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Emergengy

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159 papers 100 to 500 followers
https://www.readbyqxmd.com/read/28446982/management-of-chest-trauma
#1
REVIEW
Corinna Ludwig, Aris Koryllos
Trauma is the leading cause of death worldwide. Approximately 2/3 of the patients have a chest trauma with varying severity from a simple rib fracture to penetrating injury of the heart or tracheobronchial disruption. Blunt chest trauma is most common with 90% incidence, of which less than 10% require surgical intervention of any kind. Mortality is second highest after head injury, which underlines the importance of initial management. Many of these deaths can be prevented by prompt diagnosis and treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28139311/fluid-resuscitation-of-trauma-patients-how-much-fluid-is-enough-to-determine-the-patient-s-response
#2
Yasuaki Mizushima, Shota Nakao, Koji Idoguchi, Tetsuya Matsuoka
No abstract text is available yet for this article.
June 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27286136/clinical-and-research-considerations-for-patients-with-hypertensive-acute-heart-failure-a-consensus-statement-from-the-society-for-academic-emergency-medicine-and-the-heart-failure-society-of-america-acute-heart-failure-working-group
#3
Sean P Collins, Phillip D Levy, Jennifer L Martindale, Mark E Dunlap, Alan B Storrow, Peter S Pang, Nancy M Albert, G Michael Felker, Gregory J Fermann, Gregg C Fonarow, Michael M Givertz, Judd E Hollander, David E Lanfear, Daniel J Lenihan, JoAnn M Lindenfeld, W Frank Peacock, Douglas B Sawyer, John R Teerlink, Javed Butler
Management approaches for patients in the emergency department (ED) who present with acute heart failure (AHF) have largely focused on intravenous diuretics. Yet, the primary pathophysiologic derangement underlying AHF in many patients is not solely volume overload. Patients with hypertensive AHF (H-AHF) represent a clinical phenotype with distinct pathophysiologic mechanisms that result in elevated ventricular filling pressures. To optimize treatment response and minimize adverse events in this subgroup, we propose that clinical management be tailored to a conceptual model of disease that is based on these mechanisms...
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27027730/reliability-of-clinical-assessments-in-older-adults-with-syncope-or-near-syncope
#4
Daniel K Nishijima, Amber L Laurie, Robert E Weiss, Annick N Yagapen, Susan E Malveau, David H Adler, Aveh Bastani, Christopher W Baugh, Jeffrey M Caterino, Carol L Clark, Deborah B Diercks, Judd E Hollander, Bret A Nicks, Manish N Shah, Kirk A Stiffler, Alan B Storrow, Scott T Wilber, Benjamin C Sun
OBJECTIVES: Clinical prediction models for risk stratification of older adults with syncope or near syncope may improve resource utilization and management. Predictors considered for inclusion into such models must be reliable. Our primary objective was to evaluate the inter-rater agreement of historical, physical examination, and electrocardiogram (ECG) findings in older adults undergoing emergency department (ED) evaluation for syncope or near syncope. Our secondary objective was to assess the level of agreement between clinicians on the patient's overall risk for death or serious cardiac outcomes...
September 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27306497/spontaneous-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis-describing-the-diagnostic-accuracy-of-history-physical-examination-imaging-and-lumbar-puncture-with-an-exploration-of-test-thresholds
#5
Christopher R Carpenter, Adnan M Hussain, Michael J Ward, Gregory J Zipfel, Susan Fowler, Jesse M Pines, Marco L A Sivilotti
BACKGROUND: Spontaneous subarachnoid hemorrhage (SAH) is a rare, but serious etiology of headache. The diagnosis of SAH is especially challenging in alert, neurologically intact patients, as missed or delayed diagnosis can be catastrophic. OBJECTIVES: The objective was to perform a diagnostic accuracy systematic review and meta-analysis of history, physical examination, cerebrospinal fluid (CSF) tests, computed tomography (CT), and clinical decision rules for spontaneous SAH...
September 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27611638/emergency-department-management-of-patients-with-febrile-neutropenia-guideline-concordant-or-overly-aggressive
#6
Christopher W Baugh, Thomas J Wang, Jeffrey M Caterino, Olesya N Baker, Gabriel A Brooks, Audrey C Reust, Daniel J Pallin
OBJECTIVES: The Infectious Diseases Society of America and the American Society of Clinical Oncology recommend risk stratification of patients with febrile neutropenia (FN) and discharge with oral antibiotics for low-risk patients. We studied guideline concordance and clinical outcomes of FN management in our emergency department (ED). METHODS: Our urban, tertiary care teaching hospital provides all emergency and inpatient services to a large comprehensive cancer center...
January 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27743490/an-observational-study-of-dyspnea-in-emergency-departments-the-asia-australia-and-new-zealand-dyspnea-in-emergency-departments-study-aanzdem
#7
MULTICENTER STUDY
Anne Maree Kelly, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
OBJECTIVES: The objective was to describe the epidemiology of dyspnea presenting to emergency departments (EDs) in the Asia-Pacific region, to understand how it is investigated and treated and its outcome. METHODS: Prospective interrupted time series cohort study conducted at three time points in EDs in Australia, New Zealand, Singapore, Hong Kong, and Malaysia of adult patients presenting to the ED with dyspnea as a main symptom. Data were collected over three 72-hour periods and included demographics, comorbidities, mode of arrival, usual medications, prehospital treatment, initial assessment, ED investigations, treatment in the ED, ED diagnosis, disposition from ED, in-hospital outcome, and final hospital diagnosis...
March 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/25144398/predictive-accuracy-and-feasibility-of-risk-stratification-scores-for-28-day-mortality-of-patients-with-sepsis-in-an-emergency-department
#8
Michelle J M Hilderink, Asselina A Roest, Maud Hermans, Yolande C Keulemans, Coen D A Stehouwer, Patricia M Stassen
OBJECTIVES: Sepsis is associated with high mortality. Because early therapy has proven to decrease mortality, a risk stratification tool that quickly and easily quantifies mortality risk of patients will be helpful to guide appropriate treatment. We investigated five scores in terms of (a) predicting 28-day mortality and (b) their feasibility for use in the emergency department (ED). MATERIALS AND METHODS: We carried out a historical cohort study in the ED of Maastricht University Medical Centre (MUMC)...
October 2015: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/25377403/comparison-of-piro-sofa-and-meds-scores-for-predicting-mortality-in-emergency-department-patients-with-severe-sepsis-and-septic-shock
#9
MULTICENTER STUDY
Stephen P J Macdonald, Glenn Arendts, Daniel M Fatovich, Simon G A Brown
OBJECTIVES: The Predisposition Insult Response and Organ failure (PIRO) scoring system has been developed for use in the emergency department (ED) to risk stratify sepsis cases, but has not been well studied among high-risk patients with severe sepsis and septic shock. The PIRO score was compared with the Sequential Organ Failure Assessment (SOFA) and Mortality in ED Sepsis (MEDS) scores to predict mortality in ED patients with features suggesting severe sepsis or septic shock in the ED...
November 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/23970100/prognostic-scores-for-early-stratification-of-septic-patients-admitted-to-an-emergency-department-high-dependency-unit
#10
Francesca Innocenti, Simone Bianchi, Elisa Guerrini, Sonia Vicidomini, Alberto Conti, Maurizio Zanobetti, Riccardo Pini
OBJECTIVES: The aim of this study was to identify a reliable tool for the early prognostic stratification of septic patients admitted to the emergency department-high dependency unit (ED-HDU), a clinical setting providing a subintensive level of care; we also estimated the cost saving associated with HDU stay compared with ICU stay. MATERIALS AND METHODS: Mortality in Emergency Department Sepsis (MEDS), Acute Physiology Age Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), Sequential Organ Failure Assessment (SOFA) score (SOFA-T0) and the Charlson index were calculated at ED admission...
August 2014: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/25010926/internal-emergency-department-validation-of-the-simplified-missed-score
#11
Narani Sivayoham, Paul Holmes, Maurizio Cecconi, Andrew Rhodes
BACKGROUND: The MISSED score was derived and validated in emergency department (ED) patients with sepsis who were admitted to the ICU. This score has now been refined and simplified. The independent variables associated with mortality are age at least 65 years, serum albumin 27 g/l or less, and an international normalized ratio at least 1.3. The simplified MISSED score ranges from 0 to 3 depending on the number of variables present. OBJECTIVE: The primary objective is to validate the simplified MISSED score for predicting all-cause mortality in the ED population admitted with sepsis...
October 2015: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/24743425/external-validation-of-the-missed-score-to-predict-mortality-in-patients-with-severe-sepsis-and-septic-shock-in-the-emergency-department
#12
Seung Mok Ryoo, Shin Ahn, Won Young Kim, Kyoung Soo Lim
OBJECTIVE: The Mortality in Severe Sepsis in the Emergency Department (MISSED) score was derived to predict in-hospital mortality in septic patients in the emergency department (ED). The present study aimed to validate the MISSED score in patients receiving early goal-directed therapy (EGDT). METHODS: Data were analyzed from 280 patients who received EGDT in a tertiary center ED in Korea. Age 65 years and above, albumin level 27 g/l or less, and international normalized ratio of at least 1...
October 2015: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/23883776/the-missed-score-a-new-scoring-system-to-predict-mortality-in-severe-sepsis-in-the-emergency-department-a-derivation-and-validation-study
#13
Narani Sivayoham, Andrew Rhodes, Maurizio Cecconi
OBJECTIVE: To derive and validate a new scoring system to predict in-hospital mortality in septic patients in the emergency department (ED). PATIENTS AND METHOD: Septic patients admitted to the ICU and those in whom early goal-directed therapy (EGDT) was carried out in the ED were identified from the ED record. Univariate and multivariate regression analyses identified independent variables associated with mortality. The variables were given a score weighted by the odds ratio, the sum of which yielded the Mortality In Severe Sepsis in the Emergency Department (MISSED) score...
February 2014: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/26351976/gym-score-30-day-mortality-predictive-model-in-elderly-patients-attended-in-the-emergency-department-with-infection
#14
Juan González Del Castillo, Luis Escobar-Curbelo, Mikel Martínez-Ortíz de Zárate, Ferrán Llopis-Roca, Jorge García-Lamberechts, Álvaro Moreno-Cuervo, Cristina Fernández, Francisco Javier Martín-Sánchez
OBJECTIVE: To determine the validity of the classic sepsis criteria or systemic inflammatory response syndrome (heart rate, respiratory rate, temperature, and leukocyte count) and the modified sepsis criteria (systemic inflammatory response syndrome criteria plus glycemia and altered mental status), and the validity of each of these variables individually to predict 30-day mortality, as well as develop a predictive model of 30-day mortality in elderly patients attended for infection in emergency departments (ED)...
June 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/26702902/-short-term-prognostic-factors-in-the-elderly-patients-seen-in-emergency-departments-due-to-infections
#15
Agustín Julián-Jiménez, Juan González-Del-Castillo, Mikel Martínez-Ortiz-de-Zárate, María Jesús Arranz-Nieto, Félix González-Martínez, Pascual Piñera-Salmerón, Carmen Navarro-Bustos, César Henríquez-Camacho, Eric Jorge García-Lamberechts
OBJECTIVES: To analyse factors associated with short-term mortality in elderly patients seen in emergency departments (ED) for an episode of infectious disease. MATERIALS AND METHODS: A prospective, observational, multicentre, analytical study was carried out on patients aged 75years and older who were treated in the ED of one of the eight participating hospitals. An assessment was made of 26 independent variables that could influence mortality at 30days. They covered epidemiological, comorbidity, functional, clinical and analytical factors...
December 15, 2015: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/23995123/the-role-of-frailty-in-outcomes-from-critical-illness
#16
REVIEW
Sean M Bagshaw, Robert C McDermid
PURPOSE OF REVIEW: Frailty is a multidimensional syndrome characterized by loss of physiologic reserves that gives rise to vulnerability to adverse events. RECENT FINDINGS: Frailty has been described in older patients undergoing geriatric assessment and in noncardiac and cardiac surgical settings, in which it closely correlates with heightened risk for major morbidity including functional decline, postoperative complications, institutionalization, and short-term and long-term mortality...
October 2013: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27458825/practical-approach-on-frail-older-patients-attended-for-acute-heart-failure
#17
REVIEW
Francisco J Martín-Sánchez, Michael Christ, Òscar Miró, W Frank Peacock, John J McMurray, Héctor Bueno, Alan S Maisel, Louise Cullen, Martin R Cowie, Salvatore Di Somma, Elke Platz, Josep Masip, Uwe Zeymer, Christiaan Vrints, Susanna Price, Christian Mueller
Acute heart failure (AHF) is a multi-organ dysfunction syndrome. In addition to known cardiac dysfunction, non-cardiac comorbidity, frailty and disability are independent risk factors of mortality, morbidity, cognitive and functional decline, and risk of institutionalization. Frailty, a treatable and potential reversible syndrome very common in older patients with AHF, increases the risk of disability and other adverse health outcomes. This position paper highlights the need to identify frailty in order to improve prognosis, the risk-benefits of invasive diagnostic and therapeutic procedures, and the definition of older-person-centered and integrated care plans...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27622896/emergency-heart-failure-mortality-risk-grade-score-performance-for-7-day-mortality-prediction-in-patients-with-heart-failure-attended-at-the-emergency-department-validation-in-a-spanish-cohort
#18
Víctor Gil, Òscar Miró, Michael J Schull, Pere Llorens, Pablo Herrero, Javier Jacob, José Ríos, Douglas S Lee, Francisco J Martín-Sánchez
OBJECTIVE: The Emergency Heart Failure Mortality Risk Grade (EHMRG) scale, derived in 86 Canadian emergency departments (EDs), stratifies patients with acute-decompensated heart failure (ADHF) according to their 7-day mortality risk. We evaluated its external validity in a Spanish cohort. PATIENTS AND METHODS: We applied the EHMRG scale to ADHF patients consecutively included in the Epidemiology of Acute Heart Failure in Emergency departments (EAHFE) registry (29 Spanish EDs) and measured its performance...
September 10, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27797432/the-effect-of-frailty-on-30-day-mortality-risk-in-older-patients-with-acute-heart-failure-attended-in-the-emergency-department
#19
Francisco Javier Martín-Sánchez, Esther Rodríguez-Adrada, Christian Mueller, María Teresa Vidán, Michael Christ, W Frank Peacock, Miguel Alberto Rizzi, Aitor Alquezar, Pascual Piñera, Paula Lázaro Aragues, Pere Llorens, Pablo Herrero, Javier Jacob, Cristina Fernández, Òscar Miró
OBJECTIVE: The objective was to determine the effect of frailty on risk of 30-day mortality in nonseverely disabled older patients with acute heart failure (AHF) attended in emergency departments (EDs). METHODOLOGY: The Frailty-AHF Study is a retrospective analysis of a multicenter, observational, prospective, cohort study (Older-AHF Register). This study included consecutive patients ≥ 65 years of age without severe functional dependence or dementia attended for AHF in three Spanish EDs for 4 months...
March 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/23073273/long-term-survival-after-hospitalization-for-acute-heart-failure-differences-in-prognosis-of-acutely-decompensated-chronic-and-new-onset-acute-heart-failure
#20
MULTICENTER STUDY
Johan P E Lassus, Krista Siirilä-Waris, Markku S Nieminen, Jukka Tolonen, Tuukka Tarvasmäki, Keijo Peuhkurinen, John Melin, Kari Pulkki, Veli-Pekka Harjola
AIMS: To analyze the five-year mortality after hospitalization for acute heart failure (AHF) and compare predictors of prognosis in patients with and without a previous history of heart failure. METHODS: Patients with AHF (n=620) from the prospective multicenter FINN-AKVA study were classified as acutely decompensated chronic heart failure (ADCHF) or de-novo AHF if no previous history of heart failure was present. Both all-cause mortality during five years of follow-up and prognostic factors were determined...
September 20, 2013: International Journal of Cardiology
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