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Publisher: Hindawi   (Total: 335 journals)

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Showing 1 - 200 of 335 Journals sorted alphabetically
Abstract and Applied Analysis     Open Access   (Followers: 3, SJR: 0.343, CiteScore: 1)
Active and Passive Electronic Components     Open Access   (Followers: 7, SJR: 0.136, CiteScore: 0)
Advances in Acoustics and Vibration     Open Access   (Followers: 33, SJR: 0.147, CiteScore: 0)
Advances in Aerospace Engineering     Open Access   (Followers: 52)
Advances in Agriculture     Open Access   (Followers: 8)
Advances in Artificial Intelligence     Open Access   (Followers: 15)
Advances in Astronomy     Open Access   (Followers: 37, SJR: 0.257, CiteScore: 1)
Advances in Bioinformatics     Open Access   (Followers: 17, SJR: 0.565, CiteScore: 2)
Advances in Biology     Open Access   (Followers: 8)
Advances in Chemistry     Open Access   (Followers: 21)
Advances in Civil Engineering     Open Access   (Followers: 39, SJR: 0.539, CiteScore: 1)
Advances in Computer Engineering     Open Access   (Followers: 4)
Advances in Condensed Matter Physics     Open Access   (Followers: 10, SJR: 0.315, CiteScore: 1)
Advances in Decision Sciences     Open Access   (Followers: 3, SJR: 0.303, CiteScore: 1)
Advances in Electrical Engineering     Open Access   (Followers: 26)
Advances in Electronics     Open Access   (Followers: 68)
Advances in Emergency Medicine     Open Access   (Followers: 12)
Advances in Endocrinology     Open Access   (Followers: 5)
Advances in Environmental Chemistry     Open Access   (Followers: 5)
Advances in Epidemiology     Open Access   (Followers: 8)
Advances in Fuzzy Systems     Open Access   (Followers: 5, SJR: 0.161, CiteScore: 1)
Advances in Geology     Open Access   (Followers: 14)
Advances in Geriatrics     Open Access   (Followers: 5)
Advances in Hematology     Open Access   (Followers: 11, SJR: 0.661, CiteScore: 2)
Advances in Hepatology     Open Access   (Followers: 2)
Advances in High Energy Physics     Open Access   (Followers: 19, SJR: 0.866, CiteScore: 2)
Advances in Human-Computer Interaction     Open Access   (Followers: 20, SJR: 0.186, CiteScore: 1)
Advances in Materials Science and Engineering     Open Access   (Followers: 30, SJR: 0.315, CiteScore: 1)
Advances in Mathematical Physics     Open Access   (Followers: 4, SJR: 0.218, CiteScore: 1)
Advances in Medicine     Open Access   (Followers: 2)
Advances in Meteorology     Open Access   (Followers: 20, SJR: 0.48, CiteScore: 1)
Advances in Multimedia     Open Access   (Followers: 1, SJR: 0.173, CiteScore: 1)
Advances in Nonlinear Optics     Open Access   (Followers: 6)
Advances in Numerical Analysis     Open Access   (Followers: 5)
Advances in Nursing     Open Access   (Followers: 26)
Advances in Operations Research     Open Access   (Followers: 12, SJR: 0.205, CiteScore: 1)
Advances in Optical Technologies     Open Access   (Followers: 3, SJR: 0.214, CiteScore: 1)
Advances in Optics     Open Access   (Followers: 3)
Advances in OptoElectronics     Open Access   (Followers: 6, SJR: 0.141, CiteScore: 0)
Advances in Orthopedics     Open Access   (Followers: 8, SJR: 0.922, CiteScore: 2)
Advances in Pharmacological Sciences     Open Access   (Followers: 7, SJR: 0.591, CiteScore: 2)
Advances in Physical Chemistry     Open Access   (Followers: 9, SJR: 0.179, CiteScore: 1)
Advances in Power Electronics     Open Access   (Followers: 29, SJR: 0.184, CiteScore: 0)
Advances in Preventive Medicine     Open Access   (Followers: 5)
Advances in Public Health     Open Access   (Followers: 23)
Advances in Software Engineering     Open Access   (Followers: 10)
Advances in Statistics     Open Access   (Followers: 4)
Advances in Toxicology     Open Access   (Followers: 2)
Advances in Tribology     Open Access   (Followers: 12, SJR: 0.265, CiteScore: 1)
Advances in Urology     Open Access   (Followers: 9, SJR: 0.51, CiteScore: 1)
Advances in Virology     Open Access   (Followers: 7, SJR: 0.838, CiteScore: 2)
AIDS Research and Treatment     Open Access   (Followers: 3, SJR: 0.758, CiteScore: 2)
Analytical Cellular Pathology     Open Access   (Followers: 2, SJR: 0.886, CiteScore: 2)
Anatomy Research Intl.     Open Access   (Followers: 2)
Anemia     Open Access   (Followers: 5, SJR: 0.669, CiteScore: 2)
Anesthesiology Research and Practice     Open Access   (Followers: 14, SJR: 0.501, CiteScore: 1)
Applied and Environmental Soil Science     Open Access   (Followers: 17, SJR: 0.451, CiteScore: 1)
Applied Bionics and Biomechanics     Open Access   (Followers: 8, SJR: 0.288, CiteScore: 1)
Applied Computational Intelligence and Soft Computing     Open Access   (Followers: 11)
Archaea     Open Access   (Followers: 3, SJR: 0.852, CiteScore: 2)
Arthritis     Open Access   (Followers: 5, SJR: 0.454, CiteScore: 1)
Autism Research and Treatment     Open Access   (Followers: 25)
Autoimmune Diseases     Open Access   (Followers: 3, SJR: 0.805, CiteScore: 2)
Behavioural Neurology     Open Access   (Followers: 9, SJR: 0.786, CiteScore: 2)
Biochemistry Research Intl.     Open Access   (Followers: 6, SJR: 0.437, CiteScore: 2)
Bioinorganic Chemistry and Applications     Open Access   (Followers: 10, SJR: 0.419, CiteScore: 2)
BioMed Research Intl.     Open Access   (Followers: 4, SJR: 0.935, CiteScore: 3)
Biotechnology Research Intl.     Open Access   (Followers: 1)
Bone Marrow Research     Open Access   (Followers: 2, SJR: 0.531, CiteScore: 1)
Canadian J. of Gastroenterology & Hepatology     Open Access   (Followers: 5, SJR: 0.867, CiteScore: 1)
Canadian J. of Infectious Diseases and Medical Microbiology     Open Access   (Followers: 5, SJR: 0.548, CiteScore: 1)
Canadian Respiratory J.     Open Access   (Followers: 1, SJR: 0.474, CiteScore: 1)
Cardiology Research and Practice     Open Access   (Followers: 8, SJR: 1.237, CiteScore: 4)
Case Reports in Anesthesiology     Open Access   (Followers: 10)
Case Reports in Cardiology     Open Access   (Followers: 3, SJR: 0.219, CiteScore: 0)
Case Reports in Critical Care     Open Access   (Followers: 8)
Case Reports in Dentistry     Open Access   (Followers: 5, SJR: 0.229, CiteScore: 0)
Case Reports in Dermatological Medicine     Open Access   (Followers: 2)
Case Reports in Emergency Medicine     Open Access   (Followers: 14)
Case Reports in Endocrinology     Open Access   (Followers: 1, SJR: 0.209, CiteScore: 1)
Case Reports in Gastrointestinal Medicine     Open Access   (Followers: 2)
Case Reports in Genetics     Open Access   (Followers: 1)
Case Reports in Hematology     Open Access   (Followers: 5)
Case Reports in Hepatology     Open Access   (Followers: 1)
Case Reports in Immunology     Open Access   (Followers: 4)
Case Reports in Infectious Diseases     Open Access   (Followers: 5)
Case Reports in Medicine     Open Access   (Followers: 2)
Case Reports in Nephrology     Open Access   (Followers: 4)
Case Reports in Neurological Medicine     Open Access   (Followers: 1)
Case Reports in Obstetrics and Gynecology     Open Access   (Followers: 10)
Case Reports in Oncological Medicine     Open Access   (Followers: 2, SJR: 0.204, CiteScore: 1)
Case Reports in Ophthalmological Medicine     Open Access   (Followers: 3)
Case Reports in Orthopedics     Open Access   (Followers: 5)
Case Reports in Otolaryngology     Open Access   (Followers: 6)
Case Reports in Pathology     Open Access   (Followers: 5)
Case Reports in Pediatrics     Open Access   (Followers: 6)
Case Reports in Psychiatry     Open Access   (Followers: 13)
Case Reports in Pulmonology     Open Access   (Followers: 3)
Case Reports in Radiology     Open Access   (Followers: 8)
Case Reports in Rheumatology     Open Access   (Followers: 6)
Case Reports in Surgery     Open Access   (Followers: 11)
Case Reports in Transplantation     Open Access  
Case Reports in Urology     Open Access   (Followers: 8)
Case Reports in Vascular Medicine     Open Access  
Case Reports in Veterinary Medicine     Open Access   (Followers: 6)
Child Development Research     Open Access   (Followers: 18, SJR: 0.144, CiteScore: 0)
Chinese J. of Engineering     Open Access   (Followers: 2, SJR: 0.114, CiteScore: 0)
Chinese J. of Mathematics     Open Access  
Cholesterol     Open Access   (Followers: 1, SJR: 0.424, CiteScore: 1)
Chromatography Research Intl.     Open Access   (Followers: 6)
Complexity     Hybrid Journal   (Followers: 6, SJR: 0.531, CiteScore: 2)
Computational and Mathematical Methods in Medicine     Open Access   (Followers: 2, SJR: 0.403, CiteScore: 1)
Computational Intelligence and Neuroscience     Open Access   (Followers: 10, SJR: 0.326, CiteScore: 1)
Contrast Media & Molecular Imaging     Open Access   (Followers: 3, SJR: 0.842, CiteScore: 3)
Critical Care Research and Practice     Open Access   (Followers: 10, SJR: 0.499, CiteScore: 1)
Current Gerontology and Geriatrics Research     Open Access   (Followers: 9, SJR: 0.512, CiteScore: 2)
Depression Research and Treatment     Open Access   (Followers: 13, SJR: 0.816, CiteScore: 2)
Dermatology Research and Practice     Open Access   (Followers: 3, SJR: 0.806, CiteScore: 2)
Diagnostic and Therapeutic Endoscopy     Open Access   (SJR: 0.201, CiteScore: 1)
Discrete Dynamics in Nature and Society     Open Access   (Followers: 5, SJR: 0.279, CiteScore: 1)
Disease Markers     Open Access   (Followers: 1, SJR: 0.9, CiteScore: 2)
Economics Research Intl.     Open Access   (Followers: 1)
Education Research Intl.     Open Access   (Followers: 19)
Emergency Medicine Intl.     Open Access   (Followers: 8, SJR: 0.298, CiteScore: 1)
Enzyme Research     Open Access   (Followers: 3, SJR: 0.653, CiteScore: 3)
Evidence-based Complementary and Alternative Medicine     Open Access   (Followers: 18, SJR: 0.683, CiteScore: 2)
Game Theory     Open Access   (Followers: 1)
Gastroenterology Research and Practice     Open Access   (Followers: 2, SJR: 0.768, CiteScore: 2)
Genetics Research Intl.     Open Access   (Followers: 1, SJR: 0.61, CiteScore: 2)
Geofluids     Open Access   (Followers: 4, SJR: 0.952, CiteScore: 2)
Hepatitis Research and Treatment     Open Access   (Followers: 6, SJR: 0.389, CiteScore: 2)
HPB Surgery     Open Access   (Followers: 5, SJR: 0.824, CiteScore: 2)
Infectious Diseases in Obstetrics and Gynecology     Open Access   (Followers: 5, SJR: 1.27, CiteScore: 2)
Interdisciplinary Perspectives on Infectious Diseases     Open Access   (Followers: 1, SJR: 0.627, CiteScore: 2)
Intl. J. of Aerospace Engineering     Open Access   (Followers: 73, SJR: 0.232, CiteScore: 1)
Intl. J. of Agronomy     Open Access   (Followers: 6, SJR: 0.311, CiteScore: 1)
Intl. J. of Alzheimer's Disease     Open Access   (Followers: 11, SJR: 0.787, CiteScore: 3)
Intl. J. of Analysis     Open Access  
Intl. J. of Analytical Chemistry     Open Access   (Followers: 20, SJR: 0.285, CiteScore: 1)
Intl. J. of Antennas and Propagation     Open Access   (Followers: 11, SJR: 0.233, CiteScore: 1)
Intl. J. of Atmospheric Sciences     Open Access   (Followers: 21)
Intl. J. of Biodiversity     Open Access   (Followers: 4)
Intl. J. of Biomaterials     Open Access   (Followers: 4, SJR: 0.511, CiteScore: 2)
Intl. J. of Biomedical Imaging     Open Access   (Followers: 3, SJR: 0.501, CiteScore: 2)
Intl. J. of Breast Cancer     Open Access   (Followers: 13, SJR: 1.025, CiteScore: 2)
Intl. J. of Cell Biology     Open Access   (Followers: 3, SJR: 1.887, CiteScore: 4)
Intl. J. of Chemical Engineering     Open Access   (Followers: 7, SJR: 0.327, CiteScore: 1)
Intl. J. of Chronic Diseases     Open Access   (Followers: 1)
Intl. J. of Combinatorics     Open Access   (Followers: 1)
Intl. J. of Computer Games Technology     Open Access   (Followers: 9, SJR: 0.287, CiteScore: 2)
Intl. J. of Corrosion     Open Access   (Followers: 10, SJR: 0.194, CiteScore: 1)
Intl. J. of Dentistry     Open Access   (Followers: 6, SJR: 0.649, CiteScore: 2)
Intl. J. of Differential Equations     Open Access   (Followers: 7, SJR: 0.191, CiteScore: 0)
Intl. J. of Digital Multimedia Broadcasting     Open Access   (Followers: 5, SJR: 0.296, CiteScore: 2)
Intl. J. of Electrochemistry     Open Access   (Followers: 8)
Intl. J. of Endocrinology     Open Access   (Followers: 4, SJR: 1.012, CiteScore: 3)
Intl. J. of Engineering Mathematics     Open Access   (Followers: 5)
Intl. J. of Food Science     Open Access   (Followers: 3, SJR: 0.44, CiteScore: 2)
Intl. J. of Forestry Research     Open Access   (Followers: 3, SJR: 0.373, CiteScore: 1)
Intl. J. of Genomics     Open Access   (Followers: 2, SJR: 0.868, CiteScore: 3)
Intl. J. of Geophysics     Open Access   (Followers: 4, SJR: 0.182, CiteScore: 1)
Intl. J. of Hepatology     Open Access   (Followers: 4, SJR: 0.874, CiteScore: 2)
Intl. J. of Hypertension     Open Access   (Followers: 6, SJR: 0.578, CiteScore: 1)
Intl. J. of Inflammation     Open Access   (SJR: 1.264, CiteScore: 3)
Intl. J. of Inorganic Chemistry     Open Access   (Followers: 3)
Intl. J. of Manufacturing Engineering     Open Access   (Followers: 2)
Intl. J. of Mathematics and Mathematical Sciences     Open Access   (Followers: 3, SJR: 0.177, CiteScore: 0)
Intl. J. of Medicinal Chemistry     Open Access   (Followers: 6, SJR: 0.31, CiteScore: 1)
Intl. J. of Metals     Open Access   (Followers: 4)
Intl. J. of Microbiology     Open Access   (Followers: 4, SJR: 0.662, CiteScore: 2)
Intl. J. of Microwave Science and Technology     Open Access   (Followers: 3, SJR: 0.136, CiteScore: 1)
Intl. J. of Navigation and Observation     Open Access   (Followers: 20, SJR: 0.267, CiteScore: 2)
Intl. J. of Nephrology     Open Access   (Followers: 1, SJR: 0.697, CiteScore: 1)
Intl. J. of Oceanography     Open Access   (Followers: 7)
Intl. J. of Optics     Open Access   (Followers: 7, SJR: 0.231, CiteScore: 1)
Intl. J. of Otolaryngology     Open Access   (Followers: 3)
Intl. J. of Partial Differential Equations     Open Access   (Followers: 2)
Intl. J. of Pediatrics     Open Access   (Followers: 6)
Intl. J. of Peptides     Open Access   (Followers: 4, SJR: 0.46, CiteScore: 1)
Intl. J. of Photoenergy     Open Access   (Followers: 2, SJR: 0.341, CiteScore: 1)
Intl. J. of Plant Genomics     Open Access   (Followers: 4, SJR: 0.583, CiteScore: 1)
Intl. J. of Polymer Science     Open Access   (Followers: 24, SJR: 0.298, CiteScore: 1)
Intl. J. of Population Research     Open Access   (Followers: 2)
Intl. J. of Quality, Statistics, and Reliability     Open Access   (Followers: 15)
Intl. J. of Reconfigurable Computing     Open Access   (SJR: 0.123, CiteScore: 1)
Intl. J. of Reproductive Medicine     Open Access   (Followers: 4)
Intl. J. of Rheumatology     Open Access   (Followers: 4, SJR: 0.645, CiteScore: 2)
Intl. J. of Rotating Machinery     Open Access   (Followers: 2, SJR: 0.193, CiteScore: 1)
Intl. J. of Spectroscopy     Open Access   (Followers: 7)
Intl. J. of Stochastic Analysis     Open Access   (Followers: 3, SJR: 0.279, CiteScore: 1)
Intl. J. of Surgical Oncology     Open Access   (Followers: 1, SJR: 0.573, CiteScore: 2)
Intl. J. of Telemedicine and Applications     Open Access   (Followers: 4, SJR: 0.403, CiteScore: 2)
Intl. J. of Vascular Medicine     Open Access   (SJR: 0.782, CiteScore: 2)
Intl. J. of Zoology     Open Access   (Followers: 2, SJR: 0.209, CiteScore: 1)
Intl. Scholarly Research Notices     Open Access   (Followers: 189)
ISRN Astronomy and Astrophysics     Open Access   (Followers: 6)
J. of Addiction     Open Access   (Followers: 12)
J. of Advanced Transportation     Hybrid Journal   (Followers: 13, SJR: 0.581, CiteScore: 1)
J. of Aerodynamics     Open Access   (Followers: 5)
J. of Aging Research     Open Access   (Followers: 6, SJR: 0.573, CiteScore: 2)

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Journal Cover
Advances in Emergency Medicine
Number of Followers: 12  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2356-6671 - ISSN (Online) 2314-7644
Published by Hindawi Homepage  [335 journals]
  • Variation in Out-of-Hospital Cardiac Arrest Management

    • Abstract: Objective. To evaluate variation in airway management strategies in one suburban emergency medical services system treating patients experiencing out-of-hospital cardiac arrest (OHCA). Method. Retrospective chart review of all adult OHCA resuscitation during a 13-month period, specifically comparing airway management decisions. Results. Paramedics demonstrated considerable variation in their approaches to airway management. Approximately half of all OHCA patients received more than one airway management attempt (38/77 [49%]), and one-quarter underwent three or more attempts (25/77 [25%]). One-third of patients arrived at the emergency department with a different airway device than initially selected (25/77 [32%]). Conclusion. This study confirmed our hypothesis that paramedics’ selection of ventilation strategies in cardiac arrest varies considerably. This observation raises concern because airway management diverts time and energy from interventions known to improve outcomes in OHCA management, such as cardiopulmonary resuscitation and defibrillation. More research is needed to identify more focused airway management strategies for prehospital care providers.
      PubDate: Tue, 21 Jun 2016 10:14:35 +000
       
  • Implementing Triage Standing Orders in the Emergency Department Leads to
           Reduced Physician-to-Disposition Times

    • Abstract: Emergency departments (EDs) throughout USA have improvised various processes to curb the “national epidemic” termed ED “crowding.” Standing orders (SOs), one such process, are medical orders approved by the medical director and entered by nurses when patients cannot be seen expeditiously, expediting medical decision-making and decreasing length of stay (LOS) and time to disposition. This retrospective cohort study evaluates the impact of SOs on ED LOS and disposition time at a large university ED. Results indicate that SOs significantly improve ED throughput by reducing disposition time by up to 16.9% (), which is especially significant in busy ED settings. SOs by themselves are not sufficient for a complete diagnostic assessment. Strategies such as having a provider in the waiting area may help make key decisions earlier.
      PubDate: Wed, 15 Jun 2016 12:05:45 +000
       
  • Can Clinical Findings Prevent Negative Laparotomy in Parasitosis Mimicking
           Acute Appendicitis'

    • Abstract: Objectives. Rates of negative laparotomy (NL) for acute appendicitis have been reported as 15% and parasitosis contributed to 2%. This study was planned to reduce the rates of NL by preoperative determination of parasitosis. Methods. In retrospective examination of 2730 appendectomy specimens in Hitit University Department of General Surgery between 2008 and 2012, 55 patients were determined with parasitosis and compared with 102 age-matched randomly selected patients with lymphoid hyperplasia. Results. The parasite group comprised 63.6% females with a mean age of 15.1 years. The number of patients in the parasitosis group increased from city centre to rural areas of towns and villages (). While a lower rate of sonographic findings was found in the parasitosis group, the findings of inflammation in the histopathological evaluation were significantly low (, , resp.). A significant difference was determined between groups in respect of the eosinophil and haematocrit values. In the differentiation of patients with parasites, eosinophil of >2.2% was determined as a diagnostic value. Conclusion. It is important to determine parasitosis to prevent NL. When acute appendicitis is considered for young patients living in rural areas, the observation of high eosinophil together with negative sonographic findings should bring Enterobius vermicularis parasitosis to mind and thereby should prevent NL.
      PubDate: Wed, 27 Apr 2016 13:20:00 +000
       
  • An Analysis of Physician Productivity and Self-Sustaining Revenue
           Generation in a Free-Standing Emergency Department Medical Scribe Model

    • Abstract: Objectives. A free-standing emergency department (FSED) is a facility that provides comprehensive emergency medical care similar to a traditional emergency department but is not attached to a hospital campus. Medical scribes are increasingly likely to work in free-standing emergency departments. The purpose of this study was to retrospectively investigate the benefits of a scribe program in an FSED. Methods. A retrospective, Institutional Review Board-approved analysis from December 1, 2013, to February 1, 2015, of free-standing emergency department medical data was extracted to determine if scribed charts resulted in increased revenue and improved throughput. Results. When scribes are present in the FSED there is a small, but statistically significant, decrease in time from patient arrival to provider by 2.74 minutes. Scribed charts collected $4.69 more per chart and resulted in an increase in productivity. Incremental cost effectiveness ratios resulted in proven cost-utility with a net-positive effect. Conclusion. While there are some gains in terms of operational metrics and provider productivity with the addition of scribes to a free-standing emergency department, there is a net-positive financial impact of scribes. Implementing a scribe program at a FSED is cost-effective and justified from both an operational and a financial analysis.
      PubDate: Tue, 29 Dec 2015 12:47:09 +000
       
  • The Accuracy of Point-of-Care Creatinine Testing in the Emergency
           Department

    • Abstract: Objective. To determine the accuracy of Point-Of-Care testing (PoCT) creatinine values when compared to standard central laboratory testing (IDMS) and to demonstrate if and how a discrepancy could lead to improper risk stratification for contrast induced nephropathy (CIN). Methods. We conducted a descriptive retrospective chart review of patients seen in the Emergency Department of a single suburban, community, and academic medical center. We included patients who presented to the department between March 2013 and September 2014 who had blood samples analyzed by both PoCT and IDMS. Results. Mean IDMS creatinine values were 0.23 mg/dL higher when compared with i-Stat values. 95% of the time, the IDMS creatinine value was variable and ranged from −0.45 mg/dL to +0.91 mg/dL when compared to the i-Stat creatinine. When using i-Stat creatinine values to calculate GFR, 47 out of 156 patients had risk category variations compared to using the IDMS value. This affected 30.1% of the total eligible sample population (22.9% to 37.3% with 95% CI). Conclusion. We found a significant discrepancy between PoCT and IDMS creatinine values and found that this discrepancy could lead to improper risk stratification for CIN.
      PubDate: Mon, 07 Dec 2015 14:18:05 +000
       
  • Emergency Department Visits and Injury Hospitalizations for Female and
           Male Victims and Perpetrators of Intimate Partner Violence

    • Abstract: Introduction. The potential for hospital-based interventions for male victims of intimate partner violence (IPV) as well as adult perpetrators of both genders has been largely unexplored despite early evidence of acute-care utilization that may be as high as female victims. The current investigation compared the emergency department (ED) and injury-related-hospitalization rates of IPV-involved individuals against standardized national norms, assessing differences by gender and victim/perpetrator-status. Methods. This cross-sectional study collected one-year ED and in-patient visit data from hospital records for individuals listed as victim or perpetrator in an IPV criminal charging request in a Midwestern county (). Expected rates were calculated based upon age-adjusted national norms. Results. The IPV-involved population generated ED rates 4.1 times higher than expected and injury-related-hospitalization rates that were 4.0 times higher than expected. Bi-directionally-violent individuals (both victim and perpetrator in IPV charges) consistently had the highest utilization rates (ED 8.4 RR, injury-hospitalization 22.5 RR). Victims, primarily female, had higher ED-visits than perpetrators, primarily male (victims = 4.6 RR, perpetrator = 3.1 RR). Perpetrators, though, had higher injury hospitalizations (victims = 0.8RR, perpetrators = 5.5 RR). Conclusions. Substantial opportunities exist within acute-care medical settings to intervene with IPV-involved women, men, victims, and perpetrators, although the magnitude of the opportunity varied by setting, gender and victim/perpetrator-status.
      PubDate: Sun, 22 Nov 2015 12:04:05 +000
       
  • The Blood Alcohol Concentration Testing Emergency Room Investigation
           Analysis Study: A 1-Year Review of Blood Alcohol Concentration Testing in
           an Emergency Department

    • Abstract: Aim. To describe the actual use of blood alcohol concentration (BAC) testing in an emergency department. Method. This study was performed to examine in what circumstances emergency medicine doctors and nurses request blood alcohol concentrations and the outcome of patients so tested. A retrospective study was performed. A database of all the patients who presented to the emergency department and who were tested for BAC in 2012 was created. Descriptive statistics are used to present the findings. Results. During 2012, there were 1191 patients on whom BAC testing was performed. 37 patients had a BAC greater than the allegedly lethal concentration of 400 mg/100 mL. Using a multifactorial analysis model, a higher blood alcohol concentration was associated with a lower Glasgow Coma Score. Conclusion. BAC testing is most often performed in the context of alleged overdose. BAC was performed in other clinical scenarios albeit in less than 2% of all ED attendances.
      PubDate: Wed, 04 Nov 2015 07:36:37 +000
       
  • Time for Reflection: The Balance between Repetition and Feedback in
           Resuscitation Training—A Randomised Controlled Trial

    • Abstract: Background. The simulation literature widely agrees that the reflective learning phase after the simulation is equal to or perhaps of even greater importance than the actual simulated scenario in ensuring learning. Nevertheless, advanced life support (ALS) tends to have many simulated scenarios followed by short feedback sessions. The aim of this study was to compare the ability of two groups of novice learners to stay adherent to the ALS guidelines in their provision of ALS after they had received either 8 or 12 simulated resuscitation scenarios, both in 4 hours. Methods. This study was a randomised controlled trial. Participants were either randomised to the control group with 12 scenarios (15 minutes per scenario) with 5 minutes of feedback or the intervention group with 8 simulations (15 minutes per scenario) with 15 minutes of feedback. Results. There was no statistically significant difference in test scores between the intervention group and control group in the 1-week retention test and the 12-week retention test .  Conclusion. This study suggests that the lower number of repetitive ALS simulation scenarios does not diminish learning when the feedback is equally prolonged to ensure sufficient time for reflection.
      PubDate: Sun, 25 Oct 2015 11:00:51 +000
       
  • Epidemiology of Chain Saw Related Injuries, United States: 2009 through
           2013

    • Abstract: Problem. Chain saws are a commonly used tool with the potential to inflict severe injuries. Methods. Descriptive epidemiological estimates for emergency department (ED) visits for injuries associated with the use of a chain saw were calculated using data from the National Electronic Injury Surveillance System for the years 2009–2013. Results. A total of 115,895 ED visits for injuries related to the use of a chain saw occurred during the study period. Most injury visits occurred among males (95%) and persons aged 30–59 years and during the months of September through November. The main body sites injured were the hand/fingers and knee. The majority of injuries were lacerations (80%). Conclusions. Chain saw injuries present with characteristic patterns which can aid in prevention of injuries related to the use of these tools. Examination of the epidemiology of chain saw injuries will help to ascertain targeted needs for prevention and control efforts.
      PubDate: Thu, 17 Sep 2015 07:26:04 +000
       
  • Survey of Patient Knowledge and Expectations about a Free-Standing
           Emergency Department

    • Abstract: Objectives. A free-standing emergency department (FSED) is defined as a facility that is structurally separate and distinct from a hospital and provides emergency care. Nationally, the number of FSEDs continues to grow, but the general public may have limited knowledge about the costs and services associated with FSEDs. The purpose of this paper is to survey patient knowledge and expectations about FSEDs. Methods. A convenience sample of patients presenting to a FSED was given a 19-item survey to complete. Results. 187 surveys were collected; 126 were included for analysis. 40% of respondents thought they could be seen by a specialist at the FSED, and 55% of patients did not know they had to be transferred for hospitalization if required. Most patients did not know that the cost of services at the FSED would be the same as that at the traditional ED. Convenience and perceived shorter wait times were the primary reasons patients selected the FSED for care. Conclusion. In general, patients do not have adequate knowledge about the costs and services associated with FSEDs. Education through marketing and advertising may be helpful in creating more public awareness about FSEDs.
      PubDate: Sun, 13 Sep 2015 14:03:16 +000
       
  • Optimizing Simulated Multidisciplinary Team Training of Pediatric
           Emergencies: An Evaluation of Prerequisites for Transfer of Skills to
           Clinical Practice

    • Abstract: Introduction. Multidisciplinary simulation-based team training (STT) provides a powerful training method to train technical and team skills during emergencies. Effectiveness of STT depends on transfer of learned skills to clinical practice. In this study we examined three important prerequisites to enhance transfer from STT into clinical practice, intervention readiness, realism, and performance self-efficacy. Methods. For the quantitative part of the study, 131 participants (pediatric nurses and physicians) were asked to fill out an online questionnaire before and after training. For the qualitative part of the study we organized three one-hour focus group sessions in which participants were interviewed on attitude, realism, and self-efficacy. Results. Providing adequate preparation material and extensive debriefing of scenarios is important in creating this positive learning experience. The perspective of realism depends strongly on setting and learning goals. During STT team assembly and role playing can become more important to participants, while physical aspects become less important. Performance self-efficacy for all participants increases significantly regarding team skills. Conclusions. STT can be a very positive multidisciplinary learning experience, which creates the possibility of enhancing confidence, skills, and team performance within the clinical context. STT combines three important prerequisites for transfer of training to take place.
      PubDate: Mon, 26 Jan 2015 14:13:54 +000
       
  • Providing Care in Emergency Department Hallways: Demands, Dangers, and
           Deaths

    • Abstract: Emergency departments (ED) worldwide have experienced dramatic increases in crowding over the past 20 years that now have reached critical levels. One consequence of ED crowding has been the routine use of ED hallways for patient care. This includes ED patients who are awaiting care but are considered unstable to remain in the waiting room, patients who are undergoing active medical and trauma treatment, and patients who have been stabilized but await transfer to an inpatient bed (boarding) or another institution. Compared with licensed hospital or standard ED beds, care in ED hallways results in increased patient morbidity and mortality, as well as patient and staff dissatisfaction. Complications experienced by hallway patients include unrecognized sudden respiratory arrest or unstable cardiac arrhythmias, delay in time-sensitive procedures and laboratory testing, delay in receiving important medications, excessive or unrelieved pain, overall increased length of stay, increased disability, and exposure to traumatic psychological events. While much has been published on the general problems of ED crowding, only recently have studies focused exclusively on the issues of providing care in ED hallways. This review summarizes the current issues, challenges, and solutions for hallway care.
      PubDate: Thu, 25 Dec 2014 13:09:00 +000
       
  • A Simulated Discrete-Event and Queuing Model to Reduce Transfers from the
           Emergency Department and to Optimize Hospital Bed Management

    • Abstract: Objectives. Emergency departments (EDs) and elective hospitalizations compete for beds. Our aim was to reduce hospital transfers using a queuing-model study. Methods. Macros were created to simulate four priority groups of patients according to hospitalization mode (elective, ED) and age (≥75 and
      PubDate: Mon, 01 Dec 2014 08:51:02 +000
       
  • Trends in Demand for Acute Medical Care at Two Football Clubs over an
           Eighteen-Year Period

    • Abstract: Introduction. Following the Hillsborough disaster, there is a requirement for crowd doctors to be present during football matches. However, there are little data on long-term trends in utilisation of crowd doctor services at sporting events. Methods. A retrospective service evaluation of presentations to the crowd doctor for 18 consecutive English Football League seasons: 13 seasons at Northampton Town Football Club (NTFC) followed by five seasons at Leicester City Football Club (LCFC). Data were analysed to determine the reason for, and severity of, presentation and the magnitude of the intervention required. Results. There were 429 recorded presentations to the crowd doctor over the 18 seasons. Patients’ age ranged from 3 to 93 years. 76% of presentations were due to an injury or illness arising at the match. The majority of presentations were with minor ailments (76%) requiring only minor intervention (88%); there were a small number of life-threatening presentations (1%) including three cardiac arrests. Conclusion. Crowd doctors may see patients in all age groups, presenting in a variety of ways. Most patients will have minor symptoms, but occasionally patients present with life-threatening problems. The crowd doctor must be competent assessing and treating all of these potential patient groups and pathologies.
      PubDate: Wed, 03 Sep 2014 12:25:21 +000
       
  • Does Using a Standardised Mental Health Triage Assessment Alter Nurses
           Assessment of Vignettes of People Presenting with Deliberate Self-Harm

    • Abstract: Background. The Manchester Triage Scale is used in Irish emergency departments. This fails to provide guidance on triaging psychiatric presentations. A Mental Health Triage scale is recommended by the National Institute of Clinical Excellence. Aim. To examine the effectiveness of a Mental Health Triage scale in assessing patients presenting with self-harm. Method. Ten vignettes were created, detailing cases of deliberate self-harm. Nurses () were given five vignettes and asked to assign each vignette to a triage category, using The Manchester Triage Scale. Each nurse was subsequently asked to reevaluate the same vignettes using the Mental Health Triage Scale. Triage with each method was deemed safe or unsafe, using the benchmark triage categories assigned by a consultant in psychiatry and a consultant in emergency medicine departments. Results. 245 cases were triaged. There was a significant change in the categories assigned when the Mental Health Triage scale was in use, . The triage categories assigned using the Mental Health Triage scale were significantly safer than under the Manchester Triage Scale (79% versus 60% safe, respectively, ).
      PubDate: Wed, 03 Sep 2014 09:24:29 +000
       
  • An Assessment of Emergency Department Throughput and Provider Satisfaction
           after the Implementation of a Scribe Program

    • Abstract: Objectives. To assess the impact of a scribe program on an academic, tertiary care facility. Methods. A retrospective analysis of emergency department (ED) data, prior to and after scribe program implementation, was used to quantitatively assess the impact of the scribe program on measures of ED throughput. An electronic survey was distributed to all emergency medicine residents and advanced practice providers to qualitatively assess the impact of the scribe program on providers. Results. Several throughput time measures were significantly lower in the postscribe group, compared to prescribe implementation, including time to disposition. The left without being seen (LWBS) decrease was not statistically significant. A total of 30 providers responded to the survey. 100% of providers indicated scribes are a valuable addition to the department and they enjoy working with scribes. 90% of providers indicated scribes increase their workplace satisfaction and quality of life. Conclusions. Through evaluation of prescribe and postscribe implementation, the postscribe time period reflects many throughput improvements not present before scribes began. Scribe Program implementation led to improved ED throughput for discharged patients with further system-wide challenges needing to be addressed for admitted patients.
      PubDate: Wed, 03 Sep 2014 00:00:00 +000
       
  • Mathematical Modeling of the Impact of Hospital Occupancy: When Do
           Dwindling Hospital Beds Cause ED Gridlock'

    • Abstract: Objectives. The time emergency department (ED) patients spend from presentation to admittance is known as their length of stay (LOS). This study aimed to quantify the inpatient occupancy rate (InptOcc)/ED LOS relationship and develop a methodology for identifying resource-allocation triggers using InptOcc-LOS association-curve inflection points. Methods. This study was conducted over 200 consecutive days at a 700-bed hospital with an annual ED census of approximately 50,000 using multivariate spline (piecewise) regression to model the InptOcc/LOS relationship while adjusting for confounding covariates. Nonlinear modeling was used to assess for InptOcc/LOS associations and determine the inflection point where InptOcc profoundly impacted LOS. Results. At lower InptOcc, there was no association. Once InptOcc reached ≥88%, there was a strong InptOcc/LOS association; each 1% InptOcc increase predicted a 16-minute (95% CI, 12–20 minutes) LOS prolongation, while the confounder-adjusted analysis showed each 1% InptOcc increase >89% precipitating a 13-minute (95% CI, 10–16 minutes) LOS prolongation. Conclusions. The study hospital’s InptOcc was a significant predictor of prolonged ED LOS beyond the identified inflection point. Spline regression analysis identified a clear inflection point in the InptOcc-LOS curve that potentially identified a point at which to optimize inpatient bed availability to prevent increased costs of prolonged LOS.
      PubDate: Tue, 15 Jul 2014 08:38:11 +000
       
  • The State of Healthcare Disaster Plans in New Zealand and the Sultanate of
           Oman: An International Comparative Analysis

    • Abstract: Aim. The aim of this study was to carry out an audit of healthcare plans in New Zealand and Oman. Methods. The study utilizes a deductive content analysis method. Written plans from New Zealand District Health Boards (DHBs) and the Omani secondary and tertiary hospitals were analyzed. A checklist was used to score the plans against twelve elements which are command and control, hazard analysis, surge capability, communication, standard operating procedures (SOPs), life-line backups, public and media, training, welfare, coordination, and recovery. Results. There were 14 plans from New Zealand and 7 plans from Oman analysed. The overall coverage of New Zealand plans was 67.5% compared to 53.3% in Oman. Plans from both countries scored similarly in “command and control,” “hazard analysis,” “surge,” and “communication” elements. Omani plans scored lower than those of New Zealand in “media and the publicv” “training,” “coordination,” and “recovery.” Both countries scored very low in addressing the welfare of responders. Conclusion. This study highlighted the value of health emergency plans in New Zealand as reflected by the high score of DHBs’ coordination. Therefore, a similar approach in Oman will enhance emergency preparedness. Responders’ welfare is an issue that needs to be addressed by emergency preparedness plans in both countries.
      PubDate: Sun, 22 Jun 2014 00:00:00 +000
       
  • Validation of a Decision Rule and Derivation of a Modified Rule to Obtain
           Chest Radiograph in Patients with Nontraumatic Chest Pain in the Emergency
           Department

    • Abstract: Objectives. We sought to validate and refine a decision rule for chest X-ray (CXR) utilization in nontraumatic chest pain (CP) patients presenting to the emergency department (ED). Methods. Retrospective review of ED patients presenting with CP who had CXR performed during three nonconsecutive months was performed. The presence of 18 variables derived from history and exam was ascertained. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the original rule were calculated. Refinement using additional variables was performed. Results. 967 patient charts were reviewed. 89.9% of CXR were normal, 5.2% had insignificant findings, and 5.1% had significant findings. Application of the criteria had a sensitivity/specificity of 74%/59% and a PPV/ NPV of 9%/98%. Rule modification to obtain CXR for age ≥ 65 years, history of congestive heart failure and alcohol abuse, and exam findings of decreased breath sounds, fever, and tachypnea maintained sensitivity while improving specificity to 69%. Conclusions. Most CP patients have normal CXRs. Narrowing a decision rule to obtain CXR in patients with age ≥ 65 years, history of congestive heart failure and alcohol abuse, and exam findings of decreased breath sounds, fever, and tachypnea maintain sensitivity while improving specificity and NPV.
      PubDate: Thu, 12 Jun 2014 07:42:23 +000
       
  • Common Presenting Problems for Young People Attending the Emergency
           Department

    • Abstract: Objective. To determine the common presenting problems for young people attending the emergency department. Design. A retrospective review of electronic patient records of all young people between the ages of 13 and 17 who attended a UK University Hospital ED between 07/02/2007 and 06/02/2008 (). Results. All emergency department attendances for young people over a one-year period were studied in order to determine the common presenting problems. There were a total of 10455 attendances by 8303 young people. The presenting problem in 7505 (71.8%) was classified as injury. Of the remainder the commonest presenting problems reported for young people were abdominal pain (480, 16.3%), self-harm (314, 10.6%), fits, faints and funny turns (308, 10.4%), breathing difficulty (213, 7.2%), and intoxication (178, 6.0%). Ten presenting problems accounted for 72% of noninjury related attendances. Conclusions. Clinical guidelines and pathways developed for young people attending the emergency department should target the commonest presenting problems. In our cohort ten presenting problems account for almost three-quarters of all noninjury attendances for young people. The presenting problems are different to those described in younger children in previous studies. These results will inform the development of clinical pathways in order to improve emergency care.
      PubDate: Tue, 25 Mar 2014 09:23:11 +000
       
 
 
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