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"Emergency Department" OR "ED" OR "ER" OR "Emergency Medicine" OR "Emergency Nursing" OR "ED" OR "ER"

D Greenwood, M P Tully, S Martin, D Steinke
Background Due to a shortage of emergency department doctors and nurses, hospitals have started to employ pharmacists who have additional clinical skills, known as Emergency Department Pharmacist Practitioners, to help deliver services. Objective To describe, compare and define the Emergency Department Pharmacist Practitioner role. Setting UK emergency departments. Method Using a purpose developed questionnaire hosted on a tablet computer, Emergency Department Pharmacist Practitioners were asked to report their contribution to patient care and the wider emergency department over 10 work days...
March 16, 2019: International Journal of Clinical Pharmacy
Diana Martins Oliveira, Catarina Correia, Flávia Cunha, Patrícia Dias
An 89-year-old man presented to the emergency department with a 1-month history of upper right quadrant pain, worsened in the last 3 days and accompanied by fever and chills. On physical examination, he had scleral icterus and right upper quadrant tenderness. Laboratory findings showed hyperbilirubinemia, elevated liver enzymes and C reactive protein. The patient was admitted, suspecting of an acute cholangitis and started on antibiotics. An upper gastrointestinal endoscopy revealed the presence of a juxtapapillary diverticulum in the second portion of the duodenum, which was confirmed by a magnetic resonance cholangiopancreatography, along with upstream biliary tract ectasia...
March 16, 2019: BMJ Case Reports
Tsegazeab Laeke, Abenezer Tirsit, Finot Debebe, Biruk Girma, Desalegn Gere, Kee B Park, Aklilu Azazh
BACKGROUND: Consistent data on head injury is lacking especially in the low and middle income countries. Our study tries to characterize head injury patients at the emergency room of one of the few tertiary public hospitals giving neurosurgical care in the country. METHODS: A retrospective cross sectional study done from May 2015 -October 2015 in one of the neurosurgical teaching hospitals, Black Lion Specialized Hospital. All adult head injury patients who visited the emergency department during the study period were included...
March 13, 2019: World Neurosurgery
Branko F Olij, Martien J M Panneman, Ed F van Beeck, Juanita A Haagsma, Klaas A Hartholt, Suzanne Polinder
OBJECTIVES: Fall-related injuries are a leading cause of morbidity among older adults, leading to a high healthcare consumption and mortality. We aim to describe and quantify time trends of fall-related healthcare use and mortality among adults aged ≥65 years in the Netherlands, 1997-2016. DESIGN: Data were extracted from the Dutch Injury Surveillance System, Dutch Hospital Discharge Registry, and Cause-of-Death Statistics Netherlands, by age, sex, diagnosis, injury location, and year...
March 13, 2019: Experimental Gerontology
Elizabeth Burner, Janisse Mercado, Antonio Saenz Hernandez, Anne Peters, Lourdes Baezconde-Garbanati, Sanjay Arora, Shinyi Wu
Although diabetes is a nationwide epidemic, US Latinos are a particularly vulnerable population. Culturally appropriate interventions can combat this disparity, especially those that increase social support. However, these interventions face significant cost and time barriers, which mHealth (mobile health) may overcome. This trial examines the benefit of adding social support to an existing text-message based, patient-focused mHealth intervention for emergency department patients with poorly controlled diabetes...
March 13, 2019: Contemporary Clinical Trials
Jin Hee Lee, Jae Yun Jung, Hyun Jung Lee, Do Kyun Kim, Young Ho Kwak, Ikwan Chang, Hyuksool Kwon, Yoo Jin Choi, Joong Wan Park, So Hyun Paek, Jun Hwi Cho
OBJECTIVE: Croup treatment usually involves a single dose of systemic dexamethasone combined with nebulized epinephrine. However, the optimal dose of l-epinephrine remains unclear. We examined whether a low dose (0.1 mg/kg) was inferior to the conventional dose (0.5 mg/kg) of 1:1000 nebulized l-epinephrine in patients with moderate to severe croup. METHODS: This randomized double-blind clinical non-inferiority trial was conducted in three pediatric emergency departments from May 2015 to October 2017...
March 8, 2019: American Journal of Emergency Medicine
Michael E Winters, Kami Hu, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200% [1]! This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6 h [1]...
March 10, 2019: American Journal of Emergency Medicine
Yuka Kanazawa, Shuji Arakawa, Takafumi Shimogawa, Noriko Hagiwara, Sei Haga, Takato Morioka, Hiroaki Ooboshi, Tetsuro Ago, Takanari Kitazono
BACKGROUND: Differential diagnosis between acute ischemic stroke (AIS) and epilepsy-related stroke mimics is sometimes difficult in the emergency department. We investigated whether a combination of diffusion-weighted imaging (DWI) and arterial spin labeling imaging (ASL) is useful in distinguishing AIS from epileptic disorders. METHODS: The study included suspected AIS patients who underwent emergency MRI including both DWI and ASL, and who exhibited DWI high-intensitylesions corresponding to neurological symptoms...
March 13, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Sheri K Carey, Crystal Edds-McAfee, Valerie Martinez, Antonio P Gutierrez de Blume, Kathy M Thornton
INTRODUCTION: Despite effective treatments and interventions, asthma continues to affect children's health-related quality of life (QOL). This study explored factors affecting QOL of children with asthma and their caregivers. METHODS: A mixed-model design was used. Children (7-17 years) completed the Paediatric Asthma Quality of Life Questionnaire, and parents/caregivers completed the Paediatric Asthma Caregiver's Quality of Life Questionnaire. These surveys focused on activity limitations, emotional function, and child symptoms...
March 13, 2019: Journal of Pediatric Health Care
Jared P Beller, Robert B Hawkins, J Hunter Mehaffey, William Z Chancellor, Clifford E Fonner, Alan M Speir, Mohammed A Quader, Jeffrey B Rich, Leora T Yarboro, Nicholas R Teman, Gorav Ailawadi
OBJECTIVE: Transfer from hospital to hospital for cardiac surgery represents a large portion of some clinical practices. Previous literature in other surgical fields has shown worse outcomes for transferred patients. We hypothesized that transferred patients would be higher risk and demonstrate worse outcomes than those admitted through the emergency department. METHODS: All patients undergoing cardiac operations with a Society of Thoracic Surgeons Predicted Risk of Mortality were evaluated from a multicenter, statewide Society of Thoracic Surgeons database...
February 11, 2019: Journal of Thoracic and Cardiovascular Surgery
Ji Hoon Na, Young Mock Lee
BACKGROUND AND PURPOSE: There is an increasing rate of presentations by transient and adult patients (TAPs) to pediatric emergency departments (PED-EDs). TAPs with neurologic diseases (N-TAPs) comprise most of these patients. We investigated this trend and compared the characteristics of N-TAPs with those of pediatric patients with neurologic diseases (N-PEDs) who presented to the PED-ED of a tertiary-care hospital in Korea. METHODS: We reviewed the medical records of neurologic patients who presented to the PED-ED of a single tertiary-care hospital from 2013 to 2017...
March 11, 2019: Journal of Clinical Neurology
Mauricio La Rosa, Victoria Jauk, George R Saade, Kim Boggess, Sherri Longo, Erin A S Clark, Sean Esplin, Kirsten Cleary, Ronald Wapner, Kellet Letson, Michelle Y Owens, Sean Blackwell, Jeff M Szychowski, William Andrews, Alan T Tita
OBJECTIVE:  Hospital readmissions are increasingly tracked and assessed for value-based compensation. Our objective was to determine the incidence and risk factors associated with post-cesarean delivery (CD) readmissions or unexpected visits, defined as unexpected office or emergency room visits. STUDY DESIGN:  This is a secondary analysis of a multicenter randomized controlled trial of adjunctive azithromycin prophylaxis for CD performed in laboring patients with viable pregnancies...
March 15, 2019: American Journal of Perinatology
Amy S Kelley, Katelyn B Ferreira, Evan Bollens-Lund, Harriet Mather, Laura C Hanson, Christine S Ritchie
CONTEXT: Identifying the seriously ill population is integral to improving the value of health care. Efforts to identify this population using existing data are anchored to a list of severe medical conditions (SMCs) using diagnostic codes. Published approaches have utilized International Classification of Diseases, Ninth Revision (ICD-9) codes, which has since been replaced by ICD-10. OBJECTIVES: We translated SMCs from ICD-9 to ICD-10 using a refined code list...
March 12, 2019: Journal of Pain and Symptom Management
Abdullah Osman Kocak
INTRODUCTION: Acute musculoskeletal injuries are one of the most common painful presentation when admission to the emergency department. The aim of the study is to compare the tenoxicam mesotherapy with intravenous dexketoprofen in pain control in patients with acute musculoskeletal injury. METHODS: This parallel randomized controlled trial was conducted with the patients admitted to the emergency department with musculoskeletal injury. Intravenous dexketoprofen was administered to the control group, and mesotherapy treatment was performed to the other group...
February 28, 2019: American Journal of Emergency Medicine
Akira Kuriyama, Toshie Kaihara, Tetsunori Ikegami
BACKGROUND: In developed nations, the age of patients in emergency departments (ED) continues to increase. Many emergency triage systems, such as the Canadian Triage and Acuity Scale (CTAS), triage patients as a homogenous group, regardless of age. However, older adults have multiple comorbidities and a higher risk of undertriage. The Japan Acuity and Triage Scale (JTAS) was developed based on the CTAS and has been validated for overall adults. We assessed the validity of the JTAS for use in elderly ED patients...
March 8, 2019: American Journal of Emergency Medicine
Ashimiyu B Durojaiye, Lisa L Puett, Scott Levin, Matthew Toerper, Nicolette M McGeorge, Kristen L W Webster, Gurmehar S Deol, Hadi Kharrazi, Harold P Lehmann, Ayse P Gurses
BACKGROUND:  Electronic health record (EHR) systems contain large volumes of novel heterogeneous data that can be linked to trauma registry data to enable innovative research not possible with either data source alone. OBJECTIVE:  This article describes an approach for linking electronically extracted EHR data to trauma registry data at the institutional level and assesses the value of probabilistic linkage. METHODS:  Encounter data were independently obtained from the EHR data warehouse ( n  = 1,632) and the pediatric trauma registry ( n  = 1,829) at a Level I pediatric trauma center...
November 2018: Methods of Information in Medicine
Nisha Nataraj, Kun Zhang, Gery P Guy, Jan L Losby
OBJECTIVE: Despite recent decreases in opioid prescribing rates, evidence suggests there is substantial variation in the way opioids are prescribed by providers. This study aims to identify patterns in high-volume opioid prescribing. METHODS: We conducted partitioning-around-medoids cluster analysis using the IQVIA Prescriber Profile dataset, including the number of opioid prescriptions filled at US retail pharmacies aggregated at the prescriber-level from July 2016 through June 2017...
February 16, 2019: Drug and Alcohol Dependence
Ingrid A Binswanger, Komal J Narwaney, Edward M Gardner, Barbara A Gabella, Susan L Calcaterra, Jason M Glanz
BACKGROUND: Increasing epidemiologic and intervention research is being conducted on opioid overdose, a serious and potentially fatal outcome. However, there is little consensus on how to verify opioid overdose outcomes for research purposes. To ensure reproducibility, minimize misclassification, and permit data harmonization across studies, standardized and consistent overdose definitions are needed. The aims were to develop a case criteria classification scheme based on information commonly available in medical records and to compare it with reviewing physician clinical impression and simple encounter documentation...
March 15, 2019: Substance Abuse
(no author information available yet)
Correction to the Trends From the Field article, "Risk Stratification for Return Emergency Department Visits Among High-Risk Patients," published in the August 2017 issue of The American Journal of Managed Care.
March 2019: American Journal of Managed Care
Lisa M Kern, Joanna K Seirup, Mangala Rajan, Rachel Jawahar, Susan S Stuard
OBJECTIVES: Results of previous studies of Medicare beneficiaries have shown that more fragmented ambulatory care is associated with more emergency department (ED) visits and hospital admissions. Whether this observation is generalizable to Medicaid beneficiaries is unknown. STUDY DESIGN: We conducted a 3-year retrospective cohort study in the 7-county Hudson Valley region of New York. We included 19,330 adult Medicaid beneficiaries who were continuously enrolled, were attributed to a primary care provider, and had 4 or more ambulatory visits in the baseline year...
March 2019: American Journal of Managed Care
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