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Tara Johnson, David Gaus, Diego Herrera
INTRODUCTION: There is a paucity of data studying patients and complaints presenting to emergency departments (EDs) in low- and middle-income countries. The town of Pedro Vicente Maldonado (PVM) is located in the northwestern highlands of Ecuador. Hospital PVM (HPVM) is a rural teaching hospital providing family medicine residency training. These physicians provide around-the-clock acute medical care in HPVM's ED. This study provides a first look at a functioning ED in rural Latin America by reviewing one year of ED visits to HPVM...
January 2016: Western Journal of Emergency Medicine
Janet A Smereck, Argyro Papafilippaki, Sawali Sudarshan
Bench press exercise, which involves repetitive lifting of weights to full arm extension while lying supine on a narrow bench, has been associated with complications ranging in acuity from simple pectoral muscle strain, to aortic and coronary artery dissection. A 39-year-old man, physically fit and previously asymptomatic, presented with acute chest pain following bench press exercise. Diagnostic evaluation led to the discovery of critical multivessel coronary occlusive disease, and subsequently, highly elevated levels of lipoprotein (a)...
2016: Open Access Emergency Medicine: OAEM
Marvin A H Berrevoets, Chantal P Bleeker-Rovers
No abstract text is available yet for this article.
September 2016: Annals of Emergency Medicine
Kaveh Sadigh, Sandeep Gupta, Muzammil H Musani, Kathleen Stergiopoulos
No abstract text is available yet for this article.
September 2014: Acute Cardiac Care
Matthew C Gratton, Stefanie R Ellison, Jason Hunt, O John Ma
OBJECTIVE: It has been estimated that between 11% and 61% of ambulance transports to emergency departments are not medically necessary. This study's objective was to analyze paramedic ability to determine the medical necessity of ambulance transport to the emergency department. METHODS: Paramedics prospectively assessed adult patients transported to an emergency department during a six-week period. The setting was an urban, all advanced life support, public utility model emergency medical services (EMS) system with 58,000 transports per year...
October 2003: Prehospital Emergency Care
Lena Hjälte, Björn-Ove Suserud, Johan Herlitz, Ingvar Karlberg
OBJECTIVE: The purpose of this report was to describe the characteristics of patients transported by ambulance, in spite of being evaluated by the ambulance staff at the scene as not requiring prehospital care. A second aim was to compare these patients with those judged as being in need of this care. METHODS: Three ambulance service districts located in different rural and metropolitan geographical areas were included in the study and all three were covered by a single emergency dispatch centre...
June 2007: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Michael M Dinh, Matthew Oliver, Kendall Bein, Sandy Muecke, Therese Carroll, Anne-Sophie Veillard, Belinda J Gabbe, Rebecca Ivers
OBJECTIVES: Describe the level of agreement between prehospital (emergency medical service [EMS]) and ED vital signs in a group of trauma patients transported to an inner city Major Trauma Centre. We also sought to determine factors associated with differences in recorded vital sign measurements. METHODS: All adult patients meeting trauma triage criteria and transported directly from scene of injury by New South Wales Ambulance to our institution were included. The primary outcome was the difference in vital signs: heart rate (HR), systolic blood pressure (SBP), respiratory rate (RR) and Glasgow Coma Scale (GCS), between ED and EMS recorded measurements...
October 2013: Emergency Medicine Australasia: EMA
Amber Mehmood, Siran He, Waleed Zafar, Noor Baig, Fareed Sumalani, Juanid Razzak
BACKGROUND: Vital signs play a critical role in prioritizing patients in emergency departments (EDs), and are the foundation of most triage methods and disposition decisions. This study was conducted to determine the frequency of vital signs documentation anytime during emergency department treatment and to explore if abnormal vital signs were associated with the likelihood of admission for a set of common presenting complaints. METHODS: Data were collected over a four-month period from the EDs of seven urban tertiary care hospitals in Pakistan...
2015: BMC Emergency Medicine
F E Blum, O Idowu, S Danciu
Syncope is a recognized presenting symptom in patients with pulmonary embolism (PE), and is more common in older patients and following a large embolus. Isolated syncope, in the absence of dyspnea or tachycardia, is uncommon in this setting, and may be misdiagnosed as cardiac in origin, leading to a delay in appropriate treatment. We present a case which illustrates the importance of consideration of pulmonary embolism in the differential diagnosis of patients presenting with syncope, and the value of echocardiography in its diagnosis...
2015: Acute Medicine
Jack A Porrino, Ezekiel Maloney, Kurt Scherer, Hyojeong Mulcahy, Alice S Ha, Christopher Allan
OBJECTIVE: Fractures of the distal radius are common and frequently encountered by the radiologist. We review the epidemiology, classification, as well as the concept of instability. Salient qualitative and quantitative features of the distal radius fracture identifiable on the routine radiography series are highlighted. We conclude with a synopsis of descriptors that are of greatest utility to the clinician for treatment planning and that should be addressed in the radiology report. CONCLUSION: A detailed understanding of the intricacies of the distal radius fracture is necessary for the radiologist to provide a clinically relevant description...
September 2014: AJR. American Journal of Roentgenology
Anne Maree Kelly, Anna Holdgate, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Charles Lawoko, Said Laribi
BACKGROUND: This study aimed to determine epidemiology and outcome for patients presenting to emergency departments (ED) with shortness of breath who were transported by ambulance. METHODS: This was a planned sub-study of a prospective, interrupted time series cohort study conducted at three time points in 2014 and which included consecutive adult patients presenting to the ED with dyspnoea as a main symptom. For this sub-study, additional inclusion criteria were presentation to an ED in Australia or New Zealand and transport by ambulance...
September 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Rosa Ramaekers, Muhammad Mukarram, Christine A M Smith, Venkatesh Thiruganasambandamoorthy
OBJECTIVES: Risk-stratification of emergency department (ED) patients with upper gastrointestinal bleeding (UGIB) using pre-endoscopic risk scores can aid ED physicians in disposition decision-making. We conducted a systematic review to assess the predictive value of pre-endoscopic risk scores for 30-day serious adverse events. METHODS: We searched MEDLINE, PubMed, Embase and the Cochrane Database of Systematic Reviews from inception to March 2015. We included studies involving adult ED UGIB patients evaluating pre-endoscopic risk scores and excluded reviews, case reports and animal studies...
September 19, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Adam B Raff, Daniela Kroshinsky
IMPORTANCE: Cellulitis is an infection of the deep dermis and subcutaneous tissue, presenting with expanding erythema, warmth, tenderness, and swelling. Cellulitis is a common global health burden, with more than 650,000 admissions per year in the United States alone. OBSERVATIONS: In the United States, an estimated 14.5 million cases annually of cellulitis account for $3.7 billion in ambulatory care costs alone. The majority of cases of cellulitis are nonculturable and therefore the causative bacteria are unknown...
July 19, 2016: JAMA: the Journal of the American Medical Association
Scott D Weingart
No abstract text is available yet for this article.
June 9, 2016: Annals of Emergency Medicine
Filippo Numeroso, Gianluigi Mossini, Michela Giovanelli, Giuseppe Lippi, Gianfranco Cervellin
OBJECTIVES: Despite guidelines, admission rates and expenditures for syncope remain high. This may be caused by an imprecise definition of cardiovascular disease considered at risk and an overestimation of the role of comorbidities and advanced age. In a cohort of patients with undetermined syncope, we prospectively compared the short-term prognosis of patients at intermediate risk (i.e., with stable heart diseases or comorbidities, of any age) versus those at high risk for cardiogenic syncope and identified factors associated with serious events...
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Joshua A Greenberg, Jonathan Hsu, Mohammad Bawazeer, John Marshall, Jan O Friedrich, Avery Nathens, Natalie Coburn, Gary R May, Emily Pearsall, Robin S McLeod
There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis...
April 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Jarrod M Mosier, Cameron Hypes, Raj Joshi, Sage Whitmore, Sairam Parthasarathy, Charles B Cairns
Acute respiratory failure is commonly encountered in the emergency department (ED), and early treatment can have effects on long-term outcome. Noninvasive ventilation is commonly used for patients with respiratory failure and has been demonstrated to improve outcomes in acute exacerbations of chronic obstructive lung disease and congestive heart failure, but should be used carefully, if at all, in the management of asthma, pneumonia, and acute respiratory distress syndrome. Lung-protective tidal volumes should be used for all patients receiving mechanical ventilation, and FiO2 should be reduced after intubation to achieve a goal of less than 60%...
November 2015: Annals of Emergency Medicine
Margaret L Campbell
Critically ill patients receiving palliative care at the end of life are at high risk for experiencing pain, dyspnea, and death rattle. Nearly all these patients are at risk for the development of delirium. Patients who are alert may experience anxiety. Advanced practice nurses and staff nurses are integral to detecting and treating these symptoms. Pain, dyspnea, and anxiety should be routinely assessed by patient self-report when possible. Routine behavioral screening for delirium is recommended. Behavioral observation tools to detect pain and dyspnea and proxy assessments guide symptom identification when the patient cannot provide a self-report...
April 2015: AACN Advanced Critical Care
Gerard B Hannibal
No abstract text is available yet for this article.
April 2015: AACN Advanced Critical Care
David Barbic, Michelle Tubman, Henry Lam, Skye Barbic
OBJECTIVES: Alternative-level metrics (Altmetrics) are a new method to assess the sharing and spread of scientific knowledge. The primary objective of this study was to describe the traditional metrics and Altmetric scores of the 50 most frequently cited articles published in emergency medicine (EM) journals. Since many articles related to EM are published in other journals, the secondary aim of this study was to describe the Altmetric scores of the most frequently cited articles relevant to EM in other biomedical journals...
March 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
2016-01-13 13:48:23
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