MedWorm: Emergency Medicine

Analysis of Delayed Bleeding after Endoscopic Submucosal Dissection for Gastric Epithelial Neoplasms

Advances in Pharmacological Sciences — Wed, 08 Feb 2012 18:37:00 +0100

Conclusion. Ulcer presence/absence was considered the most significant predictor of post-ESD bleeding. (Source: Advances in Pharmacological Sciences)

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Dual Imaging Catches Risk of Second Stroke (CME/CE)

MedPage Today Emergency Medicine — Wed, 08 Feb 2012 17:43:02 +0100

NEW ORLEANS (MedPage Today) -- CT angiography should be included with brain CT for early detection of severe arterial stenosis in those presenting with transient ischemic attack or minor stroke, researchers suggested. (Source: MedPage Today Emergency Medicine)

Improving Emergency General Surgery Care And Outcomes

Health News from Medical News Today — Wed, 08 Feb 2012 09:00:00 +0100

Researchers at Wake Forest Baptist Medical Center in Winston-Salem, NC, have successfully created and implemented an emergency general surgery registry (EGSR) that will advance the science of acute surgical care by allowing surgeons to track and improve surgical patient outcomes, create performance metrics, conduct valid research and ensure quality care for all emergency general surgery (EGS) patients... (Source: Health News from Medical News Today)

Spinning Sessions Trigger The Same Biochemical Indications As Heart Attacks

Health News from Medical News Today — Wed, 08 Feb 2012 09:00:00 +0100

A short spinning session can trigger the same biochemical indications as a heart attack - a reaction that is probably both natural and harmless, but should be borne in mind when people seek emergency treatment for chest pain, reveals a study from the Sahlgrenska Academy at the University of Gothenburg, Sweden. Heart attacks increase the secretion of enzymes known as cardiac biomarkers, which can be measured using a simple blood test. This is important for rapid diagnosis and initiation of treatment... (Source: Health News from Medical News Today)

HCA to break ground on Poinciana hospital

bizjournals.com Health Care:Physician Practices headlines — Tue, 07 Feb 2012 22:38:06 +0100

Osceola Regional Medical Center will break ground Feb. 7 on a $65 million hospital project in Poinciana. The project will start with a 12-bed, one-story, 11,000-square-foot freestanding emergency department with a helicopter pad, laboratory, pharmacy and imaging. The second phase includes a $33.7 million, 30-bed, two-story, 94,000-square-foot hospital. Phase 3 is a medical office building. Once completed, the complex is expected to have 200 full-time employees. Click here to read about the state agreeing to scale down the project... (Source: bizjournals.com Health Care:Physician Practices headlines)

Orthopaedic Trauma Volume Drops as Unemployment Rate RisesOrthopaedic Trauma Volume Drops as Unemployment Rate Rises

Medscape Today Headlines — Tue, 07 Feb 2012 20:32:36 +0100

The higher the unemployment rate, the lower the number of orthopaedic trauma cases presenting at the emergency department. Medscape Medical News (Source: Medscape Today Headlines)

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Syncope and Fever in the ED: What's the Cause?Syncope and Fever in the ED: What's the Cause?

Medscape Today Headlines — Tue, 07 Feb 2012 17:27:21 +0100

This case illustrates 3 novel presentations of fever and syncope in adolescent patients. Learn the diagnosis. Medscape Emergency Medicine (Source: Medscape Today Headlines)

Pa. university installs "morning-after" machine

Health News: CBSNews.com — Tue, 07 Feb 2012 17:12:07 +0100

Shippensburg University students can buy emergency contraception for $25 from a vending machine, guaranteeing more privacy (Source: Health News: CBSNews.com)

Pa. university installs Plan B vending machine

Health News: CBSNews.com — Tue, 07 Feb 2012 17:12:07 +0100

Shippensburg University students can buy emergency contraception for $25 from a vending machine, guaranteeing more privacy (Source: Health News: CBSNews.com)

U.S. college machine dispenses 'morning-after' pill

CTV Health — Tue, 07 Feb 2012 16:35:17 +0100

Students at a U.S. university can obtain the "morning-after" emergency contraceptive pill from an unusual source -- a vending machine. (Source: CTV Health)

Emergency Department Crowding: Time for Interventions and Policy Evaluations

Computational Intelligence and Neuroscience — Tue, 07 Feb 2012 11:42:45 +0100

This paper summarises the consequences of emergency department crowding. It provides a comparison of the scales used to measure emergency department crowding. We discuss the multiple causes of crowding and present an up-to-date literature review of the interventions that reduce the adverse consequences of crowding. We consider interventions at the level of an individual hospital and a policy level. (Source: Computational Intelligence and Neuroscience)

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Management and outcome of severely elevated blood pressure in primary care: A prospective observational study.

Swiss Medical Weekly — Tue, 07 Feb 2012 05:36:02 +0100

CONCLUSION: The majority of 164 patients who presented with acutely and severely elevated blood pressure (BP >180 +/or >110 mm Hg) to their GPs was asymptomatic, had pre-existing hypertension and was managed in GP's office unless a hypertensive emergency was present. At three month follow-up mean systolic BP was still above target values. PMID: 22287296 [PubMed - in process] (Source: Swiss Medical Weekly)

Safety-Net Emergency Departments No SlowerSafety-Net Emergency Departments No Slower

Medscape Today Headlines — Tue, 07 Feb 2012 03:20:10 +0100

A new study suggests that safety-net and non-safety-net institutions show no disparity in time frames for care. Medscape Medical News (Source: Medscape Today Headlines)

Hubbies React to Stroke Symptoms Before Wives (CME/CE)

MedPage Today Cardiovascular — Mon, 06 Feb 2012 15:09:52 +0100

NEW ORLEANS (MedPage Today) -- After noticing stroke symptoms, married men called for emergency attention more quickly than married women, researchers found. (Source: MedPage Today Cardiovascular)

Hemorrhagic Shock as a Sequela of Splenic Rupture in a Patient with Infectious Mononucleosis: Focus on the Potential Role of Salicylates

Advances in Urology — Mon, 06 Feb 2012 12:46:42 +0100

Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of salicylates in the development of a hemorrhagic complication in a patient with infectious mononucleosis is discussed. (Source: Advances in Urology)

Outcome of road traffic injuries received in the emergency room of a teaching hospital, Southeast Nigeria. - Omoke NI, Chukwu CO, Madubueze CC, Oyakhiolme OP.

SafetyLit: All (Unduplicated) — Mon, 06 Feb 2012 11:54:53 +0100

This study was aimed at assessing the early outcome of RTIs received in our hospital emergency room. Understanding this will help to achieve optimum injury out... (Source: SafetyLit: All (Unduplicated))

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Foreign body traumas of the eye managed in an emergency department of a single-institution. - Yigit O, Yürüktümen A, Arslan S.

SafetyLit: All (Unduplicated) — Mon, 06 Feb 2012 11:54:53 +0100

BACKGROUND: Superficial corneal foreign bodies (SCFB) are common injuries seen in the ED. The aim of this study was to describe the eye injuries caused by FBs and to determine clinical strategies for the prevention and management of ocular trauma. METHODS:... (Source: SafetyLit: All (Unduplicated))

Emergency Medical Services Education in Emergency Medicine Residency Programs: A National Survey. - Katzer R, Cabañas JG, Martin-Gill C.

SafetyLit: All (Unduplicated) — Mon, 06 Feb 2012 11:54:53 +0100

This study aimed to descri... (Source: SafetyLit: All (Unduplicated))

Analysis of the necessity of routine tests in trauma patients in the emergency department. - Koksal O, Eren Çevik S, Akköse Aydın S, Ozdemir F.

SafetyLit: All (Unduplicated) — Mon, 06 Feb 2012 11:54:53 +0100

BACKGROUND: The necessity of routine tests as regarded in the Advanced Trauma Life Support protocols has become controversial in recent years. The aim of this study was to analyze the necessity of routine tests in trauma patients. METHODS: This was a prosp... (Source: SafetyLit: All (Unduplicated))

Aspiration pneumonia and challenges following the Samoa Tsunami in 2009. - Ah Leong-Nowell T, Ah Ching L, Fiu L, Wyber R, Nisbet M, Jones D, Blackmore T, Ioane-Cleverley T.

SafetyLit: All (Unduplicated) — Mon, 06 Feb 2012 11:54:53 +0100

On 29 September 2009, a large tsunami struck the Samoan Islands in the South Pacific Ocean, causing 142 deaths and large numbers of casualties. 199 patients presented to the emergency department within the first 72 hours. Twenty-nine patients were admitted... (Source: SafetyLit: All (Unduplicated))

Evidence-based exercise prescription for balance and falls prevention: a current review of the literature. - Shubert TE.

SafetyLit: All (Unduplicated) — Mon, 06 Feb 2012 11:54:53 +0100

Falls are the leading cause of emergency department visits, hospital admissions, and unintentional death for older adults. Balance and strength impairments are common falls risk factors for community-dwelling older adults. Though physical therapists common... (Source: SafetyLit: All (Unduplicated))

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AUDIO: Have views on NHS reform shifted?

BBC News | Health | UK Edition — Mon, 06 Feb 2012 10:35:42 +0100

Dr Michael Dixon, chair of the NHS Alliance, who supports the governments proposed reforms of the NHS and Dr John Lister, director of the Health Emergency campaign group, who opposes them, debate the Health Bill. (Source: BBC News | Health | UK Edition)

Hospital Incident Command System (HICS) performance in Iran; Decision making during disasters

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Mon, 06 Feb 2012 05:00:00 +0100

Background: Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. Methods: This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job actio...

Cardiovascular highlights from non-cardiology journals

Heart — Mon, 06 Feb 2012 05:00:00 +0100

Early diagnosis of mi using serial troponin measurements The recent introduction of high sensitivity troponin assays (hsT) has improved the sensitivity of this assay for the detection of myocardial infarction, while simultaneously decreasing specificity. To overcome this problem, the use of troponin kinetics—to identify acute myocardial damage—has been proposed, either alone or in combination with other diagnostic markers of cardiovascular disease. One thousand eight hundred and eighteen patients with suspected acute coronary syndromes were recruited from three German hospitals between 2007 and 2008. Each patient had blood drawn for the detection of 12 biomarkers, including both normal (cTnI) and high sensitivity (hsTnI) troponin, on admission and at 3 and 6 h. The main ou...

The use of positron emission tomography in the diagnosis of pacemaker related infection

Heart — Mon, 06 Feb 2012 05:00:00 +0100

A 59-year-old man underwent dual chamber permanent pacemaker (DDD PPM) implantation for complete heart block following emergency mechanical mitral valve replacement and coronary artery bypass grafting. At routine pacemaker check 5 months after the implant, a painless moderate sized swelling persisted over the box. The patient described several episodes of rigours and sweating in the preceding month. The patient was otherwise systemically well and without fever. Blood tests demonstrated a normal white blood cell count (9.9x109) and erythrocyte sedimentation rate (13 mm/h) and a mildly raised C reactive protein (11 mg/l). Chest radiograph was unremarkable. Blood cultures were negative. A transoesophageal echocardiogram did not show evidence of intracardiac vegetation. He under...

Fire reported at Russian nuclear research center

Physics Today News Picks — Mon, 06 Feb 2012 05:00:00 +0100

Reuters: Early Sunday a fire broke out at the Alikhanov Institute of Theoretical and Experimental Physics, a nuclear research center in Moscow that houses a nonoperational 60-year-old atomic reactor. Although institute officials maintain that there was no risk of a radiation leak, Greenpeace Russia officials expressed concern. The fire, which broke out in a basement area of the facility, consisted primarily of smoke that came from an area housing power cables. The smoke was visible above the institute, and an acrid smell filled the air. About 30 emergency vehicles responded. Russian news agencies issued conflicting reports, including whether fire brigades were initially denied access and when exactly the fire was extinguished. (Source: Physics Today News Picks)

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Spinning sessions trigger the same biochemical indications as heart attacks

EurekAlert! - Medicine and Health — Mon, 06 Feb 2012 05:00:00 +0100

(University of Gothenburg) A short spinning session can trigger the same biochemical indications as a heart attack -- a reaction that is probably both natural and harmless, but should be borne in mind when people seek emergency treatment for chest pain, reveals a study from the Sahlgrenska Academy at the University of Gothenburg, Sweden. (Source: EurekAlert! - Medicine and Health)

New database aims to improve emergency general surgery care and outcomes

EurekAlert! - Medicine and Health — Mon, 06 Feb 2012 05:00:00 +0100

(Weber Shandwick Worldwide) Researchers at Wake Forest Baptist Medical Center in Winston-Salem, N.C., have successfully created and implemented an emergency general surgery registry that will advance the science of acute surgical care by allowing surgeons to track and improve surgical patient outcomes, create performance metrics, conduct valid research and ensure quality care for all emergency general surgery patients. (Source: EurekAlert! - Medicine and Health)

Severe chronic heart failure in patients considered for heart transplantation in Poland*.

Cardiology Journal — Mon, 06 Feb 2012 00:36:02 +0100

Conclusions: Despite optimal treatment, the prognosis for patients with refractory HF is still not good. NYHA class IV, NT-proBNP and HFSS score can help define the highest risk group. The results are consistent with the prognosis of patients enrolled into the randomized trials. (Cardiol J 2012; 19, 1: 36-44). PMID: 22298166 [PubMed - in process] (Source: Cardiology Journal)

Zolmitriptan-induced acute myocardial infarction.

Cardiology Journal — Mon, 06 Feb 2012 00:36:02 +0100

We present the case of a 45 year-old woman with a history of migraine with visual aura since the age of 20. She had no history of diabetes mellitus, hypertension, smoking or any other risk factors for cardiovascular events before she was admitted to our emergency room with typical chest pain. An electrocardiogram revealed anterior myocardial infarction following her monthly dose of oral zolmitriptan. Catherization revealed a normal coronary arterial system. The laboratory indices for cardiac risk were within normal ranges. The patient was advised to avoid triptans permanently on being discharged. (Cardiol J 2012; 19, 1: 76-78). PMID: 22298171 [PubMed - in process] (Source: Cardiology Journal)

Tako-tsubo cardiomyopathy precipitated by alcohol withdrawal.

Cardiology Journal — Mon, 06 Feb 2012 00:36:02 +0100

We report a case of TCM in a post-menopausal woman that was precipitated by alcohol withdrawal. (Cardiol J 2012; 19, 1: 81-85). PMID: 22298173 [PubMed - in process] (Source: Cardiology Journal)

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Myocardial infarction secondary to unintentional ingestion of hydrogen peroxide.

Cardiology Journal — Mon, 06 Feb 2012 00:36:02 +0100

Authors: Islamoglu Y, Cil H, Atilgan Z, Elbey MA, Tekbas E, Yazici M Abstract Ingestion of acid-containing household products, either accidentally or as a suicide attempt, is a common form of intoxication. A clear and odorless liquid, hydrogen peroxide is an oxidizing agent found in most households and many industrial environments. Cardiovascular manifestations of hydrogen peroxide ingestion are extremely rare. Here we report a 60 year-old woman with acute inferolateral myocardial infarction (MI) after hydrogen peroxide ingestion, who had no history of coronary artery disease. Physicians dealing with hydrogen peroxide ingestion in the emergency department should be aware of the probability of MI and obtain an electrocardiogram, even if the patient has no cardiac complaint. (Cardiol...

QTc values among children and adolescents presenting to the emergency department

Child: Care, Health and Development — Sat, 04 Feb 2012 23:54:45 +0100

(Source: Child: Care, Health and Development)

Victims of toxic FEMA trailers cannot sue government, rules Big Brother federal judge

NaturalNews.com — Sat, 04 Feb 2012 06:00:00 +0100

(NaturalNews)The Federal Emergency Management Agency (FEMA) will not be held responsible for providing toxic, formaldehyde-laden trailers to thousands of displaced individuals following Hurricanes Katrina and Rita. Courthouse News Service (CNS) reports that Judge Carl Stewart from... (Source: NaturalNews.com)

Norovirus Sends Hundreds To Hospitals In Boston Area

Sat, 04 Feb 2012 01:15:33 +0100

BOSTON (CBS) – It’s been a rough cold and flu season so far and now hospitals are being flooded with patients suffering a severe stomach bug. In the MetroWest area, hundreds have visited emergency rooms over the past few weeks. Doctors say the norovirus, a highly contagious stomach flu is to blame. Health officials say once it starts, it’s very difficult to contain. WBZ-TV’s Ken MacLeod reports var videoCanvas = new WNVideoWidget("WNVideoCanvas", "wnVideo_6706243");videoCanvas.SetWidth(320);videoCanvas.SetHeight(240);videoCanvas.SetVariable("clipId", "6706243");videoCanvas.SetReportingKeywords("CBS.BOSTON");videoCanvas.SetAdvertisingZone("CBS.BOSTON/worldnowplayer");videoCanvas.SetVariable("offFaceColor", "afaeae");videoCanvas.SetVariable("overFaceColor", "ffffff");...

Abercrombie to sign organ transplant funding bill into law

bizjournals.com Health Care:Hospitals headlines — Sat, 04 Feb 2012 00:50:56 +0100

Hawaii lawmakers on Friday passed legislation for about $1.8 million in emergency funds for kidney and liver transplants in the state. Gov. Neil Abercrombie plans to sign House Bill 608 into law on Saturday at The Queen's Medical Center. The law will appropriate emergency funds, subject to private matching funds, for the transplants, as well as to support a chronic kidney disease management program. Hawaii was left without an organ transplant center after the closure last month of Hawaii Medical Center East, which ran the state's only organ transplant program before it stopped taking patients in December... (Source: bizjournals.com Health Care:Hospitals headlines)

DIY science: should you try this at home?

Guardian Unlimited Science — Fri, 03 Feb 2012 22:59:00 +0100

When Richard Handl was arrested for attempting to split the atom on his stove, he joined a growing band of home experimenters cooking up all kinds of trouble behind the kitchen doorÄngelholm is a pretty southern Swedish town, famed for its clay cuckoo manufacturing, a clay cuckoo being a kind of ocarina, which is a kind of flute. The crime rate here is practically zero. Except one of its residents was last year arrested for trying to split the atom in his kitchen. His name is Richard Handl and he buzzes me into his first-floor flat.I wanted to meet Richard because I keep seeing reports of home science experimenters clashing with the authorities. There's been a spate of them this past year or two.I glance into Richard's kitchen and recognise his cooker from the news. It was horrendously, a...

mHealth – Can You Hear Me Now?

ICMCC: The International Council on Medical and Care Compunetics — Fri, 03 Feb 2012 18:12:26 +0100

Source: Christen Brownlee, Magazine of the Johns Hopkins Bloomberg School of Public Health Content: “mHealth is short for mobile health, a growing field that takes advantage of mobile communications devices—mostly cell phones—to enhance access to health information, improve distribution of routine and emergency health services, or provide diagnostic services. With phones and other mobile technologies [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

Many Stroke Victims Still Don’t Get Treated Fast Enough: Study

The Doctors Lounge - Cardiology — Fri, 03 Feb 2012 18:00:00 +0100

Researchers found response times haven't improved since 2005 (Source: The Doctors Lounge - Cardiology)

Gastrointestinal stromal tumor arising in an ileal duplication: report of a case

Surgery Today — Fri, 03 Feb 2012 17:11:08 +0100

This report presents the extremely rare case of an adult patient who presented with peritonitis caused by the perforation of an ileal duplication, associated with a gastrointestinal stromal tumor (GIST) arising within the duplication. A 70-year-old female was admitted to the hospital with lower abdominal pain. Abdominal computed tomography showed free air in the peritoneal cavity. An emergency laparotomy was performed, presuming diffuse peritonitis caused by a perforation of the gastrointestinal tract. The surgical findings showed that the peritonitis was caused by the perforation of an ileal duplication, 90 cm proximal to the ileocecal valve, with an extrinsic tumor protruding from the duplication. A segmental resection of the ileum—including the tumor and ileal duplication�...

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Well Blog: Think Like a Doctor: Sleeping Wife Solved!

NYT — Fri, 03 Feb 2012 17:06:33 +0100

Readers solve the mystery of a 43-year-old healthy and active woman who suddenly falls asleep and can't be awakened. (Source: NYT)

Many Stroke Victims Still Don't Get Treated Fast Enough

MedlinePlus Health News — Fri, 03 Feb 2012 17:00:00 +0100

Researchers found response times haven't improved since 2005 Source: HealthDay Related MedlinePlus Pages: Emergency Medical Services, Stroke (Source: MedlinePlus Health News)

Men with Strokes Call for Help Quicker Than Women, Mayo Clinic Study Says

Mayo Clinic Research News — Fri, 03 Feb 2012 16:45:46 +0100

A Mayo Clinic study, presented at the American Stroke Conference in New Orleans in early February, says that men experiencing a stroke call for emergency help quicker than women, especially if they are married. (Source: Mayo Clinic Research News)

Child Abuse in One Year Costs Billions in Long Run (CME/CE)

MedPage Today Emergency Medicine — Fri, 03 Feb 2012 16:39:36 +0100

(MedPage Today) -- The lifetime costs -- including healthcare, lost productivity, and criminal justice costs -- of all the children abused in the U.S. over a single year total up to $124 billion, researchers reported. (Source: MedPage Today Emergency Medicine)

Digital Doctoring

RWJF News Digest - Quality/Equality — Fri, 03 Feb 2012 15:04:12 +0100

Among the most common reasons why people come to an emergency room are bouts of heart failure or pneumonia. Note: Viewing this article may require a subscription. (Source: RWJF News Digest - Quality/Equality)

New device removes stroke-causing blood clots better than standard treatment

UCLA Newsroom: Health Sciences — Fri, 03 Feb 2012 14:00:00 +0100

An experimental device for removing blood clots in stroke patients dramatically outperformed the standard mechanical treatment, according to research presented by UCLA Stroke Center director Dr. Jeffrey L. Saver at the American Stroke Association's 2012 international conference in New Orleans on Feb. 3. The SOLITAIRE Flow Restoration Device is among an entirely new generation of devices designed to remove blood clots from blocked brain arteries in patients experiencing stroke. It has a self-expanding, stent-like design and, once inserted into a clot using a thin catheter tube, it compresses and traps the clot. The clot is then removed by withdrawing the device, thus reopening the blocked blood vessel. In the first U.S. clinical trial of SOLITAIRE, the device opened blocked ve...

Molecules to Medicine: Plan B: The Tradition of Politics at the FDA

Scientific American - Official RSS Feed — Fri, 03 Feb 2012 12:39:00 +0100

Morning After The Morning's Trash In my last post , I focused on flaws in the medical device approval process. The Union of Concerned Scientists FDA at a Crossroads meeting also covered problems with drug approval. This is perhaps no better illustrated than by the disappointing decision by Secretary of Health Kathleen Sebelius to deny the emergency contraceptive, Plan B, over-the-counter status for women under the age of 17 . This was a particular disappointment to many because President Obama had promised that decisions at the FDA would be made based on science, rather than politics. Some of us, naively, hoped that change we can believe in was real, having forgotten that the Tooth Fairy wasn t. [More] (Source: Scientific American - Official RSS Feed)

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Frontline medicine: Licensed to thrill?

BMA daily feed — Fri, 03 Feb 2012 12:29:20 +0100

‘The power of televised drama has altered the public’s perception of emergency medicine’ (Source: BMA daily feed)

Ultrasound Triage of Ocular Blast Injury in the Military Emergency Department

Military Medicine — Fri, 03 Feb 2012 12:18:15 +0100

(Source: Military Medicine)

Feasibility of Partnering with Emergency Medical Services to Identify People at Risk for Uncontrolled High Blood Pressure

CDC Preventing Chronic Disease — Fri, 03 Feb 2012 12:18:10 +0100

(Source: CDC Preventing Chronic Disease)

Emergency waits show sharp rise

BMA daily feed — Fri, 03 Feb 2012 10:37:20 +0100

Figures show 19.3 per cent rising in patients waiting longer than 12 hours (Source: BMA daily feed)

The impact of summer temperatures and heatwaves on mortality and morbidity in Perth, Australia 1994-2008.

Environment International — Fri, 03 Feb 2012 09:49:28 +0100

Authors: Williams S, Nitschke M, Weinstein P, Pisaniello DL, Parton KA, Bi P Abstract Climate change projections have drawn attention to the risks of extreme heat and the importance of public health interventions to minimise the impact. The city of Perth, Western Australia, frequently experiences hot summer conditions, with recent summers showing above average temperatures. Daily maximum and minimum temperatures, mortality, emergency department (ED) presentations and hospital admissions data were acquired for Perth for the period 1994 to 2008. Using an observed/expected analysis, the temperature thresholds for mortality were estimated at 34-36°C (maximum) and 20°C (minimum). Generalised estimating equations (GEEs) were used to estimate the percentage increase in mortality and mor...

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Sunday hospital admissions 'a bigger risk'

NHS News Feed — Fri, 03 Feb 2012 09:42:00 +0100

Conclusion The main finding of this study was that being admitted to hospital at the weekend (Saturday or Sunday) is associated with a significant increased risk of death over the following 30-days. This study has strengths in that it has used an extremely large and reliable data set representative of almost all hospital admissions within the NHS in England during one financial year. The researchers’ model also accounted for a wide range of medical and sociodemographic factors and characteristics of admission that could have influenced the risk of death. While the researchers’ models adjusted for a variety of important confounders, it is difficult to see from the report how they did this, making it difficult to decide whether all relevant factors have been appropriately adjusted for. M...

Online asthma test could help cut emergency admissions

Nursing Times Breaking News — Fri, 03 Feb 2012 09:40:00 +0100

A new asthma test to help people work out the extent to which they risk a serious attack should also help cut down on the number of emergency hospital admissions. (Source: Nursing Times Breaking News)

CQC issues trust with urgent warning to increase A&E staffing

Nursing Times Breaking News — Fri, 03 Feb 2012 09:30:00 +0100

A hospital trust in the north west has been issued with an urgent warning to improve “crisis” staffing levels in accident and emergency by the Care Quality Commission. (Source: Nursing Times Breaking News)

MedCallAssist to Display Mobile Medical Product Kits and 24/7 Medical...

PRWeb: Medical Pharmaceuticals — Fri, 03 Feb 2012 06:24:02 +0100

MedCallAssist, a company that provides hunters, travelers, truck drivers and others who spend time in remote areas of the world and who may need help with medical emergencies with telemedicine, hereby...(PRWeb February 01, 2012)Read the full story at http://www.prweb.com/releases/telemedicine/medical-kits/prweb9155460.htm (Source: PRWeb: Medical Pharmaceuticals)

Corporate Whistle Blower Center Urges ER Physicians Or Hospital...

PRWeb: Medical Pharmaceuticals — Fri, 03 Feb 2012 06:24:02 +0100

The Corporate Whistle Blower Center is urging Emergency Room Physicians, nursing managers, or hospital accounting, or coding staff to turn in their hospital for Medicare, or Medicaid fraud, if the...(PRWeb February 01, 2012)Read the full story at http://www.prweb.com/releases/2012/2/prweb9156050.htm (Source: PRWeb: Medical Pharmaceuticals)

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Emergency day surgery: Improving productivity and reducing bed days

NHS Networks — Fri, 03 Feb 2012 05:00:00 +0100

Patients referred by GPs or attending the emergency department with minor emergency surgical conditions are assessed against certain criteria. Those with abscesses requiring drainage or hernias that are painful but not obstructed or strangulated are not admitted but instead sent home and allocated to unplanned gaps in elective surgery lists. Patients are notified of their surgery slot once known and usually attend the following day in a day surgery unit (weekdays) or short-stay ward (weekends), to fast before undergoing surgery. More ….. (Source: NHS Networks)

Usefulness of CT Angiography for Therapeutic Decision Making in Thrombolyzing Intubated Patients with Suspected Basilar Artery Thrombosis

Journal of Neuroimaging — Fri, 03 Feb 2012 05:00:00 +0100

CONCLUSIONIn patients with BAT, intubated before assessment by neurologist, CTA might help in confirming the diagnosis and facilitating therapeutic decision making for initiating thrombolysis. J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)

Critical Care Management of Severe Traumatic Brain Injury in Adults

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Fri, 03 Feb 2012 05:00:00 +0100

Traumatic brain injury (TBI) is a major medical and socio-economic problem, and is the leading cause of death in children and young adults. The critical care management of severe TBI in adults is largely derived from the "Guidelines for the Management of Severe Traumatic Brain Injury" that have been published by the Brain Trauma Foundation. The main objectives are prevention and treatment of intracranial hypertension and secondary brain insults, preservation of cerebral perfusion pressure (CPP), and optimization of cerebral oxygenation. In this review, the critical care management of severe TBI will be discussed with focus on monitoring, avoidance and minimization of secondary brain insults, and optimization of cerebral oxygenation and CPP. (Source: Scandinavian Journal of Trauma, Resuscit...

Prehospital trauma care reduces mortality. Ten-year results from a time-cohort and trauma audit study in Iraq

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion: In case of long prehospital transit times simple life support measures by paramedics and lay first responders reduce trauma mortality in major injuries. Delegating life-saving skills to paramedics and lay people is a key factor for efficient prehospital trauma systems in low-resource communities.. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)

Health utility after emergency medical admission: A cross-sectional survey

Health and Quality of Life Outcomes — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions: Health utility can be measured after emergency medical admission, although responder bias may be significant. Health utility after emergency medical admission is poor compared to population norms. We have identified independent predictors or health utility that need to be measured and taken into account in non-randomized evaluations of emergency care. (Source: Health and Quality of Life Outcomes)

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Is Computer-assisted Telephone Triage Safe?Is Computer-assisted Telephone Triage Safe?

Medscape Today Headlines — Fri, 03 Feb 2012 04:00:00 +0100

Can computer-assisted telephone triage safely assess patient medical conditions in the emergency department? Emergency Medicine Journal (Source: Medscape Today Headlines)

The frailty dilemma. Review of the predictive accuracy of major frailty scores.

European Journal of Internal Medicine — Fri, 03 Feb 2012 00:28:11 +0100

CONCLUSIONS: As the number of false positive values of most available tests is substantial, these frailty scores are of limited value for both screening and diagnostic purposes in daily practice. As diagnostic instruments they can best be used to exclude frailty. The false-positive rate of currently available tests is too high to allow major decisions on medical care to be made on the basis of a positive test. PMID: 22284239 [PubMed - in process] (Source: European Journal of Internal Medicine)

Serum osmolarity as an outcome predictor in hospital emergency medical admissions.

European Journal of Internal Medicine — Fri, 03 Feb 2012 00:25:42 +0100

CONCLUSION: Admission osmolarity, a simple calculation, is associated with the risk of mortality in acutely ill medical patients; deviations outside the normal range are relevant. A useful clinical predictive algorithm requires the incorporation of additional predictors. PMID: 22284254 [PubMed - in process] (Source: European Journal of Internal Medicine)

Emergency visits and hospital admissions in aged people living close to a gas-fired power plant.

European Journal of Internal Medicine — Fri, 03 Feb 2012 00:25:12 +0100

DISCUSSION: Combustion of natural gas for energy generation produces a rise in air concentration of PM10 and NO(2) close to the plant, with a concentration-dependent increment of daily emergency visits and hospital admissions in elderly people, and with an age-dependent susceptibility. PMID: 22284257 [PubMed - in process] (Source: European Journal of Internal Medicine)

Countering health threats by chemicals with a potential terrorist background - creating a rapid alert system for Europe.

European Journal of Internal Medicine — Fri, 03 Feb 2012 00:24:52 +0100

CONCLUSION: The RAS-CHEM database works and will be integrated into the Health Emergency Operations Facility (HEOF) with other European Rapid Alert Systems. Poisons centres receive a large number of enquiries and could be important sentinels in this field of toxicovigilance. PMID: 22284259 [PubMed - in process] (Source: European Journal of Internal Medicine)

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Chairman quits troubled NHS trust

BBC News | Health | UK Edition — Fri, 03 Feb 2012 00:19:19 +0100

The chairman of a hospital trust that closed an emergency department and considered bringing in army medics is to stand down. (Source: BBC News | Health | UK Edition)

Married Men Seek Help for Stroke Sooner Than Their Wives

The Doctors Lounge - Neurology — Thu, 02 Feb 2012 22:00:00 +0100

Men called 911 in less than a half hour, while women waited well over an hour, study finds (Source: The Doctors Lounge - Neurology)

New NLM Web Page: Disaster Apps and Mobile Optimized Web Pages

Network News — Thu, 02 Feb 2012 21:18:34 +0100

The Disaster Information Management Research Center (DIMRC) recently launched a new web page titled “Disaster Apps and Mobile Optimized Web Page”: http://disasterinfo.nlm.nih.gov/dimrc/disasterapps.html . This page includes links to various mobile tools and apps that have been selected based upon utility in a disaster or emergency context and which adhere to the National Library of Medicine’s (NLM) Selection Guidelines for non-NLM resources. The page is organized into three sections based on the type of information provided by the app or web site: Disaster Medicine Tools – tools which provide medical or health information that might be useful in preparing for, responding to, or recovering from a disaster or emergency. Disaster Resources: tools that provide informatio...

New NLM Webpage: Disaster Apps and Mobile Optimized Web Pages

Network News — Thu, 02 Feb 2012 21:18:34 +0100

The Disaster Information Management Research Center (DIMRC) recently launched a new web page titled “Disaster Apps and Mobile Optimized Web Page”: http://disasterinfo.nlm.nih.gov/dimrc/disasterapps.html . This page includes links to various mobile tools and apps that have been selected based upon utility in a disaster or emergency context and which adhere to NLM’s Selection Guidelines for non-NLM resources. The page is organized into three sections based on the type of information provided by the app or web site: Disaster Medicine Tools – tools which provide medical or health information that might be useful in preparing for, responding to, or recovering from a disaster or emergency. Disaster Resources: tools that provide information on resources that may be needed in a ...

FairWarning announces 2011 milestones

Healthcare IT News — Thu, 02 Feb 2012 19:43:27 +0100

FairWarning, supplier of cross-platform healthcare privacy auditing solutions for EHRs, has announced its 2011 milestones. FairWarning solutions are now in use in over 800 hospitals and 2,500 clinics across the U.K., United States, Canada and France. NHS Scotland selected FairWarning for every board throughout Scotland as well as privacy protection for the country’s HIE and Emergency Care Summary. HCA International, London’s top private hospital group, has chosen FairWarning Privacy Breach Detection to enhance patient privacy. read more (Source: Healthcare IT News)

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Low-Risk Chest Pain In The Emergency Department: Current Guidelines

EM Practice Guidelines Update — Thu, 02 Feb 2012 19:20:39 +0100

This issue of EM Practice Guidelines Update reviews 3 scientific statements that focus on strategies for the management of chest pain patients with possible acute coronary syndromes (ACS). (Source: EM Practice Guidelines Update)

Cardinal Health Releases Smart-Seal Surgical Mask

Medgadget Anesthesiology — Thu, 02 Feb 2012 19:11:23 +0100

Cardinal Health has made available its Smart-Seal surgical mask that improves both its fit and reduces interior fogging while providing a high level of filtration and resistance to liquids.From the announcement:Read More (Source: Medgadget Anesthesiology)

Lodox/Statscan facilitates the early detection of commonly overlooked extracranial injuries in patients with traumatic brain injury

European Journal of Trauma and Emergency Surgery — Thu, 02 Feb 2012 18:16:54 +0100

Conclusion The Lodox/Statscan can provide benefits for surveying extracranial injuries in patients with diminished level of consciousness. The Lodox/Statscan also emits a notably low dose of radiation and appears to be a relatively inexpensive adjunct to screen torso or extremity injuries in TBI patients. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00068-012-0176-zAuthors H.-C. Huang, Trauma and Emergency Center, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404 Taiwan, ROCC.-Y. Fu, Trauma and Emergency Center, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404 Taiwan, ROCC.-H. Hsieh, Trauma and Emergency Center, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404 Taiwan, ROCY.-...

Apolipoprotein E e4 allele does not increase the risk of early postoperative delirium after major surgery

Journal of Anesthesia — Thu, 02 Feb 2012 18:14:05 +0100

Conclusions Apolipoprotein e4 carrier status was not associated with an increased risk for early postoperative delirium. Age, congestive heart failure, and emergency surgery were independent risk factors for the development of delirium after major surgery. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00540-012-1326-5Authors Fernando José Abelha, Anesthesiology and Perioperative Care Unit, Surgical Department, Faculty of Medicine, University of Porto, Porto, PortugalVera Fernandes, Department of Anesthesiology, Centro Hospitalar de São João, Porto, PortugalMiguela Botelho, Department of Anesthesiology, Centro Hospitalar de São João, Porto, PortugalPatricia Santos, Department of Anesthesiology, Centro Hospitalar de São João, Porto,...

Concomitant measurement of copeptin and high-sensitivity troponin for fast and reliable rule out of acute myocardial infarction

Intensive Care Medicine — Thu, 02 Feb 2012 18:13:11 +0100

Conclusion Copeptin in association with HsTnT is a fast and reliable tool to rule out AMI, with a sensitivity and NPV of 1.00 in our sample. Interventional studies are warranted to confirm these findings. Content Type Journal ArticleCategory OriginalPages 1-7DOI 10.1007/s00134-012-2481-8Authors Yonathan Freund, Service d’Accueil des Urgences, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris (APHP), Université Pierre et Marie Curie-Paris 6 (UPMC), 47-83 Boulevard de l’Hôpital, 75651 Paris cedex 13, FranceCamille Chenevier-Gobeaux, Departement de Biochimie, Hôpital Cochin–Hôtel Dieu, APHP, 27 rue du Faubourg Saint-Jacques, 75679 Paris cedex 14, FranceYann-Erick Claessens, Service d’Accueil des Urgences, Hôpital Cochin–Hôtel Dieu, AP...

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Acute Treatment Options for Spinal Cord Injury

Current Treatment Options in Neurology — Thu, 02 Feb 2012 18:12:19 +0100

Opinion statement Most treatment options for acute traumatic spinal cord injury (SCI) are directed at minimizing progression of the initial injury and preventing secondary injury. Failure to adhere to certain guiding principles can be detrimental to the long-term neurologic and functional outcome of these patients. Therapy for the hyperacute phase of traumatic SCI focuses on stabilizing vital signs and follows the Advanced Trauma Life Support (ATLS) algorithm for ensuring stability of airway, breathing and circulation, and disability (neurologic evaluation)—with spinal stabilization—and exposure. Spinal stabilization, with cervical collars and long backboards, is used to prevent movement of a potentially unstable spinal column injury to prevent further injury to the sp...

Are CT Scans For Dizziness In ER Cost-Effective?

Health News from Medical News Today — Thu, 02 Feb 2012 18:00:00 +0100

Henry Ford Hospital researchers have found that conducting CT scans in the emergency department (ED) for individuals experiencing dizziness may not be cost effective. The researchers discovered that less than 1% of CT scans carried out in the ED showed a more serious underlying cause for dizziness (stroke or intracranial bleeding), which required intervention. The finding comes at a time when hospitals across the nation seek ways to reduce costs without sacrificing patient care... (Source: Health News from Medical News Today)

Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA): Applicability to Hospital Inpatients and Hospitals With Specialized Capabilities

Federal Register updates via the Rural Assistance Center — Thu, 02 Feb 2012 15:22:44 +0100

This request for comments from the Centers for Medicare & Medicaid Services addresses the applicability of the Emergency Medical Treatment and Labor Act (EMTALA) to hospital inpatients. (Source: Federal Register updates via the Rural Assistance Center)

Long-Term Mortality and Role of Troponin Elevation in Hypertensive Emergencies

The American Journal of Cardiology — Thu, 02 Feb 2012 14:05:53 +0100

We read with great interest the report “Effect of Joint National Committee VII Report on Hospitalizations for Hypertensive Emergencies in the United States” by Deshmukh et al. The investigators provided a comprehensive overview of trends in hospitalizations and inpatient mortality for hypertensive emergencies before and after the publication of the Seventh Joint National Committee report on the prevention, detection, evaluation, and treatment of high blood pressure. They reported an average increase in hospitalizations of 1.11% and a decrease in inpatient mortality from 2.8% to 2.6% (after the publication of the report). (Source: The American Journal of Cardiology)

Can pharmacies be forced to sell emergency contraceptives?

CTV Health — Thu, 02 Feb 2012 13:22:37 +0100

A federal judge is considering whether Washington state can require pharmacies to stock and sell Plan B or other emergency contraceptives, even in the face of religious objections by druggists who believe they destroy human life. (Source: CTV Health)

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Dyspnea Caused by Atlantoaxial Subluxation in a Patient with Rheumatoid Arthritis

Clinical and Developmental Immunology — Thu, 02 Feb 2012 11:21:45 +0100

We report a patient with rheumatoid arthritis whose chief complaint was dyspnea on arrival to the emergency department (ED). After further investigation, spinal cord compression caused by atlantoaxial subluxation was diagnosed. This is an uncommon but important case that ED physicians should be aware of. (Source: Clinical and Developmental Immunology)

A meeting of hearts if not minds

Los Angeles Times - Science — Thu, 02 Feb 2012 08:00:00 +0100

Some Jehovah's Witnesses with leukemia turn to an atheist Cedars-Sinai doctor who respects their refusal to accept blood transfusions.Christina Blouvan-Cervantes had been battling aggressive leukemia when her blood count plummeted and she landed in the emergency room in Fresno. Her doctors told her a blood transfusion was her only hope. But her faith wouldn't allow her to receive one. (Source: Los Angeles Times - Science)

Emergency Departments' Quality Evaluation Requires Hospital-Wide Effort

Health News from Medical News Today — Thu, 02 Feb 2012 08:00:00 +0100

Time can be important in an emergency department especially in a busy Level 1 Trauma Center like MetroHealth Medical Center in Cleveland, when getting patients appropriate care is essential. However, when the quality of an emergency department is judged by a patient's length of stay, time takes on a new meaning. A study published in The Journal of the American Medical Association (JAMA) found that there is no significant difference between safety-net and non-safety-net hospitals when it comes to the length of stay for emergency patients... (Source: Health News from Medical News Today)

[PHTLS team course: a pilot project : Structured student education in prehospital care of severely injured patients.]

Der Unfallchirurg — Thu, 02 Feb 2012 05:00:00 +0100

CONCLUSION: Especially the treatment of multiply injured patients is a challenge for young medical professionals. However, there is a high motivation to learn and train in emergency medicine. The students long for a practical trauma course compared to the advanced medical CPR course provided by the Department of Anaesthesiology of the University of Heidelberg. Those algorithm-based trauma courses do exist with PHTLS® and ATLS®. Based on these courses we developed the PHTLS® TEAM course. PMID: 22294422 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)

CT/CT Angiography and MRI Findings Predict Recurrent Stroke After Transient Ischemic Attack and Minor Stroke: Results of the Prospective CATCH Study.

Stroke — Thu, 02 Feb 2012 05:00:00 +0100

CONCLUSIONS: Early assessment of the intracranial and extracranial vasculature using CT/CTA predicts recurrent stroke and clinical outcome in patients with transient ischemic attack and minor stroke. In many institutions, CTA is more readily available than MRI and physicians should access whichever technique is more quickly available at their institution. PMID: 22302109 [PubMed - as supplied by publisher] (Source: Stroke)

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Domestic violence screening of obstetric triage patients in a military population

Journal of Perinatology — Thu, 02 Feb 2012 05:00:00 +0100

Authors: M A Lutgendorf, A Thagard, P D Rockswold, J M Busch & E F Magann (Source: Journal of Perinatology)

Study: Emergency visits increase risk of infections for long-term care residents

Drug Topics - Pharmacy News — Thu, 02 Feb 2012 05:00:00 +0100

There was an increased risk of acute infection among long-term care residents who visited hospital emergency departments, according to a study published online January 23 in the Canadian Medical Association Journal. (Source: Drug Topics - Pharmacy News)

Reducing the burden of morbidity and medical utilization of older patients by outpatient geriatric services: Implications to primary health‐care settings

Geriatrics and Gerontology International — Thu, 02 Feb 2012 05:00:00 +0100

Conclusion: Outpatient GEM could effectively reduce growth of BOM and medical utilization for relatively healthy elderly patients in Taiwan where elderly patients haverelatively free access to general and specialty care. The results of this study implied the potential benefits of systematically implementing GEM in primary health‐care settings to improve the quality of care and slow down the growth of BOM for elderly patients. Geriatr Gerontol Int 2012; ••: ••–••. (Source: Geriatrics and Gerontology International)

Mediastinal goiter presenting with ventricular tachycardia

Head and Neck — Thu, 02 Feb 2012 05:00:00 +0100

ConclusionTo our knowledge, this case represents the first documented presentation of ventricular tachycardia as a unique and sole feature of mediastinal goiter. © 2012 Wiley Periodicals, Inc. Head Neck, 2012 (Source: Head and Neck)

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The development of simple survival prediction models for blunt trauma victims treated at Asian emergency centers

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Thu, 02 Feb 2012 05:00:00 +0100

Conclusion: These equations allow physicians to perform real-time assessments of survival by easy mental calculations at Asian emergency centers, which are overcrowded with blunt injury victims of traffic accidents. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)

Evaluation of Performance of Two Different Chest Tubes with either a Sharp or a Blunt Tip for Thoracostomy in 100 Human Cadavers

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Thu, 02 Feb 2012 05:00:00 +0100

Conclusion: Data suggest that chest drain insertion with trocars is associated with a 6-14% operator-related complication. No difference in average time could be found. However, misplacements and organ injuries occurred more frequently using sharp tips. Consequently, if using a trocar technique, the use of blunt tipped kits is recommended. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)

Differences and discrepancies between 2005 and 2008 Abbreviated Injury Scale versions - time to standardise

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Thu, 02 Feb 2012 05:00:00 +0100

The aim of this letter is to facilitate the standardisation of Abbreviated Injury Scale (AIS) codesets used to code injuries in trauma registries. We have compiled a definitive list of the changes which have been implemented between the AIS 2005 and Update 2008 versions. While the AIS 2008 codeset appears to have remained consistent since its release, we have identified discrepancies between the codesets in copies of AIS 2005 dictionaries. As a result, we recommend that use of the AIS 2005 should be discontinued in favour of the Update 2008 version. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)

Preventing emergency readmissions to hospital: A scoping review

NeLM - News — Thu, 02 Feb 2012 05:00:00 +0100

This report prepared for the UK Department of Health (England) aims to inform the development of emergency readmissions for use as a potential indicator within the NHS Outcomes Framework through addressing five broad aims: 1. To review the evidence on emergency readmissions within 28 days of discharge from hospital, published from 2000. 2. To provide a synopsis of work undertaken in a small sample of countries on current patterns of readmissions and the interpretation of observed patterns. 3. To comment on the statistical properties of the indicator. 4. To comment on the need for case mix adjustment of data on readmission rates. 5. To comment on the strengths and weaknesses of the indicator 'emergency readmissi...

Study: Emergency visits increase risk of infections for long-term care residents

Drug Topics - Top News — Thu, 02 Feb 2012 05:00:00 +0100

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The U.S. HIV Epidemic Suggests an EmergencyThe U.S. HIV Epidemic Suggests an Emergency

Medscape Today Headlines — Thu, 02 Feb 2012 04:00:00 +0100

The latest nationwide data illustrate the need for much greater effort across the spectrum of care for HIV/AIDS. AIDS Clinical Care (Source: Medscape Today Headlines)

Science Shows How Massage Eases Sore Muscles

The Doctors Lounge - Neurology — Wed, 01 Feb 2012 23:00:00 +0100

Getting one post-workout can spur cellular processes that cut inflammation and pain (Source: The Doctors Lounge - Neurology)

Many Hispanics Don’t Call an Ambulance For Stroke: Study

The Doctors Lounge - Cardiology — Wed, 01 Feb 2012 22:00:00 +0100

That may be one reason why they tend to do worse afterward than whites, researchers say (Source: The Doctors Lounge - Cardiology)

Morning-After Pill Does Double Duty (CME/CE)

MedPage Today OB/GYN — Wed, 01 Feb 2012 21:00:00 +0100

(MedPage Today) -- An emergency contraceptive pill is also effective at controlling excessive bleeding associated with fibroids, two studies found. (Source: MedPage Today OB/GYN)

Effects of a short text message reminder system on emergency department length of stay

ICMCC: The International Council on Medical and Care Compunetics — Wed, 01 Feb 2012 18:56:13 +0100

Source: Kim MJ et al, International Journal of Medical Informatics, 2012 Content: Purpose Specialty consultations and waiting for admission to a hospital bed are major contributors to increased length of stay and overcrowding in the emergency department. We implemented a computerized short messaging service to inform care providers of patient delay in order to reduce length [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

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Treatment of Neurocritical Care Emergencies in Pregnancy

Current Treatment Options in Neurology — Wed, 01 Feb 2012 17:14:15 +0100

Opinion statement Neurologic emergencies are a major cause of morbidity and mortality in pregnant women. In part because the patient population is young, the nihilistic approach that often accompanies neurologically devastating disorders in other contexts is largely absent. A number of studies have demonstrated improved patient outcomes in the setting of aggressive care delivered by neurointensivists in a specialty-specific environment. It stands to reason that young, pregnant women who suffer from neurologically devastating disorders and who have a wide range of prognosis may also benefit from such specialized care. Close collaboration between obstetricians and neurointensivists is critical in this context. A number of unique considerations in diagnosis and management pre...

Validation of the Better Care® system to detect ineffective efforts during expiration in mechanically ventilated patients: a pilot study

Intensive Care Medicine — Wed, 01 Feb 2012 17:14:14 +0100

Conclusions In this pilot, Better Care® classified breaths as IEE in close agreement with experts and the EAdi signal. Content Type Journal ArticleCategory OriginalPages 1-9DOI 10.1007/s00134-012-2493-4Authors Lluis Blanch, Critical Care Center, Hospital de Sabadell, Corporacio Sanitaria Universitària Parc Tauli, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208 Sabadell, SpainBernat Sales, CIBER Enfermedades Respiratorias, ISCiii, Madrid, SpainJaume Montanya, Fundació Parc Tauli, Corporacio Sanitaria Universitària Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, SpainUmberto Lucangelo, Department of Perioperative Medicine, Intensive Care and Emergency, Cattinara Hospital, Trieste University, Trieste, ItalyOscar Garcia-Esquirol, Critical Care Cente...

Socio-economic disparities in mortality due to pandemic influenza in England

International Journal of Public Health — Wed, 01 Feb 2012 17:12:22 +0100

Conclusion Tackling socio-economic health inequalities is a central concept within public health, but has not always been a part of emergency preparedness plans. These data demonstrate the opportunity to reduce the overall impact and narrow inequalities by considering socio-economic disparities in future pandemic planning. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00038-012-0337-1Authors Paul D. Rutter, Imperial College, London, UKOliver T. Mytton, University of Oxford, Oxford, UKMatthew Mak, King’s College Hospital, London, UKLiam J. Donaldson, Imperial College, London, UK Journal International Journal of Public HealthOnline ISSN 1661-8564Print ISSN 1661-8556 (Source: International Journal of Public Health)

Safety Alerts Concerning NHS Direct 111 Pilots

Health News from Medical News Today — Wed, 01 Feb 2012 17:00:00 +0100

After a Pulse investigation uncovered several safety alerts within the Government's NHS 111 pilots, as well as expressing concern that GP commissioners are being excluded from the rollout - the GPC has been prompted to call for the program to be put on hold. According to information released by PCTs and NHS Direct, there have been nine serious inappropriate incidents in four of the seven 111 pilots. The pilots have been designed to offer patients a single point of content for urgent care that excludes emergencies... (Source: Health News from Medical News Today)

Safety Net EDs Meet Goals for Length of Stay (CME/CE)

MedPage Today Public Health — Wed, 01 Feb 2012 14:21:10 +0100

(MedPage Today) -- Emergency department visits as hospitals that care for large numbers of Medicaid and uninsured patients are about the same length as those at hospitals serving more economically stable populations, researchers found. (Source: MedPage Today Public Health)

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Toxics Release Inventory Data Updated

What's New on JEFFLINE — Wed, 01 Feb 2012 14:00:55 +0100

The National Library of Medicine (NLM) recently announced its TOXMAP and TOXNET TRI resources have added 2010 Toxics Release Inventory data (TRI) – the most current Environmental Protection Agency (EPA) data available. TRI contains information on the annual estimated releases of toxic chemicals to the environment and is based on data collected by the EPA. Mandated by the Pollution Prevention Act, TOXNET TRI data covers air, water, land, and underground injection releases, as well as transfers to waste sites, and waste treatment methods and efficiency, as reported by certain industrial facilities around the United States. TRI also includes data related to source reduction and recycling. TOXMAP contains 20,587 facilities that reported to the EPA TRI program in 2010, with 78,423 chem...

Government urged to slow NHS 111 rollout

HSJ — Wed, 01 Feb 2012 13:57:00 +0100

GPs and nurses are urging the government to slow the implementation of the new non-emergency NHS telephone number amid fears it could actually increase pressure on services. (Source: HSJ)

Chad: Why Polio Is So Hard to Eliminate

AllAfrica News: Polio — Wed, 01 Feb 2012 09:48:05 +0100

[IRIN] Dakar - Poor-quality emergency immunization campaigns and low routine polio immunization coverage are helping the polio virus to spread in Chad, with 132 cases reported in 2011 - five times the number in 2010. More commitment is needed across the board, especially from local health authorities, to try to get immunizations right, say aid agencies. (Source: AllAfrica News: Polio)

National Study Shows Majority Of Self-Harming Adolescents Don't Receive A Mental Health Assessment During Emergency Room Visit

Health News from Medical News Today — Wed, 01 Feb 2012 09:00:00 +0100

A national study of Medicaid data shows most young people who present to emergency departments with deliberate self-harm are discharged to the community, without receiving an emergency mental health assessment. Even more, a roughly comparable proportion of these patients receive no outpatient mental health care in the following month. These are the findings from a study conducted by researchers at Nationwide Children's Hospital that appears in the Journal of the American Academy of Child & Adolescent Psychiatry... (Source: Health News from Medical News Today)

Info for Authors

The American Journal of Emergency Medicine — Wed, 01 Feb 2012 05:00:00 +0100

(Source: The American Journal of Emergency Medicine)

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The American Journal of Emergency Medicine — Wed, 01 Feb 2012 05:00:00 +0100

(Source: The American Journal of Emergency Medicine)

Editorial Board

The American Journal of Emergency Medicine — Wed, 01 Feb 2012 05:00:00 +0100

(Source: The American Journal of Emergency Medicine)

Masthead

The American Journal of Emergency Medicine — Wed, 01 Feb 2012 05:00:00 +0100

(Source: The American Journal of Emergency Medicine)

From Other Journals

Emergency Medicine Australasia — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Emergency Medicine Australasia)

How do clinicians obtain urine samples in young children?

Emergency Medicine Australasia — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Emergency Medicine Australasia)

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Myth of tension spontaneous pneumothorax

Emergency Medicine Australasia — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Emergency Medicine Australasia)

Selective versus mandatory whole‐body computed tomography scanning in the multiply injured patient

Emergency Medicine Australasia — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Emergency Medicine Australasia)

Acute ST‐elevation myocardial infarction in a 24‐year‐old woman with atheromatous coronary artery disease

Emergency Medicine Australasia — Wed, 01 Feb 2012 05:00:00 +0100

We report the case of a 24‐year‐old Torres Strait Islander woman who presented to a rural hospital ED with chest pain suspicious for myocardial ischaemia and was found to have an anterior ST‐elevation myocardial infarction. She was thrombolysed and transferred to a tertiary centre where subsequent angiography revealed atheromatous disease of the left anterior descending coronary artery. We believe this to be one of the youngest reported cases of myocardial infarction due to atheromatous coronary artery disease, and demonstrates important learning points regarding the demographics and risk factors of indigenous patients with chest pain. (Source: Emergency Medicine Australasia)

Practically speaking: Emergency medicine and the palliative care movement

Emergency Medicine Australasia — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Emergency Medicine Australasia)

Rebalancing the major trauma computed tomography pan‐scan between panacea and Pandora's Box

Emergency Medicine Australasia — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Emergency Medicine Australasia)

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Cardiac CT in the Emergency Department

Cardiology Clinics — Wed, 01 Feb 2012 05:00:00 +0100

Current triage strategies are not effective in correctly identifying patients suffering from acute coronary syndrome (ACS). The diagnostic workup of patients presenting with acute chest pain continues to represent a major challenge for emergency department (ED) personnel. This statement holds especially true for patients with a low to intermediate likelihood for ACS. Taking current concepts for the diagnosis and management of patients presenting with acute chest pain to the ED into account, this article discusses the evidence and potential role of coronary computed tomography angiography to improve management of patients with possible ACS. (Source: Cardiology Clinics)

Incidence of elbow dislocations in the United States population.

The Journal of Bone and Joint Surgery. American volume — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: The estimated incidence of elbow dislocations in the U.S. population is 5.21 per 100,000 person-years, with use of a national database. Adolescent males are at highest risk for dislocation. Nearly half of acute elbow dislocations occurred in sports, with males at highest risk with football, and females at risk with gymnastics and skating activities. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. PMID: 22298056 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

Giant urethral diverticulum calculus presenting as scrotal abscess.

Hong Kong Med J — Wed, 01 Feb 2012 05:00:00 +0100

We report herein a patient with a urethral calculus associated with urethral diverticulum. A 39-year-old man presented with scrotal swelling and acute retention of urine. Computed tomography of the pelvis and cystoscopy demonstrated a giant calculus in the proximal penile urethra. Emergency in-situ lithotripsy was performed. Complete stone clearance was achieved and a large urethral diverticulum was encountered. The rare occurrence of urethral diverticulum and associated stone disease were discussed. PMID: 22302916 [PubMed - in process] (Source: Hong Kong Med J)

Salvaging kidneys with renal allograft compartment syndrome

Transplant International — Wed, 01 Feb 2012 05:00:00 +0100

SummaryRenal allograft compartment syndrome is an under recognized cause of early allograft dysfunction which can be reversed by early intervention. It occurs early after renal transplantation where closure of the anterior abdominal wall seems to compress the transplant in the limited retroperitoneal space. The literature about this syndrome in renal transplantation is sparse. Our report describes the diagnostic criteria and the management of two renal transplant recipients with this syndrome. Its diagnosis depends upon duplex vascular scan findings of reversed or absent diastolic flow in the renal vasculature in the absence of any perigraft collection or severe acute tubular necrosis. In our hands emergency laparotomy, decompression of the transplant and closure with interposition mesh sa...

PHANTOM‐S: the prehospital acute neurological therapy and optimization of medical care in stroke patients – study

International Journal of Stroke — Wed, 01 Feb 2012 05:00:00 +0100

RationaleTime from symptom onset to treatment is closely associated with the effectiveness of intravenous thrombolysis in acute ischemic stroke patients. Hospitals are encouraged to take every effort to shorten delay of treatment. Despite combined efforts to streamline procedures in hospitals to provide treatment as soon as possible, most patients receive tissue plasminogen activator with considerable delay and very few of them within 90 mins. Germany has an internationally acknowledged prehospital emergency care system with specially trained doctors on ambulances. We developed an ambulance equipped with a Computed Tomography (CT) scanner, point‐of‐care laboratory, teleradiological support, and an emergency‐trained neurologist on board. In the Pre‐Hospital Acute Neurological Ther...

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Double‐Masked, Placebo‐Controlled Study of Intravenous Levetiracetam for the Treatment of Status Epilepticus and Acute Repetitive Seizures in Dogs

Journal of Veterinary Internal Medicine — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions and Clinical ImportanceLEV was safe and potentially effective for the treatment of SE and ARS in these client‐owned dogs. Larger, controlled clinical trials are needed to confirm this preliminary observation. (Source: Journal of Veterinary Internal Medicine)

Intensive care admissions and outcome at the University of Calabar Teaching Hospital, Nigeria

Journal of Critical Care — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: An intensive care unit (ICU) is for critically ill patients who are likely to benefit from the expertise care provided. The outcome is dependent on the available human and material resources. The University of Calabar Teaching Hospital is a 410-bed hospital. It has a 3-bed general ICU consisting of 2 adult and 1 pediatric beds. A retrospective analysis of all ICU admissions as well as the mortality rate during a 12-month period that spans April 2009 and March 2010 was done. The data were collected from the ICU admissions and nurses' report books. The data extracted were the patients ages, stratified to pediatric (0-18 years) and adult (>18 years); the source of admission, primary diagnosis, the duration of admission, and the patients who were ventilated were also noted. The outco...

Risk factors for patient‐reported medical errors in eleven countries

Health Expectations — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions Safety remains a global challenge affecting many patients throughout the world. Large variability exists in the frequency of patient‐reported error across countries. To learn from others’ errors is not only essential within countries but may also prove a promising strategy internationally. (Source: Health Expectations)

Development of Posttraumatic Stress Disorder After Mild Traumatic Brain Injury

Archives of Physical Medicine and Rehabilitation — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Rates of PTSD in civilian MTBI in this study are consistent with prior research. Results suggest that personality characteristics and attribution regarding the injury may impact the development of PTSD. Early interventions addressing risk factors may prevent or reduce the likelihood of developing PTSD. (Source: Archives of Physical Medicine and Rehabilitation)

[Analysis of the inclussion of police personnel on the out of hospital cardiac arrest emergency response].

Salud Publica de Mexico — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: In Queretaro interventions can be performed taking advantage of the response capacity of the existing police focused on diminishing mortality from OCHA at a lesser cost than delegating this function only to ambulances. PMID: 22286829 [PubMed - in process] (Source: Salud Publica de Mexico)

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Adoption and Meaningful Use of Computerized Physician Order Entry With an Integrated Clinical Decision Support System for Radiology: Ten-Year Analysis in an Urban Teaching Hospital

Journal of the American College of Radiology : JACR — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Imaging CPOE with embedded decision support integrated into the IT infrastructure of the health care enterprise and clinicians' workflow can be broadly accepted clinically. (Source: Journal of the American College of Radiology : JACR)

ACR Appropriateness Criteria® Acute Trauma to the Knee

Journal of the American College of Radiology : JACR — Wed, 01 Feb 2012 05:00:00 +0100

There are more than 1 million visits to the ER annually in the United States for acute knee trauma. Many of these are twisting injuries in young patients who can walk and bear weight, and emergent radiography is not required. Several clinical decision rules have been devised that can considerably reduce the number of radiographic studies ordered without missing a clinically significant fracture. Although fractures are seen on only 5% of emergency department knee radiographs, 86% of knee fractures result from blunt trauma. In patients with falls or twisting injuries who have focal tenderness, effusion, or inability to bear weight, radiography should be the first imaging study performed. If radiography shows no fracture, MRI is best for evaluating for a suspected meniscal or ligament tear or...

Dispensing Medications at the Hospital Upon Discharge From an Emergency Department

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

Although most health care services can and should be provided by their medical home, children will be referred or require visits to the emergency department (ED) for emergent clinical conditions or injuries. Continuation of medical care after discharge from an ED is dependent on parents or caregivers’ understanding of and compliance with follow-up instructions and on adherence to medication recommendations. ED visits often occur at times when the majority of pharmacies are not open and caregivers are concerned with getting their ill or injured child directly home. Approximately one-third of patients fail to obtain priority medications from a pharmacy after discharge from an ED. The option of judiciously dispensing ED discharge medications from the ED’s outpatient pharmacy withi...

Successful Treatment of Type 1 Diabetes and Seizures With Combined Ketogenic Diet and Insulin

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

We report the case of a 2-year-old girl who presented to the emergency department with 1-week history of decreased activity, polyuria, and decreased oral intake. Her past medical history was remarkable for epilepsy, for which she was started on the KD with a significant improvement. Her laboratory evaluation was compatible with DKA, and fluids and insulin were given until correction. Because of concerns regarding recurrence of her seizures, the KD was resumed along with the simultaneous use of insulin glargine and insulin aspart. Urine ketones were kept in the moderate range to keep the effect of ketosis on seizure control. Under this combined therapy, the patient remained seizure-free with no new episodes of DKA. (Source: PEDIATRICS)

Multicenter Analysis of Quality Indicators for Children Treated in the Emergency Department for Asthma

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: We found no clinically significant association between process and outcome quality measures in the delivery of asthma-related care to children in a multicenter study. Although the quality of emergency department care does not predict successful discharge, other factors, such as outpatient care, may better predict outcomes. (Source: PEDIATRICS)

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Intellectual, Behavioral, and Social Outcomes of Accidental Traumatic Brain Injury in Early Childhood

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: Moderate/severe TBI at an early age appears to be associated with lowered intellectual function and possibly behavior problems. A child’s environment influences cognitive and behavior function after TBI. (Source: PEDIATRICS)

Multicenter Analysis of Quality Indicators for Children Treated in the Emergency Department for Asthma

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

Studies of the association between process and outcome measures of the quality of acute asthma care for children have been mixed. These studies are limited by small, single-institution settings or by examining the association at the aggregate level. This first multicenter analysis of the process-outcome association in acute asthma care for children revealed no association. Because the validity of process measures depends on association with outcomes, further study is needed before implementing existing process measures as performance metrics. (Read the full article) (Source: PEDIATRICS)

Rapid Intravenous Rehydration in Gastroenteritis

AAP Grand Rounds — Wed, 01 Feb 2012 05:00:00 +0100

(Source: AAP Grand Rounds)

Unannounced Mock Drills for Violent Situations

Nurse Leader — Wed, 01 Feb 2012 05:00:00 +0100

Violence in hospital emergency departments is a dangerous problem. The International Council of Nurses described this problem as a “world-wide epidemic” in 2008, and recent studies have clearly indicated that emergency nurses are particularly vulnerable to workplace violence. These abuses and assaults have a direct effect on staff morale, the amount of nonproductive work, and the length of staff employment in our emergency departments. (Source: Nurse Leader)

Lateral Service to Deliver Better Patient Care

Nurse Leader — Wed, 01 Feb 2012 05:00:00 +0100

“As director of our level I emergency department, I was called to a medical-surgical unit to perform service recovery for a newly admitted female patient who expressed dissatisfaction regarding her ED wait time. As I waited outside the room, I overheard a physician say to the patient and her family, “I'm sorry that you got stuck in that black hole of an ED.” Courtney Vose, RN, MBA, MSN, APRN (Source: Nurse Leader)

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The Downside of Storytelling

Nurse Leader — Wed, 01 Feb 2012 05:00:00 +0100

This is a tale about Amy, a busy leader with a vexing challenge. For 11 months, Amy had been the director of an emergency room in a large urban hospital. She is a seasoned, skilled nurse leader who is well intentioned and inspired to do her best. (Source: Nurse Leader)

How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's Hospital, Stockholm, Sweden

BMC Health Services Research — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Drawing on Spear and Bowen's theoretical propositions, this study explains how a package of lean-like changes translated into better care process management. It adds new knowledge regarding how lean principles can be beneficially applied in healthcare and identifies changes to professional roles as a potential challenge when introducing lean thinking there. This knowledge may enable health care organizations and managers in other settings to configure their own lean program and to better understand the reasons behind lean's success (or failure). (Source: BMC Health Services Research)

Temporal differences in gamma-hydroxybutyrate overdoses involving injecting drug users versus recreational drug users in Helsinki: a retrospective study

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: There appears to be at least two distinct groups of GHB/GBL users. Injecting drug users represent the majority of GHB/GBL overdose patients outside weekend nights. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)

An artificial neural network to safely reduce the number of ambulance ECGs transmitted for physician assessment in a system with prehospital detection of ST elevation myocardial infarction

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Our ANN had an excellent ability to predict STEMI and the need of acute PCI in ambulance ECGs, and has a potential to safely reduce the number of ECG transmitted to the CCU by almost two thirds. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)