scholarly journals Vasopressor and Inotrope Use in Canadian Emergency Departments: Evidence Based Consensus Guidelines

CJEM ◽  
2015 ◽  
Vol 17 (S1) ◽  
pp. 1-16 ◽  
Author(s):  
Dennis Djogovic ◽  
Shavaun MacDonald ◽  
Andrea Wensel ◽  
Rob Green ◽  
Osama Loubani ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Evidence Based ◽  
Consensus Guidelines

scholarly journals Vasopressor and Inotrope Use in Canadian Emergency Departments: Evidence Based Consensus Guidelines

CJEM ◽  
2015 ◽  
Vol 17 (1) ◽  
pp. 1-2 ◽  
Author(s):  
Dennis Djogovic ◽  
Shavaun MacDonald ◽  
Andrea Wensel ◽  
Rob Green ◽  
Osama Loubani ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Literature Search ◽  
Development Process ◽  
Guideline Development ◽  
Care Practice ◽  
Evidence Based ◽  
Emergency Physicians ◽  
Consensus Guidelines ◽  
Canadian Association ◽  
Practice Committee

AbstractPatients may present to Emergency Departments (ED) in shock for various reasons. Emergency medicine physicians may require the use of vasopressors or inotropes to manage these patients. The Critical Care Practice Committee of the Canadian Association of Emergency Physicians (C4) conducted an intensive literature search and guideline development process to help create an evidence based approach for use of these agents in the stabilization of shock.

scholarly journals 5 giorni di antibiotico per le polmoniti non complicate sono sufficienti: i risultati di non inferiorità del SAFER RCT

2021 ◽  
Vol 28 (5) ◽  
pp. 1
Author(s):  
Gruppo di lettura di Reggio Emilia
Keyword(s):  
Primary Care ◽  
Emergency Departments ◽  
Protocol Analysis ◽  
Brief Therapy ◽  
Community Acquired Pneumonia ◽  
High Dose ◽  
Evidence Based ◽  
Clinical Recovery ◽  
First Choice

5 days of antibiotic for uncomplicated pneumonia is enough: the non-inferiority results of the SAFER RCT The most important guidelines for the treatment of community-acquired pneumonia (CAP) indicate amoxicillin as the drug of first choice, however there is a lack of evidence-based indications about the duration of this therapy. This study conducted in 2 emergency departments in Canada randomized 281 children aged 6 months to 10 years with CAP without the need for hospitalization to treatment with high-dose amoxicillin for 5 days versus a traditional 10 day therapy. In terms of clinical recovery, both groups presented comparable results. In fact, the “per protocol” analysis, recommended for a “non-inferiority” design, did not formally provide this result. The exclusively clinical recruitment criteria (any investigations were optional), well reflect the reality of primary care, and the results, albeit with some limitations, suggest that in uncomplicated CAP, brief therapy should be considered in the guidelines.

scholarly journals The Knowledge of Nurses about Evidence-based Guideline in Patients with Acute Ischemic Stroke

2019 ◽  
pp. 1-10
Author(s):  
Mohammad Reza Yeganeh ◽  
Zahra Farhang Bagheri ◽  
Tahereh Khaleghdoost Mohammadi ◽  
Zahra Atrkar Roshan ◽  
Moluk Pouralizadeh
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Phase ◽  
Significant Relationship ◽  
Emergency Departments ◽  
Optimal Level ◽  
Evidence Based ◽  
Multiple Choice Questions ◽  
Recommended Dosage ◽  
Nurses Knowledge

Introduction: Stroke is the most common cerebrovascular disease and the third most common cause of disability in the world. The study aimed to assess the knowledge of nurses in emergency departments based on evidence-based care guidelines in the acute phase of ischemic stroke. Methods: This cross-sectional analytical study was performed on 129 nurses working in emergency departments of 16 hospitals of Guilan University of Medical Sciences in 2017. Samples were selected randomly. The study tool was a questionnaire with 10 multiple choice questions about the care of acute phase of ischemic stroke patients. Data were analyzed by SPSS software ver. 21 using descriptive tests, ANOVA, T-test, Chi-square. Results: The mean of the participants’ knowledge about acute phase of ischemic stroke care was 40.07 ± 16.46. The highest response rate was related to the symptoms of stroke (85.27%). There was a significant relationship between the number of beds in the hospitals and the nurses' knowledge about beginning treatment of Tissue Plasminogen Activator (tPA) (P<0.005), optimal level of blood pressure prior to administering intravenous tPA (P<0.001), and recommended dosage of tPA (P<0.001) .Also, a significant relationship was reported between the number of beds in the emergency departments and the nurses' knowledge about optimal level of blood pressure prior to administering intravenous tPA (P<0.001), and recommended dosage of tPA (P<0.001). Conclusion: The nurses' knowledge was not satisfactory about the guideline of the acute stage of ischemic stroke. Therefore, provision of evidence-based continuing education courses and mandatory attendance of emergency nurses in these courses is recommended.

scholarly journals A STEEEP Hill to Climb: A Scoping Review of Assessments of Individual Hospitalist Performance

2020 ◽  
Vol 15 (10) ◽  
pp. 599-605 ◽  
Author(s):  
Alan W Dow ◽  
Benjamin Chopski ◽  
John W Cyrus ◽  
Laura E Paletta-Hobbs ◽  
Rehan Qayyum
Keyword(s):  
Scoping Review ◽  
Quality Care ◽  
Transitions Of Care ◽  
Evidence Based ◽  
Consensus Guidelines ◽  
Patient Centered ◽  
Quality Healthcare ◽  
Current Assessment ◽  
Evidence Based Guidelines ◽  
Future Work

BACKGROUND: Although ensuring high-quality care requires assessment of individual hospitalist performance, current assessment approaches lack consistency and coherence. The Institute of Medicine’s STEEEP framework for quality healthcare conceptualizes quality through domains of “Safe,” “Timely,” “Effective,” “Efficient,” “Equitable,” and “Patient Centered.” This framework may be applicable to assessing individual hospitalists. OBJECTIVE: This scoping review sought to identify studies that describe variation in individual hospitalist performance and to code this data to the domains of the STEEEP framework. METHODS: Via a systematic search of peer-reviewed literature that assessed the performance of individual hospitalists in the Medline database, we identified studies that described measurement of individual hospitalist performance. Forty-two studies were included in the final review and coded into one or more domains of the STEEEP framework. RESULTS: Studies in the Safe domain focused on transitions of care, both at discharge and within the hospital. Many studies were coded to more than one domain, especially Timely, Effective, and Efficient. Examples include adherence to evidence-based guidelines or Choosing Wisely recommendations. The Patient Centered domain was most frequently coded, but approaches were heterogeneous. No included studies addressed the domain Equitable. CONCLUSIONS: Applying the STEEEP framework to the published literature on assessment of individual hospitalist performance revealed strengths and weaknesses. Areas of strength were assessments of transitions of care and application of consensus guidelines. Other areas, such as equity and some components of safe practice, need development. All domains would benefit from more practical approaches. These findings should stimulate future work on feasibility of multidimensional assessment approaches.

scholarly journals Infusion and transfusion therapy: main aspects

2021 ◽  
Vol 17 (3) ◽  
pp. 25-29
Author(s):  
V.V. Nikonov ◽  
K.I. Lyzohub ◽  
M.V. Lyzohub
Keyword(s):  
Perioperative Period ◽  
Surgical Patients ◽  
Infusion Therapy ◽  
Evidence Based ◽  
Consensus Guidelines ◽  
Successful Management ◽  
Transfusion Therapy ◽  
Vital Functions ◽  
Crystalloid Solutions ◽  
Based Medicine

The adequate choice of strategy for infusion therapy is an essential component of successful management of critically ill patients. Infusion therapy is one of the main methods of maintai-ning vital functions of patients in the perioperative period. In the practice of a doctor, there are reasonable doubts about the feasibility and safety of various solutions for infusion therapy. Both are fundamental principles of infusion therapy, and the changes that have taken place, of course, need to be understood from the standpoint of evidence-based medicine. Balanced crystalloid solutions were safe and clinically effective, their use is provided by the Bri-tish Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients.

Analysis of antibiotic use in a large network of emergency departments

2019 ◽  
Vol 76 (21) ◽  
pp. 1753-1761 ◽  
Author(s):  
Fredrick O’Neal ◽  
Joan Kramer ◽  
Mandelin Cooper ◽  
Edward Septimus ◽  
Sanya Sharma ◽  
...  
Keyword(s):  
United States ◽  
Health System ◽  
Emergency Departments ◽  
The United States ◽  
Evidence Based ◽  
Prescribing Practices ◽  
Evidence Based Practices ◽  
Infectious Origin ◽  
Tract Infections ◽  
Susceptibility Patterns

Abstract Purpose To assess antibiotic selection, administration, and prescribing practices in emergency departments across a large hospital system using evidence-based practices and susceptibility patterns. Methods This retrospective data review was conducted using health system–level electronic data compiled from 145 emergency departments (EDs) across the United States. Data were examined for national generalizability, most common diagnoses of infectious origin seen in nonadmitted patients in the ED, most commonly administered antibiotics in the ED, and geographically defined areas’ unique patterns of antibiotic resistance and susceptibility. Results More than 627,000 unique patient encounters and 780,000 antibiotic administrations were assessed for trends in patient demographics, antibiotics administered for a diagnosis of infectious origin, and corresponding susceptibility patterns. Results indicated that practices in the EDs of this health system aligned with evidence-based practices for streptococcal pharyngitis, otitis media, cellulitis, and uncomplicated urinary tract infections. Conclusion These results provide a representative sample of the current state of practices within many EDs across the United States for nonadmitted patients. A similar data reconstruction can be completed by other health systems to assess their prescribing practices in the ED to improve and elevate care for patients visiting the emergency room and treated as outpatients.

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