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Triage tool

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https://www.readbyqxmd.com/read/28628525/assessing-sensitivity-and-specificity-of-the-manchester-triage-system-in-the-evaluation-of-acute-coronary-syndrome-in-adult-patients-in-emergency-care-a-systematic-review
#1
Fernanda Ayache Nishi, Flávia de Oliveira Motta Maia, Itamar de Souza Santos, Dina de Almeida Lopes Monteiro da Cruz
BACKGROUND: Triage is the first assessment and sorting process used to prioritize patients arriving in the emergency department (ED). As a triage tool, the Manchester Triage System (MTS) must have a high sensitivity to minimize the occurrence of under-triage, but must not compromise specificity to avoid the occurrence of overtriage. Sensitivity and specificity of the MTS can be calculated using the frequency of appropriately assigned clinical priority levels for patients presenting to the ED...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28607677/design-and-implementation-of-a-trauma-care-bundle-at-a-community-hospital
#2
Ryan Andres, Elan Hahn, Steffen de Kok, Rafi Setrak, Jeffrey Doyle, Allison Brown
The Niagara Health System (NHS) in Ontario, Canada is comprised of three non-designated trauma center (NTC) hospitals which provide primary care to approximately 100 trauma patients annually. NTCs often lack standardized resources such as trauma surgeons, trauma-trained emergency room physicians, Advanced Trauma Life Support certified staff, trauma protocols, and other resources commonly found at designated trauma centers. Studies indicate that these differences contribute to poorer outcomes for trauma patients treated at community hospitals in Ontario, including the NTC hospitals of the NHS...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28599661/poor-performance-of-quick-sofa-qsofa-score-in-predicting-severe-sepsis-and-mortality-a-prospective-study-of-patients-admitted-with-infection-to-the-emergency-department
#3
Åsa Askim, Florentin Moser, Lise T Gustad, Helga Stene, Maren Gundersen, Bjørn Olav Åsvold, Jostein Dale, Lars Petter Bjørnsen, Jan Kristian Damås, Erik Solligård
BACKGROUND: We aimed to evaluate the clinical usefulness of qSOFA as a risk stratification tool for patients admitted with infection compared to traditional SIRS criteria or our triage system; the Rapid Emergency Triage and Treatment System (RETTS). METHODS: The study was an observational cohort study performed at one Emergency Department (ED) in an urban university teaching hospital in Norway, with approximately 20,000 visits per year. All patients >16 years presenting with symptoms or clinical signs suggesting an infection (n = 1535) were prospectively included in the study from January 1 to December 31, 2012...
June 9, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28588013/building-a-visual-aid-for-a-triage-tool-in-a-developing-health-service
#4
Mir Saaduddin Ahmad, Darryl R Wood
Resources in the modern day emergency department are often stretched, and this holds true more so in developing services. With limited manpower, it is essential that efficient tools are created so that processes can be run safely. Here we pilot the use of a vital signs matrix in a medical camp in Dhaka to screen patients at triage. We further modified this matrix to include the National Early Warning Score as our recording of the NEWS have remained poor in triage. A trial and validation study for the use of this matrix in an NHS setting is currently underway...
June 6, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28567101/ascites-matters
#5
REVIEW
Velauthan Rudralingam, Clare Footitt, Ben Layton
The excess accumulation of intra-peritoneal fluid, referred to as ascites, is an important clue that points to a significant underlying illness. This may be due to a pathological event within the peritoneal cavity or secondary to an underlying systemic condition. Ascites is broadly classified into transudate and exudate, based on protein content, with a potential wide range of differential diagnoses. Traditionally, computed tomography has been regarded as the imaging modality of choice to demonstrate ascites and diagnose the underlying cause...
May 2017: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/28558759/the-danish-regions-pediatric-triage-model-has-a-limited-ability-to-detect-both-critically-ill-children-as-well-as-children-to-be-sent-home-without-treatment-a-study-of-diagnostic-accuracy
#6
Lotte Høeg Hansen, Christian Backer Mogensen, Lena Wittenhoff, Helene Skjøt-Arkil
BACKGROUND: The Danish Regions Pediatric Triage model (DRPT) was introduced in 2012 and subsequent implemented in most Danish acute pediatric departments. The aim was to evaluate the validity of DRPT as a screening tool to detect both the most serious acute conditions and the non-serious conditions in the acute referred patients in a pediatric department. METHOD: The study was prospective observational, with follow-up on all children with acute referral to pediatric department from October to December 2015...
May 30, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28550609/validation-of-the-taps-1-a-four-item-screening-tool-to-identify-unhealthy-substance-use-in-primary-care
#7
Jan Gryczynski, Jennifer McNeely, Li-Tzy Wu, Geetha A Subramaniam, Dace S Svikis, Lauretta A Cathers, Gaurav Sharma, Jacqueline King, Eve Jelstrom, Courtney D Nordeck, Anjalee Sharma, Shannon G Mitchell, Kevin E O'Grady, Robert P Schwartz
BACKGROUND: The Tobacco, Alcohol, Prescription Medication, and Other Substance use (TAPS) tool is a combined two-part screening and brief assessment developed for adult primary care patients. The tool's first-stage screening component (TAPS-1) consists of four items asking about past 12-month use for four substance categories, with response options of never, less than monthly, monthly, weekly, and daily or almost daily. OBJECTIVE: To validate the TAPS-1 in primary care patients...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28540208/myocardial-ct-perfusion-imaging-for-ischemia-detection
#8
REVIEW
Patricia Carrascosa, Carlos Capunay
Coronary computed tomography angiography (CCTA) plays an important role in many specific scenarios such as in symptomatic patients with intermediate pretest of coronary artery disease (CAD), as well as in the triage of patients with acute chest pain with TIMI risk ≤2. However, it cannot detect the presence of associated ischemia, which is critical for clinical decision making among patients with moderate to severe stenosis. Although functional information can be obtained with different non-invasive tools, cardiac CT is the unique modality that can perform a comprehensive evaluation of coronary anatomy plus the functional significance of lesions...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28538608/assessing-dehydration-employing-end-tidal-carbon-dioxide-in-children-with-vomiting-and-diarrhea
#9
Stephen B Freedman, David W Johnson, Alberto Nettel-Aguirre, Angelo Mikrogianakis, Sarah Williamson-Urquhart, Nicholas Monfries, Adam Cheng
OBJECTIVE: Serum bicarbonate reflects dehydration severity in children with gastroenteritis. Previous work in children receiving intravenous rehydration has correlated end-tidal carbon dioxide (EtCO2) with serum bicarbonate. We evaluated whether EtCO2 predicts weight change in children with vomiting and/or diarrhea. METHODS: A prospective cohort study was conducted. Eligible children were 3 months to 10 years old and presented for emergency department (ED) care because of vomiting and/or diarrhea...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28533826/a-novel-triage-tool-optic-nerve-sheath-diameter-in-traumatic-brain-injury-and-its-correlation-to-rotterdam-computed-tomography-ct-scoring
#10
Sudha Kiran Das, Sachin P Shetty, Kamal Kumar Sen
BACKGROUND: Optic nerve sheath diameter (ONSD) evaluated in CT imaging as well as Rotterdam CT Score (RCTS) are proven independent predictors of outcome in patients with traumatic brain injury (TBI). To date, no study has correlated ONSD on admission CT scan with RCTS. MATERIAL/METHODS: Retrospective cohort study comprised of consecutive patients undergoing CT imaging for traumatic brain injury recruited between January and October 2015. Bilateral ONSD was measured 3 mm behind the eyeball in axial and sagittal planes and mean value was calculated...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28531395/nationwide-survey-of-nutritional-management-in-an-asian-upper-middle-income-developing-country-government-hospitals-combination-of-quantitative-survey-and-focus-group-discussion
#11
K Chittawatanarat, K Tosanguan, U Chaikledkaew, S Tejavanija, Y Teerawattananon
BACKGROUND & AIMS: The objective of this study was to identify the differences in pattern, process, and management of nutrition care in government hospitals in Thailand (an Asian upper-middle income developing country). METHODS: This is a combination of a quantitative nationwide questionnaire survey and focus group discussions. A total of 2300 questionnaires were sent to government hospitals across Thailand. The responders were divided by routine-nutrition screening/assessment unit vs...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28529202/an-evaluation-of-automated-chest-radiography-reading-software-for-tuberculosis-screening-among-public-and-private-sector-patients
#12
Md Toufiq Rahman, Andrew J Codlin, Md Mahfuzur Rahman, Ayenun Nahar, Mehdi Reja, Tariqul Islam, Zhi Zhen Qin, Md Abdus Shakur Khan, Sayera Banu, Jacob Creswell
Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28515993/triage-amalgamated-dermoscopic-algorithm-tada-for-skin-cancer-screening
#13
Tova Rogers, Maria Marino, Stephen W Dusza, Shirin Bajaj, Michael A Marchetti, Ashfaq Marghoob
IMPORTANCE: Dermoscopic triage algorithms have been shown to improve beginners' abilities for identifying pigmented skin lesions requiring biopsy. OBJECTIVE: To estimate the diagnostic accuracy of the Triage Amalgamated Dermoscopic Algorithm (TADA) for pigmented and nonpigmented skin cancers. Secondarily, to compare TADAs performance to those of existing triage algorithms for the identification of pigmented skin cancers. DESIGN: Cross-sectional, observational, reader study that took place at a beginner and intermediate level dermoscopy course...
April 2017: Dermatology Practical & Conceptual
https://www.readbyqxmd.com/read/28507997/recognizing-sudden-cardiac-arrest-may-require-more-than-two-questions-during-telephone-triage-developing-a-complementary-checklist
#14
Amir Mirhaghi, Hojjat Shafaee, Javad Malekzadeh, Farzaneh Hasanzadeh
OBJECTIVE: To develop decision-support tools to identify patients experiencing sudden cardiac arrest (SCA). METHODS: Eighty calls related to SCA were content analyzed, and the contextual patterns that emerged were organized into a checklist. Two researchers independently analyzed the recorded calls and compared their findings. Eighteen dispatchers scored 20 cases (which included SCA and non-SCA cases) both with and without the checklist. Correct responses for each case and agreement among dispatchers have been reported...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28506672/comparison-of-the-nosocomial-pneumonia-mortality-prediction-npmp-model-with-standard-mortality-prediction-tools
#15
M Srinivasan, N Shetty, S Gadekari, G Thunga, K Rao, V Kunhikatta
BACKGROUND: Severity or mortality prediction of nosocomial pneumonia could aid in the effective triage of patients and assisting physicians. AIM: To compare various severity assessment scoring systems for predicting intensive care unit (ICU) mortality in nosocomial pneumonia patients. METHODS: A prospective cohort study was conducted in a tertiary care university-affiliated hospital in Manipal, India. One hundred patients with nosocomial pneumonia, admitted in the ICUs who developed pneumonia after >48h of admission, were included...
July 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28495849/neoadjuvant-trials-in-er-breast-cancer-a-tool-for-acceleration-of-drug-development-and-discovery
#16
REVIEW
Angel L Guerrero-Zotano, Carlos L Arteaga
Neoadjuvant therapy trials offer an excellent strategy for drug development and discovery in breast cancer, particularly in triple-negative and HER2-overexpressing subtypes, where pathologic complete response is a good surrogate of long-term patient benefit. For estrogen receptor-positive (ER(+)) breast cancers, however, use of this strategy has been challenging because of the lack of validated surrogates of long-term efficacy and the overall good prognosis of the majority of patients with this cancer subtype...
June 2017: Cancer Discovery
https://www.readbyqxmd.com/read/28495830/establishing-recommendations-for-stroke-systems-in-the-thrombectomy-era-the-upstate-new-york-stakeholder-proceedings
#17
Zainab Magdon-Ismail, Curtis Benesch, Jeremy T Cushman, Ian Brissette, Andrew M Southerland, Ethan S Brandler, Cemal B Sozener, Sue Flor, Roseanne Hemmitt, Kathleen Wales, Krystal Parrigan, Steven R Levine
BACKGROUND AND PURPOSE: The American Heart Association/American Stroke Association and Department of Health Stroke Coverdell Program convened a stakeholder meeting in upstate NY to develop recommendations to enhance stroke systems for acute large vessel occlusion. METHODS: Prehospital, hospital, and Department of Health leadership were invited (n=157). Participants provided goals/concerns and developed recommendations for prehospital triage and interfacility transport, rating each using a 3-level impact (A [high], B, and C [low]) and implementation feasibility (1 [high], 2, and 3 [low]) scale...
May 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28487333/enhanced-detection-of-edema-in-malignant-anterior-circulation-stroke-edema-score-a-risk-prediction-tool
#18
Charlene Jennifer Ong, Jeffrey Gluckstein, Osvaldo Laurido-Soto, Yan Yan, Rajat Dhar, Jin-Moo Lee
BACKGROUND AND PURPOSE: Rapid recognition of those at high risk for malignant edema after stroke would facilitate triage for monitoring and potential surgery. Admission data may be insufficient for accurate triage decisions. We developed a risk prediction score using clinical and radiographic variables within 24 hours of ictus to better predict potentially lethal malignant edema. METHODS: Patients admitted with diagnosis codes of cerebral edema and ischemic stroke, NIHSS score (National Institute of Health Stroke Score) of ≥8 and head computed tomographies within 24 hours of stroke onset were included...
May 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28485904/-triage-duration-times-a-prospective-descriptive-study-in-a-level-1%C3%A2-emergency-department
#19
Stefano Bambi, Marco Ruggeri
INTRODUCTION: Triage is the most important tool for clinical risk management in emergency departments (ED). The timing measurement of its phases is fundamental to establish indicators and standards for the optimization of the system. OBJECTIVE: To evaluate the duration time of the phases of triage; to evaluate some variables exerting influence on nurses' performance. METHOD: prospective descriptive study performed in the ED of Careggi Teaching Hospital in Florence...
January 2017: Professioni Infermieristiche
https://www.readbyqxmd.com/read/28484942/minimal-training-sufficient-to-diagnose-pediatric-wrist-fractures-with-ultrasound
#20
Henrik Hedelin, Christian Tingström, Hanna Hebelka, Jon Karlsson
BACKGROUND: In children, non-fractured wrists generally need no treatment and those that are fractured may only require a 3-week cast without any clinical follow-up. The ability to perform a point-of-care triage decision if radiographs are needed could improve patient flow and decrease unnecessary radiographs. The aim of this study was to evaluate the role of ultrasound (US) as a point-of-care triage tool for pediatric wrist injuries with limited training. METHODS: Physicians with no previous US experience attended a 1...
December 2017: Critical Ultrasound Journal
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