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https://www.readbyqxmd.com/read/28339735/triage-quality-control-is-missing-tools-a-new-observation-technique-for-ed-quality-improvement
#1
Tomi Malmström, Veli-Pekka Harjola, Paulus Torkki, Salla Kumpulainen, Raija Malmström
Objective: Correct assessment of patient urgency is critical to ensuring patient safety in emergency departments (EDs). Although significant time and effort have been devoted to developing triage systems, less attention has been paid to the development of quality control. The aim of this study is to introduce and test observation technique, which enables identifying of patient groups at risk of erroneous assessment in triage. The introduced technique is aimed to be less laborious to use than existing triage quality control methods...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28338866/the-growing-challenge-of-major-trauma-in-older-people-a-role-for-comprehensive-geriatric-assessment
#2
James Michael Fisher, Charlotte Bates, Jay Banerjee
In this commentary article, we describe the impact that an ageing population is having on the nature of major trauma seen in emergency departments. The proportion of major trauma victims who are older people is rapidly increasing and a fall from standing is now the most common mechanism of injury in major trauma. Potential barriers to effective care of this patient group are highlighted, including: a lack of consensus regarding triage criteria; potentially misleading physiological parameters within triage criteria; non-linear patient presentations and diagnostic nihilism...
March 10, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28333843/does-obesity-affect-pathologic-agreement-of-initial-and-final-tumor-grade-of-disease-in-endometrial-cancer-patients
#3
Laura R Daily, Jonathan D Boone, Hannah C Machemehl, Eric D Thomas, Gerald McGwin, J Michael Straughn, Charles A Leath
OBJECTIVES: The objectives of this study were to compare preoperative and postoperative tumor grade to determine if surgical staging decisions for endometrial cancer based on preoperative biopsy are feasible and whether obesity affects the agreement. METHODS: A retrospective cohort study of women with endometrial cancer between January 2010 and December 2011 was performed. Demographics, stage of final pathology, biopsy method, preoperative and postoperative tissue grade, and histology were abstracted and stratified by patient body mass index (obese ≥30 kg/m and nonobese <30 kg/m)...
March 23, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28328688/prioritizing-the-care-of-critically-ill-children-in-south-africa-how-does-screen-perform-against-other-triage-tools
#4
Bhakti Hansoti, Peter Hodkinson, Lee Wallis
OBJECTIVE: Childhood mortality remains unacceptably high. In low-resource settings, children with critical illness often present for care. Current triage strategies are time consuming and require trained health care workers. To address this limitation, our team developed a simple subjective tool, SCREEN (Sick Children Require Emergency Evaluation Now), which is easy to administer, to identify critically ill children. This article presents the development of the SCREEN program and evaluates its performance when compared with other commonly implemented triage tools in low-resource settings...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28318478/disaster-education-a-survey-study-to-analyze-disaster-medicine-training-in-emergency-medicine-residency-programs-in-the-united-states
#5
Ritu R Sarin, Srihari Cattamanchi, Abdulrahman Alqahtani, Majed Aljohani, Mark Keim, Gregory R Ciottone
BACKGROUND: The increase in natural and man-made disasters occurring worldwide places Emergency Medicine (EM) physicians at the forefront of responding to these crises. Despite the growing interest in Disaster Medicine, it is unclear if resident training has been able to include these educational goals. Hypothesis This study surveys EM residencies in the United States to assess the level of education in Disaster Medicine, to identify competencies least and most addressed, and to highlight effective educational models already in place...
March 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28315728/can-ambulance-telephone-triage-using-nhs-pathways-accurately-identify-paediatric-cardiac-arrest
#6
Charles D Deakin, Simon England, Debbie Diffey, Ian Maconochie
BACKGROUND: Most out-of-hospital paediatric cardiac arrests (CA) are not identified until a call is made to the emergency medical services. Accurate identification increases overall survival by enabling immediate ambulance dispatch and delivery of bystander CPR. European ambulance services use a variety of didactic telephone scripts to interrogate the caller and rapidly identify paediatric CA. The performance of these scripts has not been reported. This study aims to evaluate the diagnostic accuracy of the NHS Pathways as a telephone triage tool to identify patients less than 16 years age in cardiac arrest...
March 15, 2017: Resuscitation
https://www.readbyqxmd.com/read/28294509/validation-of-an-emergency-triage-scale-for-obstetrics-and-gynaecology-a-prospective-study
#7
N Veit-Rubin, P Brossard, A Gayet-Ageron, C-Y Montandon, J Simon, O Irion, O T Rutschmann, B Martinez de Tejada
OBJECTIVE: To evaluate the reliability of a four-level triage scale for obstetrics and gynaecology emergencies and to explore the factors associated with an optimal triage. DESIGN: Thirty clinical vignettes presenting the most frequent indications for obstetrics and gynaecology emergency consultations were evaluated twice using a computerised simulator. SETTING: The study was performed at the emergency unit of obstetrics and gynaecology at the Geneva University Hospitals...
March 15, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28287909/clinical-evaluation-of-a-microwave-based-device-for-detection-of-traumatic-intracranial-hemorrhage
#8
Johan Ljungqvist, Stefan Candefjord, Mikael Persson, Lars Jönsson, Thomas Skoglund, Mikael Elam
Traumatic brain injury (TBI) is the leading cause of death and disability among young persons. A key to improve outcome for patients with TBI is to reduce the time from injury to definitive care by achieving high triage accuracy. Microwave technology (MWT) allows for a portable device to be used in the pre-hospital setting for detection of intracranial hematomas at the scene of injury, thereby enhancing early triage and allowing for more adequate early care. MWT has previously been evaluated for medical applications including the ability to differentiate between hemorrhagic and ischemic stroke...
March 13, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28286815/potential-child-abuse-screening-in-emergency-department-a-diagnostic-accuracy-study
#9
Hossein Dinpanah, Abazar Akbarzadeh Pasha
INTRODUCTION: Designing a tool that can differentiate those at risk of child abuse with great diagnostic accuracy is of great interest. The present study was designed to evaluate the diagnostic accuracy of Escape instrument in triage of at risk cases of child abuse presenting to emergency department (ED). METHOD: The present diagnostic accuracy study performed on 6120 of the children under 16 years old presented to ED during 3 years, using convenience sampling. Confirmation by the child abuse team (pediatrician, a social worker, and a forensic physician) was considered as the gold standard...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28282767/pulmonary-edema-in-preeclampsia-an-indonesian-case-control-study
#10
Manggala Pasca Wardhana, Erry Gumilar Dachlan, Gustaaf Dekker
OBJECTIVE: To analyze risk factors, obstetric outcome and the need for mechanical ventilation in preeclampsia complicated by pulmonary edema. MATERIALS AND METHODS: Case-control study using medical record on preeclampsia complicated by pulmonary edema patients in East Java tertiary referral hospital over 2 years. A simple scoring system was developed to predict the need for mechanical ventilation, using logistic regression. RESULTS: 1106 cases of preeclampsia were admitted, with 62 cases (5...
March 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28281431/the-accuracy-of-nurse-performance-of-the-triage-process-in-a-tertiary-hospital-emergency-department-in-gauteng-province-south-africa
#11
L N Goldstein, L M Morrow, T A Sallie, K Gathoo, K Alli, T M M Mothopeng, F Samodien
BACKGROUND: Triage in the emergency department (ED) is necessary to prioritise management according to the severity of a patient's condition.The South African Triage Scale (SATS) is a hospital-based triage tool that has been adopted by numerous EDs countrywide.Many factors can influence the outcome of a patient's triage result, and evaluation of performance is therefore pivotal. OBJECTIVES: To determine how often patients were allocated to the correct triage category and the extent to which they were incorrectly promoted or demoted, and to determine the main reasons for errors in a nurse-led triage system...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28265177/-epidemiology-prevention-and-early-detection-of-cervical-cancer
#12
Nicolas Wentzensen
BACKGROUND: Persistent infections with human papillomaviruses are a necessary cause of cervical carcinomas. The development of HPV-based prevention tools, HPV vaccination and HPV testing, is leading to major changes in cervical cancer prevention programs worldwide. A decade after introduction of HPV vaccination in many countries reductions of HPV infections and cancer precursors have been observed in young women. The focus is now on the integration of new approaches for screening of increasingly vaccinated populations...
October 2016: Der Onkologe: Organ der Deutschen Krebsgesellschaft E.V
https://www.readbyqxmd.com/read/28264831/head-to-head-comparison-of-procalcitonin-and-presepsin-for-the-diagnosis-of-sepsis-in-critically-ill-adult-patients-a-protocol-for-a-systematic-review-and-meta-analysis
#13
Kei Hayashida, Yutaka Kondo, Yoshitaka Hara, Morio Aihara, Kazuma Yamakawa
INTRODUCTION: Early diagnosis and immediate therapeutic intervention, including appropriate antibiotic therapy and goal-directed resuscitation, are necessary to reduce mortality in patients with sepsis. However, a single clinical or biological marker indicative of sepsis has not been adopted unanimously. Although procalcitonin and presepsin are promising biomarkers that can effectively differentiate between sepsis/infection and systemic inflammatory response syndrome of non-infectious origin, little is known about which marker is superior...
March 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28263204/reliability-and-validity-of-emergency-department-triage-tools-in-low-and-middle-income-countries-a-systematic-review
#14
Alexander Jenson, Bhakti Hansoti, Richard Rothman, Sarah S de Ramirez, Katie Lobner, Lee Wallis
OBJECTIVE: Despite the universal acknowledgment that triage is necessary to prioritize emergency care, there is no review that provides an overview of triage tools evaluated and utilized in resource-poor settings, such as low- and middle-income countries (LMICs). We seek to quantify and evaluate studies evaluating triage tools in LMICs. METHODS: We performed a systematic review of the literature between 2000 and 2015 to identify studies that evaluated the reliability and validity of triage tools for adult emergency care in LMICs...
March 3, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28260639/new-zealand-healthline-call-data-used-to-measure-the-effect-of-travel-time-on-the-use-of-the-emergency-department
#15
Edward Griffin, John P McCarthy, Fiona Thomas, Simon Kingham
Telephone triage is a health tool increasingly used to connect geographically distant populations. Such services are also utilised to address issues of Emergency Department (ED) overuse. New Zealand's tele-triage service, Healthline, has existed since 2001 but is yet to be the focus of analysis. This research sought to understand the role that travel time to ED had upon Healthline users' compliance with telephone advice. Additionally, the role of deprivation in Healthline (as a determinant of caller behaviour) was examined...
February 27, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28257309/patient-centered-anesthesia-triage-system-predicts-asa-physical-status
#16
F Kayser Enneking, Nila S Radhakrishnan, Kent Berg, Saharsh Patel, Judith M Wishin, Terrie Vasilopoulos
BACKGROUND: The purpose of this study was to validate a patient-centered anesthesia triage system (PCATS) by examining its association with, and predictive value of, ASA physical status (PS) classification. ASA PS classification is a widely used indicator of health status and the predictor of risk of perioperative complications. Thus, ASA PS is a good triage point such that healthy surgical patients (ASA PS I and II) undergoing low-complexity surgery are assessed by telephone, whereas less-healthy patients (ASA PS III and IV) or those patients undergoing highly complex surgery are seen in person at a presurgical clinic...
March 2, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28250912/identification-and-preliminary-validation-of-radiation-response-protein-s-in-human-blood-for-a-high-throughput-molecular-biodosimetry-technology-for-the-future
#17
Saibadaiahun Nongrum, S Thangminlal Vaiphei, Joshua Keppen, Mandahakani Ksoo, Ettrika Kashyap, Rajesh N Sharan
The absence of a rapid and high-throughput technology for radiation biodosimetry has been a great obstacle in our full preparedness to cope with large-scale radiological incidents. The existing cytogenetic technologies have limitations, primarily due to their time-consuming methodologies, which include a tissue culture step, and the time required for scoring. This has seriously undermined its application in a mass casualty scenario under radiological emergencies for timely triage and medical interventions. Recent advances in genomics and proteomics in the postgenomic era have opened up new platforms and avenues to discover molecular biomarkers for biodosimetry in the future...
2017: Genome Integrity
https://www.readbyqxmd.com/read/28244884/triaging-atypical-squamous-cells-cannot-exclude-high-grade-squamous-intraepithelial-lesion-with-p16-ki67-dual-stain
#18
Daja Šekoranja, Alenka Repše Fokter
OBJECTIVES: The management of women with Pap cytology results categorized as "atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion" (ASC-H) can often be challenging. We assessed the performance of p16/Ki67 dual-stained cytology as a potential triage tool for the detection of biopsy-confirmed high-grade squamous intraepithelial lesions (HSILs) in women with ASC-H. MATERIALS AND METHODS: Women with ASC-H were followed for a period of 36 months by repeat cytology and colposcopy...
February 27, 2017: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/28242965/role-of-ultrasound-based-prenatal-prediction-of-pulmonary-function-in-congenital-diaphragmatic-hernia-does-it-have-prognostic-significance-postnatally
#19
Nupur Shah, Sujit Chowdhary, Anita Kaul
BACKGROUND AND OBJECTIVES: The incidence of congenital diaphragmatic hernia (CDH) in India is 1 in 1000. About 60 % of these are isolated, and the survival prognosis in them depends upon the quantum of contralateral functional lung. Out of the various pulmonary and extrapulmonary sonological predictors, observed to expected lung-head ratio (O/E LHR) is an efficient gestation-independent predictor of pulmonary function. This study was carried out to see the correlation of this prenatal predictor with the postnatal outcome depending on the pulmonary function...
February 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28231242/predicting-ebola-infection-a-malaria-sensitive-triage-score-for-ebola-virus-disease
#20
Mary-Anne Hartley, Alyssa Young, Anh-Minh Tran, Harry Henry Okoni-Williams, Mohamed Suma, Brooke Mancuso, Ahmed Al-Dikhari, Mohamed Faouzi
BACKGROUND: The non-specific symptoms of Ebola Virus Disease (EVD) pose a major problem to triage and isolation efforts at Ebola Treatment Centres (ETCs). Under the current triage protocol, half the patients allocated to high-risk "probable" wards were EVD(-): a misclassification speculated to predispose nosocomial EVD infection. A better understanding of the statistical relevance of individual triage symptoms is essential in resource-poor settings where rapid, laboratory-confirmed diagnostics are often unavailable...
February 2017: PLoS Neglected Tropical Diseases
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