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Emergency Care

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Most cited protocols related to «Emergency Care»

This study is embedded in the MOFICHE study (Management and Outcome of Fever in children in Europe), which is part of the European Union-funded PERFORM project (Personalised Risk assessment in Febrile illness to Optimise Real-life Management) (GA:668303, www.perform2020.eu) (online supplemenatary appendix 1). MOFICHE collects information regarding patient characteristics, resource use (diagnostic tests, antibiotic prescription and hospitalisation) and outcome in febrile children.
An electronic questionnaire (online supplementary appendix 2) was sent by email to the principal investigator of each participating centre, which were 11 European hospitals in eight countries: Austria, Germany, Greece, Latvia, the Netherlands, Slovenia, Spain and the UK. The questionnaire was filled in by the principal investigator in collaboration with the head of the (paediatric) ED or one of the main consultants responsible for the care of febrile children at the ED.
The questionnaire was based on the article by Mintegi et al10 (link) on organisation of paediatric emergency care and was further developed by the MOFICHE research team, consisting of a team of experts with a background in paediatrics, epidemiology, paediatric emergency care, paediatric infectious diseases and health economics. We gathered information on factors influencing case mix as well as resource use.
We focused on local ED quality indicators, regional systems of care and local factors influencing resource use based on Medford-Davis et al1 (link) classification of value-based emergency care.1 (link)
The questionnaire was created with Google Forms. Questions consisted of multiple-choice or multiple-option questions, yes/no questions, 5-point Likert-scale questions and open questions.
All analyses were descriptive and performed with SPSS V.21 software. We analysed the correlation between the different setting characteristics using Pearson correlation coefficient.
Publication 2019
Antibiotics Child Communicable Diseases Emergency Care Europeans Fever Head Health Risk Assessment Patients Tests, Diagnostic

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Publication 2012
Anti-Inflammatory Agents Asthma Bronchiolitis Bronchodilator Agents Congenital Heart Defects Cystic Fibrosis Emergency Care Environmental Exposure Ethics Committees, Research Gastroesophageal Reflux Disease Hospitalization Infant Legal Guardians Lung Nasopharynx Parent Patients Pharmaceutical Preparations Physicians Respiratory Rate Respiratory Syncytial Virus Infections
Patients were followed up for a maximum of 14 days from their earliest COVID-19-positive specimen until the hospital admission or emergency care attendance date. Patients were censored at the date of death if this occurred without a previous hospital attendance event within the 14-day period.
In the primary analysis, stratified Cox regression was used to estimate hazard ratios (HRs) of the hospitalisation outcomes (hospital admission or emergency care attendance) for patients with the delta variant compared with patients with the alpha variant. Strata were created by intersecting the likely confounders. Additional potential confounders were included using main effects. Linear main effects terms for age and calendar date were used to adjust for residual confounding after stratification.
In the secondary analysis, the HRs of the hospitalisation outcomes by variant were estimated by vaccination status. The base models were refitted with an interaction term between variant and vaccination. Due to low numbers of patients with COVID-19 who had been vaccinated, and consequently low numbers within some vaccination categories, vaccination status was grouped into two categories: unvaccinated or less than 21 days since the first vaccination dose; and 21 days or more since the first vaccination dose, with or without the second dose.
In additional analyses, the proportional hazards assumption of the Cox regression model was graphically assessed using Schoenfeld residual plots and formally tested using the Schoenfeld test. Post-evaluations of the relative magnitudes of the confounders' contribution to the adjusted HRs were done by sequentially adding the adjustment variables in the order of the percentage change in the adjusted HRs for patients with the delta variant versus the alpha variant. To assess the impact of stratification versus regression modelling on the HRs and 95% CIs, the primary model was refitted with each stratification variable instead included as a regression variable.
HRs were assessed for sensitivity to stratification by alternative region or calendar period covariates, confounding due to recent international travel or symptomatic status subgroups, or to the precise outcome definitions. Details are shown in the appendix (p 8).
Data were prepared using Stata version 15.1. Statistical analyses were done in R version 4.1.0.
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Publication 2022
COVID 19 Emergency Care Hypersensitivity Patients Vaccination
A validated process based definition of non-urgent attendance previously published by one of the study authors was adapted for this study [6 (link)]. As with this original definition, our approach applied the definition to patients who attended a type 1 ED, as a first attendance, but who were subsequently identified as not receiving investigations, treatments or referral that required the facilities of a type 1 ED. For the purposes of this definition all follow up attendances, whether planned or unplanned were considered urgent. Attendances at single specialty emergency departments, or centres designed for non-emergency patients were not included in the analysis.
Following consultation with our expert steering group (including clinicians, NHS managers and patient representatives) lists of investigations and treatments that did not require the facilities of a fully staffed ED and that could routinely be provided in a non-emergency care setting, such as primary care, were identified. The treatment, investigation and disposal HES codes taken as indicating non-urgent ED attendance are shown in Table 1 below.
Our definition of non-urgent attendance was therefore developed as follows:
This could be summarised as identifying “first attendance with some recorded treatments or investigations all of which may have reasonably been provided in a non-emergency care setting, followed by discharge home or to GP care.”
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Publication 2018
Emergencies Emergency Care Patient Discharge Patient Representatives Patients Primary Health Care
Our primary outcome was long-term opioid use, which we defined as 180 days or more of opioids supplied in the 12 months after an index emergency department visit, excluding prescriptions within 30 days after the index visit. We applied this exclusion because otherwise this outcome, by design, would be correlated with our definition of the main exposure. We chose 180 days as a specific marker for clinically significant long-term opioid use beyond the common duration of 90 days described in previous literature.16 (link),22 (link),23 (link) Therefore, this outcome captures the extent to which other physicians prescribe opioids for the subsequent 12 months after a patient’s index emergency department visit.
Secondary outcomes were rates of hospital encounters (emergency department visits, hospitalizations, or both), including those potentially related to adverse effects of opioids and those associated with a selection of medical conditions that were unlikely to be influenced by opioid use, in the 12 months after an index emergency department visit (definitions are provided in the Methods and Results section in the Supplementary Appendix).8 (link)–10 (link),24 (link) To assess for possible undertreatment of pain by low-intensity prescribers that could have led to repeat emergency care, we also measured rates of repeat emergency department visits at 14 and 30 days that resulted in the same primary diagnosis as the initial emergency department visit, classified according to Clinical Classifications Software (CCS) groups (categorizations of codes in the International Classification of Diseases, 9th Revision).25
Publication 2017
associated conditions Diagnosis Emergency Care Hospitalization Opioids Pain Patients Physicians Prescriptions

Most recents protocols related to «Emergency Care»

After surgery, subjects were transferred to PACU Phase I recovery room where standard monitoring was applied, and vital signs were checked every 10 min [7 (link)]. When patients achieved a modified Aldrete’s score of 9 or 10, they would be transferred to PACU Phase II recovery room [8 (link)]. Finally, patients were considered safe to discharge once their Chung’s Post-Anesthetic Discharge Scoring System (PADSS) scores achieved at 9 or 10 [9 (link)]. A trained and registered nurse in the PACU evaluated all the physiological systems.
In Phase II recovery room, patients and their caregivers were educated on important signs and symptoms necessitating urgent access to care. Verbal instructions and cautions of nursing care were reinforced with a 2 min video review before discharge, and a take-home discharge brochure for common complication management was delivered to the patients at discharge. Both groups of patients were offered a 24-h telephone helpline to the physician on call if they had additional clinical questions or concerns, and they were advised to contact the local hospital emergency department if needing emergency care.
Publication 2023
Anesthetics Emergencies Emergency Care nursing Operative Surgical Procedures Patient Discharge Patients Physicians physiology Registered Nurse Signs, Vital
This study was a retrospective sub-analysis of a cohort of patients with sepsis in the JAAM Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma (FORECAST) database. The main investigation in this cohort had evaluated the characteristics, management, and outcomes among patients with severe sepsis in Japan [18 (link)]. The JAAM FORECAST study was a multicenter prospective study of acutely ill patients, including those with acute respiratory distress syndrome, sepsis, and trauma, that collected consecutive samples from 59 intensive care units in Japan from January 2016 to March 2017. This manuscript was written in accordance with the STROBE reporting guidelines (https://www.strobe-statement.org/).
This study was approved by the JAAM and the Ethics Committee of all participating hospitals, waiving written informed consent (JAAM, 2014-01, Hokkaido University Graduate School of Medicine, Head institute of the FORECAST group, 014-0307) since these were already previously obtained from each patient or their next of kin. Furthermore, the study was performed in accordance with the tenets underlying the Declaration of Helsinki.
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Publication 2023
Emergency Care Ethics Committees, Clinical Head Patients Respiratory Distress Syndrome, Acute Septicemia Severe Sepsis Wounds and Injuries
A pilot study was designed since we have advocated a novel method to prevent syncope during extraction. This pilot study was designed with a total of 30 patients. This study included only patients with a previous history of syncope and dental anxiety. Patients were divided into two groups consisting of 15 patients each. The study group consisted of 15 patients who were taught leg raise and leg fold maneuvers and were asked to perform the maneuver at regular intervals during extraction, and the control group consisted of 15 patients who underwent extraction in the conventional method.
Inclusion criteria
This study includes subjects ranging from 18-75 years of age with a previous history of syncope and dental anxiety.
Exclusion criteria
Patients with musculoskeletal disease; patients with suspected or overt heart disease with a high likelihood of cardiac syncope; patients with orthostatic hypotension; patients with episodes of loss of consciousness different from syncope; patients who are psychologically, physically, or cognitively unable to participate; patients with doubtful compliance; patients with inaccessibility to follow-up; patients who are unwilling or unable to give informed consent; and patients who are pregnant are all excluded.
Leg raise and leg fold physical maneuver technique
Group I (study group) patients undergoing extraction were educated few physical maneuvers that are to be done by the patients at regular intervals. Before extraction, the patients were educated about the physical maneuver that consists of leg lifts and leg folds. The clinician taught the patient to do this maneuver before local anesthesia administration, intraoperatively at regular intervals, if required postoperatively. The patient will raise his/her leg for five times to a minimum height of at least 15 cm (Figure 1) while sitting in the dental chair. Each leg is done individually or combined according to the patient's preference.
Once the leg raise maneuver is completed, the patient will fold the leg and stretch each leg five times using the knee joint (Figure 2). During the maneuver, sudden jerky movements should be avoided, and the patient is advised to focus primarily on physical activity.
Group II (Control group) patients conventionally underwent extraction. Informed consent was obtained from all the patients. The parameters for this study included monitoring blood pressure, SpO2, and pulse, which were monitored preoperatively, postoperatively, and verbally. Blood pressure was monitored using a manual sphygmomanometer. Pulse rate and SpO2 were assessed using a pulse oximeter. While extracting, if the patient develops any signs of unrest requiring emergency care, the procedure will be completely stopped, and maintenance of the chair in reverse trendelenburg and protocols for standard management of syncope will be followed.
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Publication 2023
Blood Pressure Dental Anxiety Dental Health Services Emergency Care Heart Disease, Coronary Hypotension, Orthostatic Knee Joint Local Anesthesia Movement Musculoskeletal Diseases Patients Physical Examination Pulse Rate Saturation of Peripheral Oxygen Sphygmomanometers Syncope Teaching
High-risk PLWD satisfying the inclusion criteria were identified by using a database from the Western Cape Data Centre. Code-named VECTOR (Virtual Emergency Care Tactical OpeRation), a group of medical officers obtained data from the data centre, which ran an algorithm to generate a list of high-risk PLWD with a COVID-19 diagnosis in a 10-day window.13 (link) These patients were then allocated to the medical officers who contacted them telephonically to offer them elective admission to the HoH.
All 61 patients who accepted admission to the HoH via the telemedicine (VECTOR) community group were included as the experimental group, while 122 purposively selected patients matching the inclusion criteria below in a 2:1 ratio were identified from those admitted prior to the introduction of the intervention (HRDCp) to make up the control group. The two groups were matched for age, gender and renal function.
Inclusion criteria were Type I or II diabetes mellitus with COVID-19 (polymerase chain reaction [PCR] test or clinical diagnosis) and renal impairment (creatinine of more than 100) or age older than or equal to 65 years of age.
Exclusion criteria were age younger than 65 and normal renal function, and for controls, the exclusion criteria were being admitted after the HRDCp was introduced and not being part of the VECTOR cohort.
Renal impairment was defined using the RIFLE (risk, injury, failure, loss of kidney function and end-stage kidney disease) criteria, which included a rise in creatinine, which results in risk, injury, failure, loss of kidney function and end-stage kidney disease (see Appendix 3).24 (link)
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Publication 2023
Chronic Kidney Diseases Cloning Vectors COVID 19 Creatinine Diabetes Mellitus Diagnosis Emergency Care Gender Injuries Kidney Kidney Failure, Chronic Patients Polymerase Chain Reaction Renal Insufficiency Telemedicine Youth
This retrospective study utilized the diagnosis procedure combination (DPC) and severity of a patient’s condition and the extent of a patient’s need for medical/nursing care (SCNMN) databases.
The DPC is a patient classification method for acute inpatients developed in Japan as a tool to make acute medical care transparent and visible. In 2003, the Ministry of Health, Labour, Welfare implemented this as a lump-sum per-diem payment system, and it is used for acute inpatient medical care and medical resource allocation. Acute care hospitals in Japan are part of this system and report medical information on medical procedures to the Ministry of Health, Labour, and Welfare.[20 (link),21 (link)] As of 2020, the DPC database had been applied to 1757 facilities and 483,180 beds, accounting for 24.5% of Japan’s general hospitals and 54.4% of its beds. This DPC database collects the following information: patient age and sex; main diagnoses, preexisting comorbidities, postadmission complications linked with the international classification of diseases, and 10th revision codes; dates of admission and discharge; route of hospital admission; discharge destination; discharge outcome; and surgical procedure.[20 (link),22 (link)]The SCNMN database is an index developed in Japan for measuring the nursing services required by inpatients. It is now mainly used as a standard for paying medical expenses such as basic hospital charges for acute care. This index consists of 21 items divided into 3 categories. Item A (7 items) refers to highly specialized nursing care, including monitoring and treatment. Item B (7 items) refers to patients’ functional status, such as activities of daily living (ADL), which influence medical care. Item C (7 items) refers to medical management, such as surgical treatment and emergency care. These items are evaluated daily for each patient and compiled into a database.[23 (link)]
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Publication 2023
Diagnosis Emergency Care Hospitalization Inpatient nursing Nursing Services Operative Surgical Procedures Patient Discharge Patients Tests, Diagnostic

Top products related to «Emergency Care»

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The PI-19E is a laboratory instrument designed for measuring various parameters. It is capable of performing precise measurements and data analysis. The core function of the PI-19E is to provide accurate and reliable measurement capabilities for laboratory applications.
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The Automatic Biochemical Analyzer is a laboratory instrument designed to perform automated chemical analysis of biological samples. Its core function is to measure the concentration of specific analytes, such as proteins, enzymes, and metabolites, in a wide range of sample types, including blood, urine, and other bodily fluids.
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The DINAMAP Pro 300 is a portable vital signs monitoring device designed for use in various healthcare settings. The device is capable of measuring and displaying a patient's blood pressure, pulse rate, and temperature.
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The Cybershot is a digital camera line produced by Sony. It is designed to capture high-quality images and video. The Cybershot features a built-in lens, image sensor, and storage media.
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Stata v14 is a statistical software package developed by StataCorp. It provides a comprehensive set of tools for data management, analysis, and visualization. Stata v14 offers a range of features, including data manipulation, statistical modeling, and graphics capabilities. The software is designed to be user-friendly and is widely used in various fields, including academia, research, and industry.
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BD Vacutainer needles are sterile, single-use needles designed for the collection of blood samples. They are compatible with BD Vacutainer blood collection tubes and offer a range of gauge sizes to accommodate various patient needs.
The GoldenGate panel is a targeted genotyping solution that enables the simultaneous analysis of multiple genetic markers. It is designed to provide researchers with a flexible and efficient platform for genotyping applications.
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SPSS 22.0 is a statistical software package developed by IBM. It is designed to analyze and manipulate data, providing users with a range of statistical tools and techniques for various applications, including market research, survey data analysis, and social science research.

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