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Upper airway bronchoscopic approach and diagnostic procedures
Published in Don Hayes, Kara D. Meister, Pediatric Bronchoscopy for Clinicians, 2023
The endoscopist should stand wherever is most comfortable and practiced, either to the patient's side or from the head of the bed. Access to definitely control the patient's airway in case of emergency should be maintained.
Schizophrenic Disorders 1
Published in Bernat-N. Tiffon, Atlas of Forensic and Criminal Psychology, 2022
Subsequent remarks: In this particular case, the emergency physician and the Catalan Police Force turned up at the site where the incident had occurred and observed an individual in a state of agitation consistent with an acute episode of psychotic disorder. They had to restrain and move him, while he was flailing, to the vehicle that would take him to the Emergency Psychiatric Department.
Telling Bad News
Published in Lisa Zammit, Georgeanne Schopp, Relational Care, 2022
Lisa Zammit, Georgeanne Schopp
POLST is a portable medical order set for Patients who are seriously ill or with advanced frailty. The form is designed to be completed by the Clinician, in conversation with the Patient and, hopefully, Family. Both Patient and Clinician keep a copy of the order set. POLST instructs all providers regarding Patient preferences across care settings and/or in case of emergency. The forms and terminology of these order sets vary by state. Every Clinician should be aware of their state’s requirements. The National POLST form and guide for use can be found in Appendix B.11.
Blood urea nitrogen/albumin ratio on admission predicts mortality in patients with non ST segment elevation myocardial infarction
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2022
Sarper Sevdımbas, Salim Satar, Muge Gulen, Selen Acehan, Armagan Acele, Gonca Koksaldı Sahin, Deniz Aka Satar
In our study, the mortality predictive value of SX score and BAR determined by AUC was higher than other biomarkers. Likewise, the specificity and sensitivity of the determined cut-offs in predicting mortality were also higher. Biomarkers that predict mortality in diseases should have high sensitivity while they should be easy to remember and access. Also, they are expected to be calculated promptly in case of emergency admission for critically ill patients. The relationship between SX score with mortality and complications is clearly shown in the literature, as in our study; however, it is only possible to be calculated after angiography. On the other hand, BAR is a parameter that can be assessed with ease in the course of emergency department admission. Moreover, we revealed that BAR (≥ 4.8) on admission to the emergency department may predict 30-day mortality in patients with NSTEMI. However, we suggest that further studies that are multicenter, large-scale, randomized, and prospective are needed to validate the hypothesis.
Measuring Quality of Care Received by Suicide Attempters in the Emergency Department
Published in Archives of Suicide Research, 2022
Jessica Rassy, Diane Daneau, Caroline Larue, Elham Rahme, Nancy Low, Suzanne Lamarre, Gustavo Turecki, Jean-Pierre Bonin, Helene Racine, Suzanne Morin, Kaberi Dasgupta, Johanne Renaud, Alain Lesage
Second, the descriptive statistic of each criterion is indicated in the “Total” column of Table 1. Quality was found in the systematic evaluation and coordination of inpatient care by mental health professionals (items 1–11). Results show that suicide risk was only assessed in 63% of all individuals who attempted suicide (item 3). Also, interviews with relatives were only conducted in 41% of the cases (item 4). However, family history was documented in the medical files (item 5) of 90% of the cases. The deficits were mostly found in the coordination of outpatient appointment. More precisely, items 8 and 9 show that only 20% of patients and 11% of relatives received written contact information of resources reachable 24/7 in case of emergency, according to the case records. Also, less than half (47%) of suicide attempters seen left with a planned appointment noted in the medical record with a psychiatrist or a psychologist (item 10). In addition, for 43% of suicide attempters, a professional was informed about their attendance to their next planned appointment, according to the medical records.
Commentary: Remote assessments of gait and balance - Implications for research during and beyond Covid-19
Published in Topics in Stroke Rehabilitation, 2022
Sangeetha Madhavan, Anjali Sivaramakrishnan, Mark G. Bowden, Neale R. Chumbler, Edelle C. Field-Fote, Trisha M. Kesar
Prior to embarking on remote assessments, in addition to ensuring the participant’s access to the internet, certain ethical considerations must also be addressed.40 A few key factors include participant privacy, confidentiality, informed consent, equitable access, and potential risks associated with the process of remotely capturing data. A discussion of risks and strategies to minimize risks and potential problems should be considered before beginning tele-assessments, and incorporated into the consent process. Possible solutions to minimize risk may include utilizing secure software, procuring participant contact information in case of emergency, and ensuring that the participant has adequate functional ability to perform the assessment. After informed consent, the study staff can interview the participant regarding medical history, physical activity, and determine whether the participant can safely progress to the remote assessment. Evaluation of cognitive function is also important to ensure that the participant can follow instructions, communicate with the study team, and learn to use the video-conferencing technologies. Tests such as the Mini-Mental State Exam and the Montreal Cognitive Assessment have shown good accuracy with telehealth administration compared to in-person administration.41,42 Participants should be provided detailed instructions regarding the functional assessment, with particular emphasis on safety.