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Search Results: 1 - 10 of 16278 matches for " emergency treatment "
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The validity of the canadian triage and acuity scale in predicting resource utilization and the need for immediate life-saving interventions in elderly emergency department patients
Ju Lee, Sang Oh, Eun Peck, Jung Lee, Kyu Park, Soo Kim, Chun Youn
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2011, DOI: 10.1186/1757-7241-19-68
Abstract: We reviewed the medical records of consecutive patients who were 65 years of age or older and presented to a single academic ED within a three-month period. The CTAS triage scores were compared to actual patient course, including disposition, discharge outcome and resource utilization. We calculated the sensitivity and specificity of the CTAS triage for identifying patients who received an immediate intervention.Of the 1903 consecutive patients who were ≥ 65 years of age, 113 (5.9%) had a CTAS level of 1, 174 (9.1%) had a CTAS level of 2, 1154 (60.6%) had a CTAS level of 3, 347 (18.2%) had a CTAS level of 4, and 115 (6.0%) had a CTAS level of 5. As a patient's triage score increased, the severity (such as mortality and intensive care unit admission) and resource utilization increased significantly. Ninety-four of the patients received a life-saving intervention within an hour following their arrival to the ED. The CTAS scores for these patients were 1, 2 and 3 for 46, 46 and 2 patients, respectively. The sensitivity and specificity of a CTAS score of ≤ 2 for identifying patients for receiving an immediate intervention were 97.9% and 89.2%, respectively.The CTAS is a triage tool with high validity for elderly patients, and it is an especially useful tool for categorizing severity and for recognizing elderly patients who require immediate life-saving intervention.Emergency department (ED) overcrowding is a serious problem worldwide [1-4]. The increase in the length of waiting lists for hospital admission in ED together with an increasing influx of new patients can cause severe overcrowding [5]. Meanwhile, in several countries (including South Korea), the exacerbation of an ageing society due to an increase in life expectancy is on the rise and is a social problem; in addition, ED visits by the elderly are increasing as well. What is characteristic among elderly patients is that their conditions are often more severe and they have a higher rate of admission to hospital
Tratamento da cefaléia em uma unidade de emergência da cidade de Ribeir?o Preto
BIGAL, MARCELO EDUARDO;BORDINI, CARLOS ALBERTO;SPECIALI, JOSé GERALDO;
Arquivos de Neuro-Psiquiatria , 1999, DOI: 10.1590/S0004-282X1999000500013
Abstract: headache is one of the most common symptoms observed in clinical practice. it has a considerable economic impact and overburdens emergency rooms. in brazil, most emergency rooms have no tryptans. the present study analyses the treatment provided by the emergency room of the university hospital of ribeir?o preto. in 1996, 1254 patients were treated for headache and 64 of them required hospitalization. of the non-hospitalized (nh) patients, 77% had primary headache, as opposed to 29.7% of hospitalized patients. of the patients with migraine, 83.6% improved with intravenous dipyrone, 66.7% improved with intramuscular diclofenac and 81.8% improved with intravenous chlorpromazine. the percentages of patients with tension-type headache who improved with the same drugs were 77.8%, 80% and 100%, respectively. among nh patients, 16.3% improved without any medication. we conclude that the drugs used have similar efficacy profiles and costs and can be used at basic health unities. the major drawback is parenteral administration.
Management of primary headache in emergency services of Santos and surrounding towns
Fragoso, Yara Dadalti;Fonseca, Priscilla Lopes da;Fortinguerra, Marcelo Bougartner;Cominato, Louise;Matte, Guilherme de Oliveira;Oliveira, Claudia Medeiros;
Sao Paulo Medical Journal , 1998, DOI: 10.1590/S1516-31801998000200002
Abstract: objectives: primary headaches are often seen by clinicians on duty at emergency services. we have investigated the treatment of such patients by 43 medical doctors who have been working at emergency services in the city of santos and surrounding towns for many years. results: we confirmed the high prevalence of primary headaches in emergency services. there seem to be diagnosis difficulties concerning differentiating attacks of migraine and tension type headache. we also observed that iv dipirone was the most frequently prescribed treatment for patients with primary headaches in this study. there is no protocol in the literature which recommends iv dipirone for the treatment of migraine attacks or other primary headaches. conclusion: it would be advisable to perform controlled double blind studies in order to verify the advantages of iv dipirone in the treatment of intense attacks primary headaches. we concluded that headache management recycling programs could be of interest for doctors who regularly work at emergency services.
Do we know how to use oxygen properly in emergeny department?
Orhan ??nar,Hülya Türkan,Ethem Duzok,Serkan Sener
Journal of Clinical and Analytical Medicine , 2010, DOI: 10.4328
Abstract: Aim: The aim of this study was to determine emergency department doctors’ and nurses’ knowledge regarding oxygen therapy. Material and Methods: A 7-item questionnaire survey was developed and applied to assess knowledge of oxygen therapy. The questionnaire was administered to a total of 100 (20 nurses, 30 resident physicians and 50 intern doctors (last-year medical students) staff from two university teaching hospital in Ankara, Turkey. Results: A response rate of 100 % was achieved from participants in the study. Only 9 % of the participants answered all the questions correctly on oxygen therapy. Conclusions: Our study shows that emergency medical staffs have significant gaps in their knowledge on appropriate oxygen therapy. Since deficiencies in emergency medicine staffs knowledge on treatment with oxygen deficits influence patient’s outcome, we recommend that emergency medicine staff should be trained regarding oxygen therapy and medical schools should pay much more attention to this issue in their curricula.
Manejo da asma aguda em adultos na sala de emergência: evidências atuais
Dalcin, Paulo de Tarso Roth;Perin, Christiano;
Revista da Associa??o Médica Brasileira , 2009, DOI: 10.1590/S0104-42302009000100021
Abstract: asthma is a disease with high prevalence in our country and worldwide. although new therapeutic approaches have been developed recently, there seems to be a global increase in morbidity and mortality from asthma. in many institutions, asthma exacerbation is still a common medical emergency. clinical evidence demonstrates that management of acute asthma in the emergency room entails crucial decisions that could determine the clinical outcome. in this review, the authors focus on assessment and treatment of patients with acute asthma and outline an appropriate management strategy. diagnosis, severity assessment, treatment, complications, decision about where additional treatment will take place and orientations on discharge from the emergency will be considered. it is expected that these recommendations will help physicians to make the appropriate decisions about care of acute asthma in the emergency room.
Asma aguda em adultos na sala de emergência: o manejo clínico na primeira hora
DALCIN, PAULO DE TARSO ROTH;MEDEIROS, ALAN CASTOLDI;SIQUEIRA, MARCELO KURZ;MALLMANN, FELIPE;LACERDA, MARIANE;GAZZANA, MARCELO BASSO;BARRETO, SéRGIO SALDANHA MENNA;
Jornal de Pneumologia , 2000, DOI: 10.1590/S0102-35862000000600005
Abstract: asthma is a disease with high prevalence in our country and around the world. although new therapeutic approaches have been recently developed, there appears to be a worldwide increase in morbidity and mortality from asthma. in many institutions, asthma exacerbation is still a common medical emergency. clinical evidence demonstrates that the first hour of management of acute asthma in the emergency room entails crucial decisions that could be determinant in the clinical outcome. in this non-systematic review, the authors focus on the first hour assessment and treatment of patients with acute asthma and outline an appropriate strategy for their management. diagnosis, severity assessment, pharmacological treatment, complications, and the decision regarding the place where additional treatment will take place will be considered. it is reasonable to expect that these recommendations will help physicians make appropriate decisions about the first hour care of acute asthma in the emergency room.
What an emergency physician needs to know about acute care of cardiac arrhythmias
Stellbrink Christoph
Journal of Emergencies, Trauma and Shock , 2010,
Abstract: The treat of cardiac arrhythmias has been studied extensively in the last decades. There has been a major shift in antiarrhythmia treatment from drugs to interventional electrophysiological procedures and implantable devices. Published data indicate that for long-term treatment of arrhythmias, non-pharmacological treatment is more effective than drugs in many patients. Similarly, the overhelming success of radiofrequency catheter ablation of supraventricular tachycardias has almost eliminated the need for chronic drug treatment. Today, catheter ablation plays an increasingly important role in the prevention of atrial fibrillation recurrences. However, in the emergency room or in the intensive care unit, drug treatment remains the gold standard for the treatment of cardiac arrhythmias. Arrhythmias are very common in emergency medicine, occurring in 12% to 20% of all patients in an intensive care unit and there is great need for good diagnostic and therapeutic algorithms to aid the emergency physician dealing with patients suffering from arrhythmias
Urticaria-Angio Edema: Profile of Patients in the Emergency Department and Factors Affecting Revisits
Yeliz BERK,Oktay ERAY,?zlem Y???T,Neslihan SAYRA?
Turkish Journal of Emergency Medicine , 2012,
Abstract: Objectives: The precise definition of the acute urticaria patients presenting to emergency department will improve the clinical approach to the urticaria patient. The aim of this study is to define the demographic features of urticaria patients visiting the emergency department and to find the factors that affect emergency department revisits due to urticaria symptoms. Methods: This was a retrospective case control study. Patients aged 16 and older were enrolled to the study. The number of revisits for the same complaints in the five days following the first visit was determined and the factors affecting the number of recurrent visits was searched. Results: The mean age of 3813 urticaria patients was 40.2±15.8, 2304 of whom were female. 2940 were triaged as non-urgent and 3787 were discharged from the emergency department. The 78 patients with recurrent visits were identified and there was no significant difference between the sex, urticaria or allergy history in the past, receiving H1 and H2 receptor blockers together or receiving two different H1 receptor blockers, the season of the year, comorbid diseases, or medicines for chronic illness between patients who visited the emergency department once and those who visited the emergency department repeatedly. The presence of a possible cause for the urticaria symptoms and chronic urticaria diagnosis were found to be more common in the revisit group.Conclusions: This study has pointed out that scores of urticaria patients are entering emergency departments and these patients may have life-threatening problems. This information can be used to modify emergency clinic curriculum and can contribute to the standardization of urticaria management and follow up. Future prospective studies may be conducted for urticaria management in light of our results.
Difficulties in Management of Occupational Exposure in Our Country: A Case Report
Serkan YILMAZ,Murat PEKDEM?R,Elif YAKA
Turkish Journal of Emergency Medicine , 2012,
Abstract: Occupational exposure to hazardous materials is a serious problem in developing countries. Unfortunately, the different presentations result in nonspecific clinical syndromes, making diagnosis difficult.We discuss lessons learned during the assessment and treatment of occupational exposure in two industrial workers. Two employees of a facility that manufactures plastic floor covering were admitted to the emergency department with complaints including inability to ambulate, lethargy and dizziness. It was thought that the patients’ neurological symptoms resulted from toxic encephalitis and refractory hypokalemia due to renal medullary damage. No material safety data sheets were available for consultation, and the authorities at the manufacturing facility were unable to provide reliable information about the material involved. On-site exposure evaluation was not performed and these conditions made the exact etiology of the patients’ condition unclear. It was thought that toluene, which was used as a solvent during the manufacture of vinyl fluoride, could be responsible for the existing clinical condition. Both patients were treated symptomatically and discharged with minor cognitive impairment, which was assessed during follow-up. Various difficulties were experienced during the management of patients suffered from occupational exposure. Material safety data sheets for industrial chemicals should be available at manufacturing plants. On-site exposure evaluation would be useful for more accurate assessment of exposed patients.
Management of violence in emergency service
Cem SENGUL,Deniz SIMSEK,Mustafa SERINKEN
Turkish Journal of Emergency Medicine , 2009,
Abstract: Violence is one of the serious problems that should be taken into consideration in emergency service. Violence may be the symptoms of a phsychiatric disorder generally, but it may also be seen in many organic disorders. Although it is an important issue in emergency setting, there is no any standard treatment guideline for its management. However, many pharmacological and non-pharmacological treatment approaches have been reported in the literature. The aim of this article is to review the researches about the management of violence in emergency service.
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