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38 papers 25 to 100 followers
Mohamad Alameddine, Afif Mufarrij, Miriam Saliba, Yara Mourad, Rima Jabbour, Eveline Hitti
BACKGROUND: Peer evaluation is increasingly used as a method to assess physicians' interpersonal and communication skills. We report on experience with soliciting registered nurses' feedback on physicians' non-clinical performance in the ED of a large academic medical center in Lebanon. METHODS: We utilized a secondary analysis of a de-identified database of ED nurses' assessment of physicians' non-clinical performance coupled with an evaluation of interventions carried out as a result of this evaluation...
February 27, 2015: BMC Health Services Research
Lynsey Flowerdew, Ruth Brown, Stephanie Russ, Charles Vincent, Maria Woloshynowych
OBJECTIVE: To identify key stressors for emergency department (ED) staff, investigate positive and negative behaviours associated with working under pressure and consider interventions that may improve how the ED team functions. METHODS: This was a qualitative study involving semistructured interviews. Data were collected from staff working in the ED of a London teaching hospital. A purposive sampling method was employed to recruit staff from a variety of grades and included both doctors and nurses...
December 2012: Emergency Medicine Journal: EMJ
Fikret Er, Amir M Nia, Natig Gassanov, Evren Caglayan, Erland Erdmann, Uta C Hoppe
BACKGROUND: Cardiac arrest in patients with pulmonary embolism (PE) is associated with high morbidity and mortality. Thrombolysis is expected to improve the outcome in these patients. However studies evaluating rescue-thrombolysis in patients with PE are missing, mainly due to the difficulties of clinical diagnosis of PE. We aimed to determine the success influencing factors of thrombolysis during resuscitation in patients with PE. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed retrospectively the outcome of 104 consecutive patients with confirmed (n = 63) or highly suspected (n = 41) PE and monitored cardiac arrest...
December 15, 2009: PloS One
Hans-Richard Arntz, Volker Wenzel, Rüdiger Dissmann, Angela Marschalk, Jan Breckwoldt, Dirk Müller
Up to 90% of cardiac arrests are due to acute myocardial infarction or severe myocardial ischaemia. Thrombolysis is an effective treatment for ST-elevation myocardial infarction (STEMI), but there is no evidence or guideline to put forward a thrombolysis strategy during cardiopulmonary resuscitation (CPR). In two physician-manned emergency medical service (EMS) units in Berlin, Germany, using thrombolysis is based on an individual judgment of the EMS physician managing the CPR attempt. In this retrospective analysis over 3 years (total 22...
February 2008: Resuscitation
W A Wetsch, F Spöhr, P Teschendorf, B W Böttiger, S A Padosch
Sudden cardiac death is a leading cause of death in Europe. In the vast majority, myocardial infarction or pulmonary embolism is the underlying cause. Lethality is still high, especially if the arrest occurs out of hospital. For these two severe conditions, thrombolysis has proven to be an established therapy. Coronary perfusion is restored or the occlusion in the pulmonary arteries is removed, restoring normal circulation and normalising right-ventricular afterload. Nevertheless, thrombolysis was contraindicated during cardio-pulmonary resuscitation (CPR) for many years due to the fear of severe bleeding complications...
October 2010: Deutsche Medizinische Wochenschrift
J Wernerman, G H Sigurdsson
No abstract text is available yet for this article.
February 2016: Acta Anaesthesiologica Scandinavica
Kevin R Scott, Cindy H Hsu, Nicholas J Johnson, Mira Mamtani, Lauren W Conlon, Francis J DeRoos
No abstract text is available yet for this article.
October 2014: Annals of Emergency Medicine
Philip Kaye, Matthew Govier
Many emergency patients present with cardiac arrhythmias requiring emergency direct current countershock cardioversion (DCCV) as a part of their management. Almost all require sedation to facilitate the procedure. Propofol has been used for procedural sedation in Emergency Medicine since 1995. In 1996, in a review article in Anaesthesia, it was recommended as the drug which most closely approaches the ideal agent for DCCV. However, the existing evidence for the dosage requirements and safety of propofol in emergency DCCV is limited...
November 2014: Emergency Medicine Journal: EMJ
Ben L C Wright, James T F Lai, Alexandra J Sinclair
Cerebrospinal fluid is vital for normal brain function. Changes to the composition, flow, or pressure can cause a variety of neurological symptoms and signs. Equally, disorders of nervous tissue may alter cerebrospinal fluid characteristics. Analysis of cerebrospinal fluid can provide information on diagnosis, may be therapeutic in certain conditions, and allows a research opportunity into neurological disease. However, inappropriate sampling, inaccurate technique, and incomplete analysis can contribute to significant patient morbidity, and reduce the amount of accurate information obtained...
August 2012: Journal of Neurology
Gregory W Hendey
No abstract text is available yet for this article.
January 2016: Annals of Emergency Medicine
Leonie Rose Bovino, Marjorie Funk, Michele M Pelter, Mayur M Desai, Vanessa Jefferson, Laura Kierol Andrews, Kenneth Forte
Practice standards for electrocardiographic monitoring recommend continuous ST-segment monitoring (C-STM) in patients presenting to the emergency department (ED) with signs and/or symptoms of acute coronary syndrome (ACS), but few studies have evaluated its use in the ED. We compared time to diagnosis and 30-day adverse events before and after implementation of C-STM. We also evaluated the diagnostic accuracy of C-STM in detecting ischemia and infarction. We prospectively studied 163 adults (preintervention: n = 78; intervention: n = 85) in a single ED and stratified them into low (n = 51), intermediate (n = 100), or high (n = 12) risk using History, ECG, Age, Risk factors, and Troponin (HEART) scores...
October 2015: Advanced Emergency Nursing Journal
Elizabeth L Alford, James W Wheless, Stephanie J Phelps
Generalized convulsive status epilepticus (GCSE) is one of the most common neurologic emergencies and can be associated with significant morbidity and mortality if not treated promptly and aggressively. Management of GCSE is staged and generally involves the use of life support measures, identification and management of underlying causes, and rapid initiation of anticonvulsants. The purpose of this article is to review and evaluate published reports regarding the treatment of impending, established, refractory, and super-refractory GCSE in pediatric patients...
July 2015: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Alexander C Fanaroff, Jennifer A Rymer, Sarah A Goldstein, David L Simel, L Kristin Newby
IMPORTANCE: About 10% of patients with acute chest pain are ultimately diagnosed with acute coronary syndrome (ACS). Early, accurate estimation of the probability of ACS in these patients using the clinical examination could prevent many hospital admissions among low-risk patients and ensure that high-risk patients are promptly treated. OBJECTIVE: To review systematically the accuracy of the initial history, physical examination, electrocardiogram, and risk scores incorporating these elements with the first cardiac-specific troponin...
November 10, 2015: JAMA: the Journal of the American Medical Association
Johanna E Bischof, Christine Worrall, Peter Thompson, David Marti, Stephen W Smith
BACKGROUND: ST-segment elevation (STE) due to inferior STE myocardial infarction (STEMI) may be misdiagnosed as pericarditis. Conversely, this less life-threatening etiology of ST elevation may be confused for inferior STEMI. We sought to determine if the presence of any ST-segment depression in lead aVL would differentiate inferior STEMI from pericarditis. METHODS: Retrospective study of 3 populations. Cohort 1 included patients coded as inferior STEMI, cohort 2 included patients with a discharge diagnosis of pericarditis who presented with chest pain and at least 0...
February 2016: American Journal of Emergency Medicine
Peter W Macfarlane, Charles Antzelevitch, Michel Haissaguerre, Heikki V Huikuri, Mark Potse, Raphael Rosso, Frederic Sacher, Jani T Tikkanen, Hein Wellens, Gan-Xin Yan
The term early repolarization has been in use for more than 50 years. This electrocardiographic pattern was considered benign until 2008, when it was linked to sudden cardiac arrest due to idiopathic ventricular fibrillation. Much confusion over the definition of early repolarization followed. Thus, the objective of this paper was to prepare an agreed definition to facilitate future research in this area. The different definitions of the early repolarization pattern were reviewed to delineate the electrocardiographic measures to be used when defining this pattern...
July 28, 2015: Journal of the American College of Cardiology
Savithiri Ratnapalan
No abstract text is available yet for this article.
November 2015: Emergency Medicine Journal: EMJ
Jo Nijs, Adri Apeldoorn, Hank Hallegraeff, Jacqui Clark, Rob Smeets, Annaleen Malfliet, Enrique L Girbes, Margot De Kooning, Kelly Ickmans
BACKGROUND: Low back pain (LBP) is a heterogeneous disorder including patients with dominant nociceptive (e.g., myofascial low back pain), neuropathic (e.g., lumbar radiculopathy), and central sensitization pain. In order to select an effective and preferably also efficient treatment in daily clinical practice, LBP patients should be classified clinically as either predominantly nociceptive, neuropathic, or central sensitization pain. OBJECTIVE: To explain how clinicians can differentiate between nociceptive, neuropathic, and central sensitization pain in patients with LBP...
May 2015: Pain Physician
Julie L Welch, Dylan D Cooper
No abstract text is available yet for this article.
January 2016: Annals of Emergency Medicine
Jeremy S Furyk, Kevin Chu, Colin Banks, Jaimi Greenslade, Gerben Keijzers, Ogilvie Thom, Tom Torpie, Carl Dux, Rajan Narula
STUDY OBJECTIVE: We assess the efficacy and safety of tamsulosin compared with placebo as medical expulsive therapy in patients with distal ureteric stones less than or equal to 10 mm in diameter. METHODS: This was a randomized, double-blind, placebo-controlled, multicenter trial of adult participants with calculus on computed tomography (CT). Patients were allocated to 0.4 mg of tamsulosin or placebo daily for 28 days. The primary outcomes were stone expulsion on CT at 28 days and time to stone expulsion...
January 2016: Annals of Emergency Medicine
Xiao Wu, Vivek B Kalra, David Durand, Ajay Malhotra
PURPOSE: To determine the most effective follow-up strategy for evaluation of patients with thunderclap headache and negative initial non-contrast CT for acute subarachnoid haemorrhage (SAH). MATERIALS AND METHODS: Institutional review was performed to assess the frequency of CT angiography (CTA) in screening patients with negative non-contrast CT. A comparative effectiveness analysis based on decision tree modelling was subsequently performed to assess three different strategies--no follow-up, lumbar puncture (LP) and CTA...
January 2016: Emergency Medicine Journal: EMJ
2015-07-26 14:35:55
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