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https://www.readbyqxmd.com/read/29054018/isolated-aphasia-in-the-emergency-department-the-likelihood-of-ischemia-is-low
#1
Gabriel Casella, Rafael H Llinas, Elisabeth B Marsh
OBJECTIVE: Aphasia is a common presentation of ischemic stroke, often diagnosed in the acute setting using tools such as the NIH Stroke Scale (NIHSS). Due to the vascular distribution of the middle cerebral artery, it is often accompanied by other symptoms such as weakness, sensory loss, or visual changes. Isolated aphasia due to ischemia is possible, but language problems mimicking aphasia syndromes can also be seen with other diagnoses such as metabolic abnormalities or dementia. In this study, we determine the incidence of aphasia-only strokes using the NIHSS, and factors associated with a higher likelihood of ischemia...
October 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29053543/decreased-time-to-antibiotic-prophylaxis-for-open-fractures-at-a-level-one-trauma-center
#2
Joey P Johnson, Avi D Goodman, Adam M Haag, Roman A Hayda
OBJECTIVE: To determine whether time to administration of antibiotics decreased after the implementation of an open fracture working group and antibiotic prophylaxis protocol. DESIGN: Retrospective cohort study. SETTING: One Level 1 Trauma Center. PATIENTS: Patients 18 years of age and older who sustained an open fracture and presented directly to our emergency department. INTERVENTION: Prompt irrigation and debridement in the operating room and fracture stabilization dictated by the treating surgeon...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053521/smartphone-based-patient-education-in-plastic-surgery
#3
Warren Noel, Romain Bosc, Samer Jabbour, Elio Kechichian, Barbara Hersant, Jean-Paul Meningaud
BACKGROUND: Internet use for health information has dramatically increased in the past decade. Mobile medical applications (MMAs) could be a useful tool to improve postoperative patient education and care. The objective of this study is to evaluate the impact of an MMA on patient care in plastic surgery. METHODS: An MMA was developed to improve postoperative plastic surgery patients care. All patients who underwent surgery at our plastic surgery department between August and November 2014 and were willing to download the MMA were included...
October 19, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29052835/role-of-percutaneous-transhepatic-biliary-drainage-in-the-management-of-blunt-liver-trauma-a-case-report
#4
Şükrü Oğuz, Reyyan Yıldırım, Serdar Topaloğlu
The liver is the most commonly injured intra-abdominal organ after blunt trauma. The management of massive liver injury is complex. Percutaneous transhepatic biliary drainage is the first approach considered, particularly for proximal bile duct strictures after liver surgery. A 27-year-old female patient was transferred to our emergency department with grade V blunt injury. Regarding the patient's unresponsive hemodynamic instability, right hepatectomy was performed. The patient presented with benign biliary duct stricture after surgery that were treated via the percutaneous approach...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29052830/diaphragmatic-rupture-a-single-institution-experience-and-literature-review
#5
Carlo Corbellini, Stefano Costa, Tiberio Canini, Roberta Villa, Ettore Contessini Avesani
BACKGROUND: Diaphragmatic rupture (DR) is a rare and potentially life-threatening event caused by trauma or spontaneously. DR occasionally occurs several months after the injury. Chest X-ray and computed tomography are the most effective diagnostic methods. Delay in DR diagnosis occurs frequently. This study aimed to examine and improve our understanding of the etiology, clinical presentation, and management of DR. METHODS: This study was performed at the Emergency and General Surgery Department of Fondazione I...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29052823/can-we-predict-mortality-in-patients-with-necrotizing-fasciitis-using-conventional-scoring-systems
#6
Necdet Fatih Yaşar, Mustafa Ufuk Uylaş, Bartu Badak, Uğur Bilge, Setenay Öner, Enver İhtiyar, Tarık Çağa, Ercüment Paşaoğlu
BACKGROUND: This study compared the predictive accuracy of four scoring systems, namely Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score II (SAPS II), and Mortality in Emergency Department (MEDS), for estimating prognosis in patients with necrotizing fasciitis. METHODS: Seventy-four patients who presented with necrotizing fasciitis were retrospectively examined. The ability of the scoring systems to predict mortality was assessed by comparing the estimated mortality rates in mortality groups (survivors/non-survivors), and mortality rates among survivors and non-survivors with an estimated mortality of >10%, 30%, and 50% in the scoring systems were compared in pairs...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29052805/sublingual-buprenorphine-efficacy-in-renal-colic-pain-relief-a-randomized-placebo-controlled-clinical-trial
#7
Javad Mozafari, Kambiz Masoumi, Arash Forouzan, Hassan Motamed, Malehi Amal Saki, Marzieh Dezham
INTRODUCTION: This study was designed to compare the analgesic efficacy of sublingual (SL) buprenorphine and intravenous (IV) ketorolac for renal colic pain relief. METHODS: The present study was carried out as a double-blind, double-dummy randomized clinical trial in patients diagnosed with acute renal colic attending the emergency department. The study subjects were 63 patients with confirmed renal stones. The subjects were randomly divided into two groups. One group, which included 32 patients, received SL buprenorphine tablets (2 mg) with an IV placebo, and another group, including 31 patients, received ketorolac tromethamine (30 mg) with a SL placebo...
October 20, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29052224/opiate-prescribing-in-hospitalized-older-adults-patterns-and-outcomes
#8
Sutapa Maiti, Liron Sinvani, Michele Pisano, Andrzej Kozikowski, Vidhi Patel, Meredith Akerman, Karishma Patel, Christopher Smilios, Christian Nouryan, Guang Qiu, Renee Pekmezaris, Gisele Wolf-Klein
BACKGROUND/OBJECTIVES: Whereas opiate prescribing patterns have been well described in outpatient and emergency department settings, they have been less defined in hospitalized older adults. The objective was to describe patterns of opiate prescribing and associated outcomes in hospitalized older adults. DESIGN: Retrospective cohort study. SETTING: Tertiary care facility. PARTICIPANTS: Hospitalized medical patients aged 65 and older (N = 9,245; mean age 80...
October 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29052109/assessments-of-opportunities-to-improve-antibiotic-prescribing-in-an-emergency-department-a-period-prevalence-survey
#9
Tristan T Timbrook, Aisling R Caffrey, Anais Ovalle, Maya Beganovic, William Curioso, Melissa Gaitanis, Kerry L LaPlante
INTRODUCTION: Approximately 30% of all outpatient antimicrobials are inappropriately prescribed. Currently, antimicrobial prescribing patterns in emergency departments (ED) are not well described. Determining inappropriate antimicrobial prescribing patterns and opportunities for interventions by antimicrobial stewardship programs (ASP) are needed. METHODS: A retrospective chart review was performed among a random sample of non-admitted, adult patients who received an antimicrobial prescription in the ED from January 1 to December 31, 2015...
October 19, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29051871/bilateral-divergent-shoulder-s-fracture-dislocation-case-in-an-ischemic-stroke-patient
#10
Atchi Walla, Faré Gnandi-Piou, Pilakimwé Egbohou, Komi Assogba, Mawuko Quacoe
INTRODUCTION: The literature review revealed that nowadays only about 15 cases of bilateral shoulder dislocation associated with the fracture of the upper end of the humerus have been published. The triad of lesional mechanism designated by the triple syndrome E composed of epilepsy, electrocution, and external trauma was the circumstances noted in which these fractures dislocations occur with migration of the two humeral heads either forward or backward. CASE REPORT: An architect of 36-year-old, right-handed, was admitted in emergency department for loss of knowledge of progressive installation...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29051837/emergency-department-demand-associated-with-seasonal-influenza-2010-through-2014-new-south-wales-australia
#11
David J Muscatello, Kendall J Bein, Michael M Dinh
INTRODUCTION: Influenza's impact on health and health care is underestimated by influenza diagnoses recorded in health-care databases. We aimed to estimate total and non-admitted influenza-attributable hospital Emergency Department (ED) demand in New South Wales (NSW), Australia. METHODS: We used generalized additive time series models to estimate the association between weekly counts of laboratory-confirmed influenza infections and weekly rates of total and non-admitted respiratory, infection, cardiovascular and all-cause ED visits in NSW, Australia for the period 2010 through 2014...
July 2017: Western Pacific Surveillance and Response Journal: WPSAR
https://www.readbyqxmd.com/read/29050886/disparities-in-access-to-emergency-general-surgery-care-in-the-united-states
#12
Jasmine A Khubchandani, Connie Shen, Didem Ayturk, Catarina I Kiefe, Heena P Santry
BACKGROUND: As fewer surgeons take emergency general surgery call and hospitals decrease emergency services, a crisis in access looms in the United States. We examined national emergency general surgery capacity and county-level determinants of access to emergency general surgery care with special attention to disparities. METHODS: To identify potential emergency general surgery hospitals, we queried the database of the American Hospital Association for "acute care general hospital," with "surgical services," and "emergency department," and ≥1 "operating room...
October 16, 2017: Surgery
https://www.readbyqxmd.com/read/29050845/high-rate-of-isolated-right-ventricular-dysfunction-in-patients-with-non-significant-computed-tomographic-pulmonary-angiography
#13
Frances M Russell, Jeffrey A Kline, Timothy Lahm
BACKGROUND: Right ventricular (RV) dysfunction and pulmonary hypertension (PH) are commonly unrecognized in the emergency department (ED), but are associated with poor outcomes. Prior research has found a 30% prevalence of isolated RV dysfunction in ED patients after non-significant computed tomographic pulmonary angiography (CTPA). We aimed to prospectively define the prevalence of RV dysfunction and/or PH in short of breath ED patients, and assess outcomes. METHODS: Prospective observational study of patients with a non-significant CTPA...
October 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29050844/monitoring-the-corrected-qt-in-the-acute-care-setting-a-comparison-of-the-12%C3%A2-lead-electrocardiogram-and-bedside-monitor
#14
James A Chenoweth, Aaron M Hougham, Daniel K Colby, Jonathan B Ford, Jordan Sandhu, Timothy E Albertson, Mark E Sutter
INTRODUCTION: Prolongation of the QT interval is a well-recognized complication associated with many commonly used medications. Emergency Department monitoring of the corrected QT (QTc) both before and after medication administration is typically performed using the 12‑lead electrocardiogram (ECG). The purpose of this study is to compare the QTc reported on the 12‑lead ECG to that reported by single brand of bedside monitor. METHODS: A convenience sample of emergency department patients over the age of 18 undergoing bedside monitoring and who had an ECG ordered by their treating physician were enrolled...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29050837/forensic-patients-in-the-emergency-department-who-are-they-and-how-should-we-care-for-them
#15
Celia J Filmalter, T Heyns, R Ferreira
BACKGROUND: Patients who suffer violent, crime related injuries are likely to seek medical assistance in emergency departments. Forensic patients may not disclose the cause of their injuries leading to the impairment of evidence. We explored healthcare providers' perceptions of forensic patients and how they should be cared for. METHOD: The perceptions of physicians and nurses regarding the profiles and care of forensic patients were explored in three urban emergency departments...
October 16, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/29050836/emergency-department-nurses-experience-of-performing-cpr-in-south-korea
#16
Mi-Ran Lee, Chiyoung Cha
BACKGROUND: Emergency Department (ED) nurses often confront unexpected cardiopulmonary resuscitation (CPR) with little information about the patients. METHODS: This qualitative study explored the experience of performing CPR among ED nurses. Data collection took place between May and June 2016 using an online advertisement to recruit 17 ED nurses. Each participant was interviewed for 40-90min. Interviews were recorded and transcribed verbatim. Data analysis was conducted using a conventional content-analysis method...
October 16, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/29050835/patient-handover-in-the-emergency-department-how-is-as-important-as-what
#17
Santel de Lange, Ilze van Eeden, Tanya Heyns
We explored the existing patient handover practices between emergency care practitioners and healthcare professionals in the emergency department. In the emergency department, patient handover between emergency care practitioner's and healthcare professionals is a complex process involving multiple functions, such as the transfer of information, responsibility and accountability from one person to another. We used a qualitative study design. Emergency care practitioners and healthcare professionals were identified using purposive and convenience sampling data...
October 16, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/29050752/maternal-substance-use-disorders-and-infant-outcomes-in-the-first-year-of-life-among-massachusetts-singletons-2003-2010
#18
Sunah S Hwang, Hafsatou Diop, Chia-Ling Liu, Qi Yu, Hermik Babakhanlou-Chase, Xiaohui Cui, Milton Kotelchuck
OBJECTIVE: To determine the association of maternal substance use disorders (SUDs) during pregnancy with adverse neonatal outcomes and infant hospital re-admissions, observational stays, and emergency department utilization in the first year of life. STUDY DESIGN: We analyzed 2 linked statewide datasets from 2002 to 2010: the Massachusetts Pregnancy to Early Life Longitudinal data system and the Massachusetts Bureau of Substance Abuse Services Management Information System...
October 16, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29050638/discussion-of-follow-up-trends-after-emergency-department-discharge-for-acutely-symptomatic-hernias
#19
Lara Spence, Eric Pillado, Dennis Kim, David Plurad
No abstract text is available yet for this article.
September 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29049488/concentration-of-potentially-preventable-spending-among-high-cost-medicare-subpopulations-an-observational-study
#20
Jose F Figueroa, Karen E Joynt Maddox, Nancy Beaulieu, Robert C Wild, Ashish K Jha
Background: Little is known about whether potentially preventable spending is concentrated among a subset of high-cost Medicare beneficiaries. Objective: To determine the proportion of total spending that is potentially preventable across distinct subpopulations of high-cost Medicare beneficiaries. Design: Beneficiaries in the highest 10% of total standardized individual spending were defined as "high-cost" patients, using a 20% sample of Medicare fee-for-service claims from 2012...
October 17, 2017: Annals of Internal Medicine
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