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Specialty: Emergency Medicine
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Total 89 results found since Jan 2013.

Clinical Factors and Expenditures Associated With ICD ‐9‐CM Coded Trauma for the US Population: A Nationally Representative Study
ConclusionsTrauma results in a significant health care expenditure burden, both per person and on the US population. Clinicians should be aware that individuals in the U.S. population with certain comorbidities such as stroke, joint pain, arthritis and asthma are more likely to have trauma, and that differences exist in expenditures for office‐based, outpatient, dental and the ER.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - December 14, 2016 Category: Emergency Medicine Authors: Clara E. Dismuke, Kinfe G. Bishu, Samir Fakhry, Rebekah J. Walker, Leonard E. Egede Tags: Original Contribution Source Type: research

Potentially Missed Diagnosis of Ischemic Stroke in the Emergency Department in the Greater Cincinnati/Northern Kentucky Stroke Study
ConclusionIn a large population‐based sample of AIS cases, 1 in 7 cases were not diagnosed as AIS in the ED, but the impact on acute treatment rates is likely small. Missed diagnosis was more common among those with decreased LOC, suggesting the need for improved diagnostic approaches in these patients.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - June 16, 2016 Category: Emergency Medicine Authors: Tracy E. Madsen, Jane Khoury, Rhonda Cadena, Opeolu Adeoye, Kathleen A. Alwell, Charles J. Moomaw, Erin McDonough, Matthew L. Flaherty, Simona Ferioli, Daniel Woo, Pooja Khatri, Joseph P. Broderick, Brett M. Kissela, Dawn Kleindorfer Tags: Original Contribution Source Type: research

Patient and process factors associated with type of first neuroimaging and delayed diagnosis in childhood arterial ischemic stroke
ConclusionsStrategies to improve rapid diagnosis of pediatric stroke should include shared regional hospital networks protocols to optimize local imaging strategies, and where possible rapid transfer to the tertiary center. Future priorities should include development of pediatric ED physician decision support tools to differentiate stroke from mimics, and the development and implementation of rapid ED imaging stroke protocols to improve access to confirmatory MRI scanning.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - May 6, 2016 Category: Emergency Medicine Authors: Marco Daverio, Silvia Bressan, Dario Gregori, Franz E. Babl, Mark T. Mackay Tags: Original Contribution Source Type: research

The incidence and significance of acute kidney injury following emergent contrast administration in patients with STEMI and stroke
Abstract The authors have investigated the incidence of acute kidney injury (AKI) and short-term mortality following an activated STEMI and stroke alert at a tertiary referral and academic center. A single center, retrospective chart review of STEMI and stroke activation patients from January 2010 to March 2012. Data was collected and reviewed from an institutional database following IRB-approval. Inclusion criteria were STEMI patients taken for cardiac catheterization, excluding patients receiving hemodialysis due to end-stage renal disease (ESRD). Primary outcome measures were the incidence of AKI using the RIFL...
Source: Internal and Emergency Medicine - February 24, 2016 Category: Emergency Medicine Source Type: research

Are all stroke patients eligible for fast alteplase treatment? An analysis of unavoidable delays
ConclusionsUp to 31% of patients have delays due to medical or eligibility‐related causes that may be legitimate reasons for providing alteplase later than the benchmark time of 60 minutes.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - January 29, 2016 Category: Emergency Medicine Authors: Philip M C Choi, Jamsheed A Desai, Devika Kashyap, Caroline Stephenson, Noreen Kamal, Sheldon Vogt, Victoria Bohm, Michael Suddes, Erin Bugbee, Michael D Hill, Andrew M Demchuk, Eric E Smith Tags: Original Contribution Source Type: research

Perceived Appropriateness of Shared Decision‐Making in the Emergency Department: A Survey Study
ConclusionsAcceptance of SDM among emergency physicians appears to be strong across management categories (diagnostic testing, treatment, and disposition) and in a variety of clinical scenarios. SDM is perceived by most EPs to be medicolegally protective.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - January 25, 2016 Category: Emergency Medicine Authors: Marc A. Probst, Hemal K. Kanzaria, Dominick L. Frosch, Erik P. Hess, Gary Winkel, Ka Ming Ngai, Lynne D. Richardson Tags: Original Contribution Source Type: research

Perceived Appropriateness of Shared Decision-Making in the Emergency Department: A Survey Study.
CONCLUSIONS: Acceptance of SDM among emergency physicians appears to be strong across management categories (diagnostic testing, treatment, and disposition) and in a variety of clinical scenarios. SDM is perceived by most EPs to be medicolegally protective. This article is protected by copyright. All rights reserved. PMID: 26806170 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - January 25, 2016 Category: Emergency Medicine Authors: Probst MA, Kanzaria HK, Frosch DL, Hess EP, Winkel G, Ngai KM, Richardson LD Tags: Acad Emerg Med Source Type: research

Automated Outcome Classification of Computed Tomography Imaging Reports for Pediatric Traumatic Brain Injury
ConclusionsA hybrid NLP and machine learning automated classification system continues to show promise in coding free‐text electronic clinical data. For complex outcomes, it can reliably identify negative reports, but manual review of positive reports may be required. As such, it can still streamline data collection for clinical research and performance improvement.
Source: Academic Emergency Medicine - January 14, 2016 Category: Emergency Medicine Authors: Kabir Yadav, Efsun Sarioglu, Hyeong−Ah Choi, Walter B. Cartwright, Pamela S. Hinds, James M. Chamberlain Tags: Original Contribution Source Type: research

Assessing Fluid Responsiveness in Spontaneously Breathing Patients
ConclusionsNoninvasive assessment of fluid responsiveness in healthy volunteers and prediction of this response with a PLR maneuver is achievable. Further work is indicated to test these methods in acutely ill patients.
Source: Academic Emergency Medicine - January 14, 2016 Category: Emergency Medicine Authors: Joseph Miller, Chuan‐Xing Ho, Joy Tang, Richard Thompson, Jared Goldberg, Ahmed Amer, Bashar Nahab Tags: Original Contribution Source Type: research

Comparison of Four Bleeding Risk Scores to Identify Rivaroxaban‐treated Patients With Venous Thromboembolism at Low Risk for Major Bleeding
ConclusionsFour scoring systems that use criteria obtained in routine clinical practice, derived to predict low bleeding risk with VKA treatment for VTE, identified patients with less than a 1% risk of major bleeding during full‐course treatment with rivaroxaban.
Source: Academic Emergency Medicine - January 14, 2016 Category: Emergency Medicine Authors: Jeffrey A. Kline, David Jimenez, D. Mark Courtney, Juliana Ianus, Lynn Cao, Anthonie W.A. Lensing, Martin H. Prins, Philip S. Wells Tags: Original Contribution Source Type: research

Monte Carlo Simulation Modeling of a Regional Stroke Team's Use of Telemedicine
ConclusionsGiven the potential societal benefits, continued efforts to deploy telemedicine appear warranted. Aligning the incentives between those who would have to fund the up‐front technology investments and those who will benefit over time from reduced ongoing health care expenses will be necessary to fully realize the benefits of telemedicine for stroke care.
Source: Academic Emergency Medicine - December 31, 2015 Category: Emergency Medicine Authors: Elham Torabi, Craig M. Froehle, Christopher J. Lindsell, Charles J. Moomaw, Daniel Kanter, Dawn Kleindorfer, Opeolu Adeoye Tags: Original Contribution Source Type: research

The Association Between Emergency Department Crowding and the Disposition of Patients With Transient Ischemic Attack or Minor Stroke
ConclusionsThese results suggest that crowding may influence clinical decision‐making in the disposition of patients with TIA or minor stroke and that, as crowding worsens, the likelihood of hospitalization increases.
Source: Academic Emergency Medicine - September 1, 2015 Category: Emergency Medicine Authors: Maxim Ben‐Yakov, Moira K. Kapral, Jiming Fang, Shudong Li, Marian J. Vermeulen, Michael J. Schull Tags: Original Contribution Source Type: research

There Are Sex Differences in the Demographics and Risk Profiles of Emergency Department (ED) Patients With Atrial Fibrillation and Flutter, but no Apparent Differences in ED Management or Outcomes
ConclusionsFemale ED AFF patients were older, had more comorbidities, and were more likely to be admitted. However, the overall management and outcomes, including 30‐day revisits, appeared to be similar to that of males, indicating that there appeared to be little sex‐based discrepancy in ED care and outcomes. Resumen Existen Diferencias Respecto al Sexo en los Perfiles de Riesgo y Demográficos de los Pacientes con Flutter y Fibrilación Auricular del Servicio de Urgencias, Pero Aparentemente no Existen Diferencias en el Manejo en el SU o los Resultados ObjetivosEn escenarios distintos al servicio de urgencias (SU), ...
Source: Academic Emergency Medicine - August 20, 2015 Category: Emergency Medicine Authors: Frank Xavier Scheuermeyer, Martha Mackay, Jim Christenson, Eric Grafstein, Reza Pourvali, Claire Heslop, Jan MacPhee, John Ward, Brett Heilbron, Lorraine McGrath, Karin Humphries Tags: Original Contribution Source Type: research

Geographic Clustering of Emergency Department Presentations for Atrial Fibrillation and Flutter in Alberta, Canada
ConclusionsThis population‐based study spanned 12 fiscal years and showed variations in the number of people presenting to EDs for AFF and the number of ED presentations for AFF over geography. The potential clusters identified may represent geographic areas with higher disease severity or a lower availability of non‐ED health services. The clusters are not all likely to have occurred by chance, and further investigation and intervention could occur to reduce ED presentations for AFF.
Source: Academic Emergency Medicine - July 1, 2015 Category: Emergency Medicine Authors: Rhonda J. Rosychuk, Hensley H. Mariathas, Michelle M. Graham, Brian R. Holroyd, Brian H. Rowe Tags: Original Contribution Source Type: research

The Emergency Medicine Debate on tPA for Stroke: What Is Best for Our Patients? Efficacy in the First Three Hours
Source: Academic Emergency Medicine - June 25, 2015 Category: Emergency Medicine Authors: Joseph B. Miller, Laura Heitsch, Matthew S. Siket, Jon W. Schrock, Charles R. Wira, Christopher Lewandowski, Tracy E. Madsen, Lisa H. Merck, David W. Wright, Tags: Commentary Source Type: research