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https://www.readbyqxmd.com/read/28715794/an-introduction-to-the-emergency-department-adult-clinical-escalation-protocol-ed-ace
#1
Eoin Coughlan, Una Geary, Abel Wakai, Ronan O'Sullivan, John Browne, Eilish McAuliffe, Marie Ward, Fiona McDaid, Conor Deasy
PURPOSE OF THE STUDY: This study demonstrates how a participatory action research approach was used to address the challenge of the early and effective detection of the deteriorating patient in the ED setting. The approach enabled a systematic approach to patient monitoring and escalation of care to be developed to address the wide-ranging spectrum of undifferentiated presentations and the phases of ED care from triage to patient admission. This paper presents a longitudinal patient monitoring system, which aims to provide monitoring and escalation of care, where necessary, of adult patients from triage to admission to hospital in a manner that is feasible in the unique ED environment...
November 14, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28705687/antecedents-and-precipitants-of-patient-related-violence-in-the-emergency-department-results-from-the-australian-vent-study-violence-in-emergency-nursing-and-triage
#2
Jacqueline V Pich, Ashley Kable, Mike Hazelton
INTRODUCTION: Workplace violence is one of the most significant and hazardous issues faced by nurses globally. It is a potentially life-threatening and life-affecting workplace hazard often downplayed as just "part of the job" for nurses. METHODS: A cross-sectional design was used and data were collected using a purpose developed survey tool. Surveys were distributed to all members of the College of Emergency Nurses' Australasia (CENA) in 2010 and 537 eligible responses were received (RR=51%)...
July 10, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28695610/anion-gap-can-differentiate-between-psychogenic-and-epileptic-seizures-in-the-emergency-setting
#3
Yi Li, Liesl Matzka, Louise Maranda, Daniel Weber
Differentiation between psychogenic nonepileptic seizures (PNES) and generalized convulsive epileptic seizures (ES) is important for appropriate triaging in the emergency department (ED). This can be difficult in the ED, as the event is often not witnessed by a medical professional. In the current study, we investigated whether anion gap (AG), bicarbonate, and the Denver Seizure Score (DSS) could differentiate between PNES and ES. Of a total of 1,354 subjects reviewed from a tertiary care medical center, 27 PNES and 27 ES patients were identified based on clinical description and subsequent electroencephalogram...
July 11, 2017: Epilepsia
https://www.readbyqxmd.com/read/28692399/risk-assessment-during-the-pan-american-and-parapan-american-games-toronto-2015
#4
Adam van Dijk, Emily Dawson, Kieran Michael Moore, Paul Belanger
During the summer of 2015, the Pan American and Parapan American Games took place in the Greater Toronto area of Ontario, Canada, bringing together thousands of athletes and spectators from around the world. The Acute Care Enhanced Surveillance (ACES) system-a syndromic surveillance system that captures comprehensive hospital visit triage information from acute care hospitals across Ontario-monitored distinct syndromes throughout the games. We describe the creation and use of a risk assessment tool to evaluate alerts produced by ACES during this period...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28680866/the-effect-of-start-triage-education-on-knowledge-and-practice-of-emergency-medical-technicians-in-disasters
#5
Mahboub Pouraghaei, Jaafar Sadegh Tabrizi, Payman Moharamzadeh, Rozbeh Rajaei Ghafori, Farzad Rahmani, Baharak Najafi Mirfakhraei
Introduction: Pre-hospital triage is one of the most fundamental concepts in emergency management. Limited human resource changes triage to an inevitable solution in the management of disasters. The aim of this study was to evaluate the role of education of simple triage and rapid treatment (START) in the knowledge and practice of Emergency Medical Service (EMS) employees of Eastern Azerbaijan. Methods: This is a pre-and post-intervention study conducted on two hundred and five (205) of employees of EMS sector, in the disaster and emergency management center of Eastern Azerbaijan Province, 2015...
June 2017: Journal of Caring Sciences
https://www.readbyqxmd.com/read/28673376/adaptive-process-triage-system-cannot-identify-patients-with-gastrointestinal-perforation
#6
Aske Mathias Bohm, Mai-Britt Tolstrup, Ismail Gögenur
INTRODUCTION: Adaptive process triage (ADAPT) is a triage tool developed to assess the severity and address the priority of emergency patients. In 2009-2011, ADAPT was the most frequently used triage system in Denmark. Until now, no Danish triage system has been evaluated based on a selective group of patients in need of acute abdominal surgery. Gastrointestinal perforation (GIP) is acknowledged as one of the surgical conditions with the highest mortality rates. The aim of this study was to evaluate whether ADAPT can identify patients with GIP...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28673333/telephone-consultations-for-general-practice-a-systematic-review
#7
Martin J Downes, Merehau C Mervin, Joshua M Byrnes, Paul A Scuffham
BACKGROUND: The use of information technology, including internet- and telephone-based resources, is becoming an alternative and supporting method of providing many forms of services in a healthcare and health management setting. Telephone consultations provide a promising alternative and supporting service for face-to-face general practice care. The aim of this review is to utilize a systematic review to collate evidence on the use of telephone consultation as an alternative to face-to-face general practice visits...
July 3, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28669152/cervical-cancer-screening-in-resource-constrained-countries-current-status-and-future-directions
#8
REVIEW
Ruchika Gupta, Sanjay Gupta, Ravi Mehrotra, Pushpa Sodhani
Cervical cancer continues to be a major public health problem affecting large numbers of women in many developing countries. Limitations of various screening modalities and the lack of ready availability of a cost-effective point-of-care screening tool have hindered the efficient implementation of population-based screening programs in these settings. It has not proved possible for many countries to adopt cytology as a screening modality due to inadequate infrastructure and trained manpower. However, recent developments, notably design and testing of a low-cost HPV test kit and initiatives by countries like India in developing and putting into operation a framework for large-scale screening of women, have raised hopes that cervical cancer control may be possible even in resource-constrained locations...
June 25, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28655589/identification-of-seniors-at-risk-isar-in-the-emergency-room-a-prospective-study
#9
João Paulo de Almeida Tavares, Pedro Sá-Couto, Marie Boltz, Elizabeth Capezuti
INTRODUCTION: The Identification of Seniors at Risk (ISAR) is one of the most frequently utilized risk screening tools in emergency departments (ED). The goal of this study was to evaluate the predictive validity of the ISAR screening tool for adverse outcomes in an ED. METHODS: This was a prospective single-center observational study in a Portuguese urban university hospital ED, and included 402 older adults (OA). After triage, baseline sociodemographic and clinic data were collected by the researcher and the ISAR was administered...
June 24, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28647803/chronic-joint-pain-and-handgrip-strength-correlates-with-osteoporosis-in-mid-life-women-a-singaporean-cohort
#10
S Logan, W P P Thu, W K Lay, L Y Wang, J A Cauley, E L Yong
This study aimed to identify novel correlates which may relate to low bone mass at lumbar spine in mid-life Asian women. The possibility of developing a prediction model for osteoporosis (OP) was explored which resulted in a risk assessment tool that performed better than currently available tools. INTRODUCTION: In order to identify novel correlates associated with low spinal bone mineral density (BMD) in mid-life women, we examined a large number of lifestyle and medical and performance measurements and developed a prediction model for triage to BMD scanning...
June 24, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28647160/a-clinical-decision-rule-to-predict-zygomatico-maxillary-fractures
#11
Simon Haworth, Anthony Bates, Andrea Beech, Greg Knepil
Patients presenting with periorbital trauma require clinical assessment to exclude zygomatico-maxillary fractures. A single-centre pilot investigation was undertaken at a general hospital in the United Kingdom. The sample was composed of 229 adult patients attending our emergency department with periorbital injuries. Findings from 17 signs or symptoms of facial injury were recorded on a validated tool. The relationship between clinical presentation and displaced zygomatico-maxillary fracture was assessed using diagnostic test parameters and tests for correlation...
May 25, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28646642/universal-postpartum-mental-health-screening-for-parents-of-newborns-with-prenatally-diagnosed-birth-defects
#12
Joanna C M Cole, Michelle Olkkola, Haley Zarrin, Kelsey Berger, Julie S Moldenhauer
OBJECTIVE: To describe the implementation of a nurse-led project to screen parents for depression and traumatic stress in the postpartum period after visiting their newborns in the NICU. DESIGN: A standardized universal mental health postpartum screening and referral protocol was developed for parents of high-risk neonates. SETTING/LOCAL PROBLEM: The project occurred at the Garbose Family Special Delivery Unit, the first high-risk obstetrics unit serving healthy women who give birth to newborns with prenatally diagnosed fetal anomalies...
June 21, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28639854/rapid-on-site-evaluation-of-endobronchial-ultrasound-guided-transbronchial-needle-aspirations-for-the-diagnosis-of-lung-cancer-a-perspective-from-members-of-the-pulmonary-pathology-society
#13
Deepali Jain, Timothy Craig Allen, Dara L Aisner, Mary Beth Beasley, Philip T Cagle, Vera Luiza Capelozzi, Lida P Hariri, Sylvie Lantuejoul, Ross Miller, Mari Mino-Kenudson, Sara E Monaco, Andre Moreira, Kirtee Raparia, Natasha Rekhtman, Anja Christiane Roden, Sinchita Roy Chowdhuri, Gilda da Cunha Santos, Erik Thunnissen, Giancarlo Troncone, Marina Vivero
CONTEXT: - Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a very useful tool in the field of diagnostic respiratory cytology. Rapid on-site evaluation (ROSE) of EBUS-TBNA not only has the potential to improve diagnostic yield of the procedure but also to triage samples for predictive molecular testing to guide personalized treatments for lung cancer. OBJECTIVE: - To provide an overview of the current status of the literature regarding ROSE of EBUS-TBNA in the diagnosis of lung cancer...
June 22, 2017: Archives of Pathology & Laboratory Medicine
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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