2016...
February 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28219452/stop-stroke-a-brief-report-on-door-to-needle-times-and-performance-after-implementing-an-acute-care-coordination-medical-application-and-implications-to-emergency-medical-services
#16
Robert Dickson, Adrian Nedelcut, Melissa McPeek Nedelcut
OBJECTIVE: The objective of this study was to evaluate the effect of the Stop Stroke (Pulsara; Bozeman, Montana USA) medical application on door-to-needle (DTN) time in patients presenting to the emergency department (ED) with an acute ischemic stroke (AIS). METHODS: This was a retrospective cohort study of the Good Shepherd Health System (Longview, Texas USA) stroke quality improvement dashboard for a 25-month period from February 2012 through February 2014. Data analysis includes all data from Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) reportable cases receiving Tissue Plasminogen Activator (TPA) for AIS during the study period...
February 21, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28219383/the-alice-springs-hospital-readmission-prevention-project-ashrapp-a-randomised-control-trial
#17
Gabrielle Diplock, James Ward, Simon Stewart, Paul Scuffham, Penny Stewart, Carole Reeve, Lea Davidson, Graeme Maguire
BACKGROUND: Hospitals are frequently faced with high levels of emergency department presentations and demand for inpatient care. An important contributing factor is the subset of patients with complex chronic diseases who have frequent and preventable exacerbations of their chronic diseases. Evidence suggests that some of these hospital readmissions can be prevented with appropriate transitional care. Whilst there is a growing body of evidence for transitional care processes in urban, non-indigenous settings, there is a paucity of information regarding rural and remote settings and, specifically, the indigenous context...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28219189/-effects-of-phentolamine-on-haemodynamics-of-patients-with-severe-sepsis
#18
W Yang, X B Li, Y Zhou, X M Mo
Objective: To explore the effects of phentolamine on hemodynamic of patients with severe sepsis . Methods: From January 2015 to August 2016, using random number table, 59 patients with severe sepsis were divided into research group and the control group by conventional treatment in Department of Emergency, the Second People's Hospital of Nanning City. The patients of the research group were given phentolamine injection. The CI, ITBVI, EVLWI, SVRI of the patients were monitored by PICCO on 6, 12, 24, 48, 72 h before and after treatment...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28219054/frequency-and-factors-associated-with-emergency-department-attendance-for-people-with-epilepsy-in-a-rural-uk-population
#19
Jon Allard, Rohit Shankar, William Henley, Andrew Brown, Brendan McLean, Mark Jadav, Mary Parrett, Richard Laugharne, Adam J Noble, Leone Ridsdale
Attendance at UK Emergency Departments (EDs) for people with epilepsy (PWE) following a seizure can be unnecessary and costly. The characteristics of PWE attending a UK rural district ED in a 12-month period were examined to foster better understanding of relevant psycho-social factors associated with ED use by conducting cross-sectional interviews using standardized questionnaires. Of the total participants (n=46), approximately one-third of the study cohort attended ED on three or more occasions in the 12-month study period and accounted for 65% of total ED attendances reported...
February 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28218986/risk-factors-hindering-asthma-symptoms-control-in-saudi-children-and-adolescents
#20
Rabih Halwani, Alejandro Vazquez-Tello, Nour Horanieh, Said Dulgom, Zohair Al-Aseri, Nouf Al-Khamis, Zubaida Al-Sum, Hamdan Al-Jahdali, Saleh Al-Muhsen
BACKGROUND: Maintaining well control of asthma symptoms can help preventing exacerbations and its associated complications. The Asthma Control Test (ACT) can rapidly assess the effectiveness of asthma management plan and therapy. OBJECTIVE: To identify risk factors associated with uncontrolled asthma symptoms in young Saudi asthmatics (3-17 years-old). METHODS: In this cross-sectional hospital-based survey, the ACT was administered to 297 asthmatic children/adolescents, recruited at the emergency department (ED) of two major hospitals...
February 20, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
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