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https://www.readbyqxmd.com/read/27912778/medical-priority-dispatch-codes-comparison-with-national-early-warning-score
#1
Marko Hoikka, Sami Länkimäki, Tom Silfvast, Tero I Ala-Kokko
BACKGROUND: In Finland, calls for emergency medical services are prioritized by educated non-medical personnel into four categories-from A (highest risk) to D (lowest risk)-following a criteria-based national dispatch protocol. Discrepancies in triage may result in risk overestimation, leading to inappropriate use of emergency medical services units and to risk underestimation that can negatively impact patient outcome. To evaluate dispatch protocol accuracy, we assessed association between priority assigned at dispatch and the patient's condition assessed by emergency medical services on the scene using an early warning risk assessment tool...
December 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27912757/the-sydney-triage-to-admission-risk-tool-start-to-predict-emergency-department-disposition-a-derivation-and-internal-validation-study-using-retrospective-state-wide-data-from-new-south-wales-australia
#2
Michael M Dinh, Saartje Berendsen Russell, Kendall J Bein, Kris Rogers, David Muscatello, Richard Paoloni, Jon Hayman, Dane R Chalkley, Rebecca Ivers
BACKGROUND: Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Emergency Department to assist with triage, patient flow and clinical decision making. METHODS: This was a retrospective analysis of State-wide Emergency Department data in New South Wales, Australia. Adult patients (age ≥ 16 years) were included if they presented to a Level five or six (tertiary level) Emergency Department in New South Wales, Australia between 2013 and 2014...
December 3, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27908493/diagnostic-accuracy-of-the-kampala-trauma-score-using-estimated-abbreviated-injury-scale-scores-and-physician-opinion
#3
Andrew Gardner, Paa Kobina Forson, George Oduro, Barclay Stewart, Nkechi Dike, Paul Glover, Ronald F Maio
BACKGROUND: The Kampala Trauma Score (KTS) has been proposed as a triage tool for use in low- and middle-income countries (LMICs). This study aimed to examine the diagnostic accuracy of KTS in predicting emergency department outcomes using timely injury estimation with Abbreviated Injury Scale (AIS) score and physician opinion to calculate KTS scores. METHODS: This was a diagnostic accuracy study of KTS among injured patients presenting to Komfo Anokye Teaching Hospital A&E, Ghana...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/27906867/external-validation-of-the-air-medical-prehospital-triage-score-for-identifying-trauma-patients-likely-to-benefit-from-scene-helicopter-transport
#4
Joshua B Brown, Mark L Gestring, Francis X Guyette, Matthew R Rosengart, Nicole A Stassen, Raquel M Forsythe, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry
BACKGROUND: The Air Medical Prehospital Triage (AMPT) score was developed to identify injured patients who may benefit from scene helicopter emergency medical services (HEMS) transport. External validation using a different dataset is essential to ensure reliable performance. The study objective was to validate the effectiveness of the AMPT score to identify patients with a survival benefit from HEMS using the Pennsylvania Trauma Outcomes Study (PTOS) registry. METHODS: Patients age≥16years undergoing scene HEMS or ground EMS (GEMS) transport in the PTOS registry 2000-2013 were included...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#5
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27896450/extremity-cta-for-penetrating-trauma-10-year-experience-using-a-64-detector-row-ct-scanner
#6
Charles G Colip, Varun Gorantla, Christina A LeBedis, Jorge A Soto, Stephan W Anderson
PURPOSE: The purpose of this study is to assess the performance of CT angiography (CTA) in the evaluation of penetrating vascular trauma to the extremities in a large cohort of patients at our level I trauma center. METHODS: A retrospective, IRB-approved review of consecutive CTAs for the evaluation of penetrating trauma to the extremities in 446 patients (M/F = 396:50, mean age = 27 years) from 1/1/2005 to 5/1/2015 was performed. Medical records were reviewed to correlate diagnostic imaging findings with clinical history and subsequent interventions...
November 29, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27889266/the-effect-anticoagulation-status-on-geriatric-fall-trauma-patients
#7
Julia Coleman, Mustafa Baldawi, David Heidt
BACKGROUND: This research study aims to identify the effect of anticoagulation status on hospital course, complications, and outcomes among geriatric fall trauma patients. METHODS: The study design is a retrospective cohort study, looking at fall trauma among patients aged 60 to 80 years from 2009 to 2013 at a university hospital in the United States. The statistical analysis, conducted with SPSS software with a threshold for statistical significance of P < ...
October 1, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27886161/cardiac-ct-in-the-emergency-department-in-the-era-of-highly-sensitive-troponins-is-there-still-a-role
#8
Admir Dedic, Koen Nieman, Udo Hoffmann, Maros Ferencik
INTRODUCTION: Physicians practicing cardiovascular medicine are every day confronted with patients presenting with symptoms suggestive of an acute coronary syndrome (ACS). Over the years, there have been substantial technical advances, such as the introduction of new non-invasive imaging techniques and the introduction of new highly sensitive cardiac biomarkers. EVIDENCE ACQUISITION AND SYNTHESIS: Physicians have adopted these new assets and have become more experienced with them thus improving medical care...
November 25, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27878444/is-a-mobile-emergency-severity-index-esi-triage-better-than-the-paper-esi
#9
Sorravit Savatmongkorngul, Chaiyaporn Yuksen, Chanakarn Suwattanasilp, Kittisak Sawanyawisuth, Yuwares Sittichanbuncha
This study aims to evaluate the mobile emergency severity index (ESI) tool in terms of validity compared with the original ESI triage. The original ESI and mobile ESI were used with patients at the Department of Emergency Medicine, Ramathibodi Hospital, Thailand. Eligible patients were evaluated by sixth-year medical students/emergency physicians using either the original or mobile ESI. The ESI results for each patient were compared with the standard ESI. Concordance and kappa statistics were calculated for pairs of the evaluators...
November 22, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27874187/performance-of-a-new-hpv-and-biomarker-assay-in-management-of-hrhpv-positive-women-subanalysis-of-the-ongoing-multicenter-trace-clinical-trial-n-6-000-to-evaluate-pou4f3-as-a-potential-biomarker-of-cervical-precancer-and-cancer
#10
Adrienn Kocsis, Tibor Takács, Csaba Jeney, Zsuzsa Schaff, Róbert Koiss, Balázs Járay, Gábor Sobel, Károly Pap, István Székely, Tamás Ferenci, Hung-Cheng Lai, Miklós Nyíri, Márta Benczik
The ongoing TRACE prospective, multicenter study aimed to provide a clinical evaluation of the CONFIDENCE™ assay, which comprises an HPV DNA and a human epigenetic biomarker test. Between 2013 and 2015 over 6,000 women aged 18 or older were recruited in Hungary. Liquid based cytology, hrHPV DNA detection and single target host-gene methylation test of the promoter sequence of the POU4F3 gene by quantitative methylation specific PCR were performed from the same LBC sample. The current analysis is focused on the baseline cross-sectional clinical results of 5,384 LBC samples collected from subjects aged 25 years or older...
November 22, 2016: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/27865370/hypermethylated-znf582-and-pax1-are-effective-biomarkers-for-detection-of-oral-dysplasia-and-oral-cancer
#11
Shih-Jung Cheng, Chi-Feng Chang, Jang-Jaer Lee, Hsin-Ming Chen, Huei-Jen Wang, Yu-Ligh Liou, Carolyn Yen, Chun-Pin Chiang
OBJECTIVES: This study investigated whether the methylation of ZNF582, PAX1, SOX1, NKX6.1, and PTPRR genes in oral scrapings could be used to detect oral dysplasia and oral cancer and to predict oral cancer recurrence. MATERIALS AND METHODS: Oral scrapings were collected from 65 normal oral mucosa subjects, 107 oral precancer patients, and 95 oral squamous cell carcinoma patients. Methylation levels of the five genes were quantified by real-time methylation-specific PCR after bisulfite conversion...
November 2016: Oral Oncology
https://www.readbyqxmd.com/read/27863295/the-effect-of-early-psychological-symptom-severity-on-long-term-functional-recovery-a-secondary-analysis-of-data-from-a-cohort-study-of-minor-injury-patients
#12
Sara F Jacoby, Justine Shults, Therese S Richmond
BACKGROUND: The mental health consequences of injuries can interfere with recovery to pre-injury levels of function and long term wellbeing. OBJECTIVES: The purpose of this study was to explore the relationship between psychological symptoms after minor injury and long-term functional recovery and disability. DESIGN: This exploratory study uses secondary data derived from a longitudinal cohort study of psychological outcomes after minor injury...
November 9, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27859848/evaluation-of-double-immunocytochemical-staining-for-ck20-and-p53-as-a-potential-adjunct-to-cytology-for-urothelial-cancer-diagnosis
#13
M Lenos, I Katafigiotis, K Vrettou, D Papaioannou, F Malta, E-A Trigka, S Sousouris, C Constantinides, P Mikou
OBJECTIVE: To evaluate double immunocytochemical staining with p53 and CK20, as a tool for improving the accuracy of urinary cytology. The aim of the present study was to clarify the diagnostic significance of the expression of these markers and to investigate the possibility of using this information for better monitoring of bladder cancer patients during follow-up. MATERIAL AND METHODS: One hundred and twenty-five urine cytology cases were retrieved with corresponding histology from our files...
November 18, 2016: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/27845915/automatic-metastatic-brain-tumor-segmentation-for-stereotactic-radiosurgery-applications
#14
Yan Liu, Strahinja Stojadinovic, Brian Hrycushko, Zabi Wardak, Weiguo Lu, Yulong Yan, Steve B Jiang, Robert Timmerman, Ramzi Abdulrahman, Lucien Nedzi, Xuejun Gu
The objective of this study is to develop an automatic segmentation strategy for efficient and accurate metastatic brain tumor delineation on contrast-enhanced T1-weighted (T1c) magnetic resonance images (MRI) for stereotactic radiosurgery (SRS) applications. The proposed four-step automatic brain metastases segmentation strategy is comprised of pre-processing, initial contouring, contour evolution, and contour triage. First, T1c brain images are preprocessed to remove the skull. Second, an initial tumor contour is created using a multi-scaled adaptive threshold-based bounding box and a super-voxel clustering technique...
December 21, 2016: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/27831733/personal-assistance-disability-and-intimate-partner-violence-a-guide-for-healthcare-providers
#15
Jessica K Salwen, Anthea Gray, Linda R Mona
PURPOSE/OBJECTIVE: Our objective was to provide evidence-based guidance for health care providers to engage in brief and extensive assessment of intimate partner violence (IPV) and to initiate appropriate safety precautions and referrals, all within the context of disability. Research Method/Design: This article is a review of the literature on prevalence and risk factors for IPV in nondisabled couples and in couples where a partner has a disability, on various assessment tools, and on the impact of personal assistance on relationships...
November 2016: Rehabilitation Psychology
https://www.readbyqxmd.com/read/27822127/objective-triage-in-the-disaster-setting-will-children-and-expecting-mothers-be-treated-like-others
#16
Timur Kouliev
The study of disaster triage is made difficult by the complex emotional response of potentially lifesaving intervention that a triage officer must make basing decisions on a succinct and efficient algorithm. A survey of triage professionals in international settings was designed to identify possible emotionally led bias that affects objective decision making in identifying victims most likely to benefit from immediate life support intervention. This survey suggests a lack of correlation between triage priority and predictable clinical outcomes as predicted by the Revised Trauma Score tool...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27803369/oxygen-exchange-and-c-reactive-protein-predict-safe-discharge-in-patients-with-h1n1-influenza
#17
B Morton, K Nweze, J O'Connor, P Turton, E Joekes, J D Blakey, I D Welters
BACKGROUND: Pandemic influenza has potential to overwhelm healthcare resources. There is uncertainty over performance of existing triage tools for hospital admission and discharge decisions. AIM: Our aim was to identify clinical criteria that predict safe discharge from hospital and develop a pragmatic triage tool to guide physician decision-making. DESIGN: We retrospectively examined an existing database of patients who presented to the Royal Liverpool University Hospital during the 2010-11 influenza pandemic...
October 18, 2016: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/27798478/use-of-transportable-radiation-detection-instruments-to-assess-internal-contamination-from-intakes-of-radionuclides-part-ii-calibration-factors-and-icat-computer-program
#18
Robert Anigstein, Richard H Olsher, Donald A Loomis, Armin Ansari
The detonation of a radiological dispersion device or other radiological incidents could result in widespread releases of radioactive materials and intakes of radionuclides by affected individuals. Transportable radiation monitoring instruments could be used to measure radiation from gamma-emitting radionuclides in the body for triaging individuals and assigning priorities to their bioassay samples for in vitro assessments. The present study derived sets of calibration factors for four instruments: the Ludlum Model 44-2 gamma scintillator, a survey meter containing a 2...
December 2016: Health Physics
https://www.readbyqxmd.com/read/27797986/ambulance-smartphone-tool-for-field-triage-of-ruptured-aortic-aneurysms-filtr-study-protocol-for-a-prospective-observational-validation-of-diagnostic-accuracy
#19
Thomas L Lewis, Rachael T Fothergill, Alan Karthikesalingam
INTRODUCTION: Rupture of an abdominal aortic aneurysm (rAAA) carries a considerable mortality rate and is often fatal. rAAA can be treated through open or endovascular surgical intervention and it is possible that more rapid access to definitive intervention might be a key aspect of improving mortality for rAAA. Diagnosis is not always straightforward with up to 42% of rAAA initially misdiagnosed, introducing potentially harmful delay. There is a need for an effective clinical decision support tool for accurate prehospital diagnosis and triage to enable transfer to an appropriate centre...
October 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27797673/baseline-hba1c-to-identify-high-risk-gestational-diabetes-utility-in-early-versus-standard-gestational-diabetes
#20
Arianne Natasha Sweeting, Glynis P Ross, Jon Hyett, Lynda Molyneaux, Kris Tan, Maria Constantino, Anna Jane Harding, Jencia Wong
CONTEXT: The increasing prevalence of gestational diabetes (GDM) necessitates risk stratification measures directing limited antenatal resources to those at greatest risk. Recent evidence demonstrates that an early pregnancy HbA1c≥5.9% (41 mmol/mol) predicts adverse pregnancy outcomes. OBJECTIVE: Determine the optimal HbA1c threshold for adverse pregnancy outcomes in GDM in a treated multi-ethnic cohort and whether this differs in women diagnosed <24 versus ≥24 weeks' gestation (early versus standard GDM)...
October 31, 2016: Journal of Clinical Endocrinology and Metabolism
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