scholarly journals Impact of a Local Low-Cost Ward-Based Response System in a Canadian Tertiary Care Hospital

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Andrea Blotsky ◽  
Louay Mardini ◽  
Dev Jayaraman
Keyword(s):  
Clinical Teaching ◽  
Tertiary Care Hospital ◽  
Low Cost ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Care Hospital ◽  
Response System ◽  
Code Blue ◽  
Initial Intervention ◽  
Teaching Unit

Background. Medical emergency teams (METs) or rapid response teams (RRTs) facilitate early intervention for clinically deteriorating hospitalized patients. In healthcare systems where financial resources and intensivist availability are limited, the establishment of such teams can prove challenging.Objectives. A low-cost, ward-based response system was implemented on a medical clinical teaching unit in a Montreal tertiary care hospital. A prospective before/after study was undertaken to examine the system’s impact on time to intervention, code blue rates, and ICU transfer rates.Results. Ninety-five calls were placed for 82 patients. Median time from patient decompensation to intervention was 5 min (IQR 1–10), compared to 3.4 hours (IQR 0.6–12.4) before system implementation (p<0.001). Total number of ICU admissions from the CTU was reduced from 4.8/1000 patient days (±2.2) before intervention to 3.3/1000 patient days (±1.4) after intervention (IRR: 0.82,p=0.04(CI 95%: 0.69–0.99)). CTU code blue rates decreased from 2.2/1000 patient days (±1.6) before intervention to 1.2/1000 patient days (±1.3) after intervention (IRR: 0.51,p=0.02(CI 95%: 0.30–0.89)).Conclusion. Our local ward-based response system achieved a significant reduction in the time of patient decompensation to initial intervention, in CTU code blue rates, and in CTU to ICU transfers without necessitating additional usage of financial or human resources.

scholarly journals Prevalence of Liver Disease and Utilization of a Hepatology Consultation Service at an Urban Tertiary Care Hospital

2015 ◽  
Vol 38 (6) ◽  
pp. 358
Author(s):  
Stephen G Wong ◽  
Richard Pollock ◽  
Gerald Y Minuk
Keyword(s):  
Liver Disease ◽  
Liver Enzyme ◽  
Clinical Teaching ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Consultation Service ◽  
Function Tests ◽  
Teaching Unit ◽  
And Function

Purpose: The prevalence of liver disease and frequency of consultations to a Hepatology Consultation service for patients with liver enzyme/function abnormalities admitted to a clinical teaching unit at an urban tertiary care hospital have not been previously described. To document these data, a retrospective chart review of adult patients admitted for non-hepatobiliary problems to a general Internal Medicine clinical teaching unit at an urban, tertiary care hospital during a three month period was performed. Methods: Laboratory test results were reviewed to determine if liver enzymes and function tests had been ordered during the first five days of admission and, in those with abnormal results, whether referrals had been sent to the hospital’s Hepatology Consultation service for further investigations and/or management. Results: A total of 506 admissions occurred during the study period. Of these, 452 (89%) were for patients with no known liver disease. Liver biochemistry testing was obtained in 218 (48.2%) of these individuals. In 192 (88.1%), liver enzyme or function tests were abnormal and in 91 (41.7%), both enzymes and function tests were abnormal (suggesting more advanced disease). Referrals to the Hepatology Consultation service were requested for 5/91 (5.5%) patients with more advanced disease and none with only liver enzyme or function tests abnormalities. Conclusions: Although liver enzymes and/or function test abnormalities are common in this patient population, screening for liver disease is relatively uncommon and consultation to a Hepatology Consultation service occurs in less than 10% of cases.

scholarly journals Timing and Location of Medical Emergency Team Activation Is Associated with Seriousness of Outcome: An Observational Study in a Tertiary Care Hospital

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0168729 ◽  
Author(s):  
Takeo Kurita ◽  
Taka-aki Nakada ◽  
Rui Kawaguchi ◽  
Koichiro Shinozaki ◽  
Ryuzo Abe ◽  
...  
Keyword(s):  
Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Care Hospital ◽  
Emergency Team

scholarly journals Cerebral malaria in children : an update

2015 ◽  
Vol 6 (2) ◽  
pp. 45-47
Author(s):  
Mirza Md Ziaul Islam ◽  
M Mizanur Rahman
Keyword(s):  
Cerebral Malaria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Care Hospital ◽  
Medical College ◽  
Antimalarial Therapy ◽  
Neurological Presentation ◽  
Supportive Management ◽  
Prompt Diagnosis

Cerebral malaria (CM) is the most severe neurological presentation of acute falciparum malaria. It is a medical emergency, the hallmark of which is the presence of coma probably due to diffuse encephalopathy. A compromised microcirculation with sequestration of parasitized erythrocytes is central to the pathogenesis of cerebral malaria. The death is unacceptably high even with effective antimalarials in tertiary care hospital. The mainstay of treatment of cerebral malaria include prompt diagnosis and early institution of effective antimalarial therapy, recognition of complications, and appropriate supportive management in an ICU. Neurological sequlae are increasingly recognized, but further research on the pathogenesis of coma and neurological damage is required to develop other ancillary treatmentsNorthern International Medical College Journal Vol.6(2) 2015: 45-47

scholarly journals Success Rate of Endoscopic Sphenopalatine Artery Ligation for the Management of Refractory Posterior Epistaxis Patients in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Meenakshi Basnet ◽  
Bibek Ghimire ◽  
Akriti Shrestha ◽  
Gyan Raj Aryal
Keyword(s):  
Success Rate ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Medical Emergency ◽  
Care Hospital ◽  
Sectional Study ◽  
Artery Ligation ◽  
Cross Sectional ◽  
Sphenopalatine Artery

Introduction: Epistaxis is a common medical emergency with 5% to 15% of patients admitted for epistaxis will require surgical management as nasal packing has high failure rates. A modern endoscopic technique like Endoscopic Sphenopalatine Artery Ligation has increased in popularity for managing intractable posterior epistaxis. It has less complication and a high success rate. The study conducted to estimate the success rate of Endoscopic Sphenopalatine Artery Ligation of refractory posterior epistaxis among admitted patients in a tertiary care hospital. Methods: This is a descriptive cross-sectional study conducted from June 2019 to June 2020 at the Department of Otorhinolaryngology, Nobel Medical College and Teaching Hospital among the patient with refractory posterior epistaxis with the help of retrospective data. A convenient sampling method was used. These patients underwent endoscopic sphenopalatine artery cauterization for recurrent/intractable posterior epistaxis. Ethical clearance was taken from the Institutional Review Board. Data were analyzed in Statistical Package for the Social Sciences. Results: Out of the total patient with refractory posterior epistaxis who underwent Endoscopic Sphenopalatine Artery Ligation, the overall success rate was 39 (95.12%). Among them, 25 (60.97%) males and 16 (39.02%) females underwent endoscopic sphenopalatine artery ligation. Twenty (48.78%) of them were unilateral whilst 21 (51.21%) were bilateral disease. About 2 (4.8%) cases had re-bleeding within 48 hours which was managed conservatively. Hypertension was found to be the most common comorbid condition followed by diabetes, chronic kidney. Conclusions: From our study, we conclude that the success rate for Endoscopic Sphenopalatine Artery Ligation in a patient with refractory posterior epistaxis was high.

scholarly journals Analysis of functioning and efficiency of a code blue system in a tertiary care hospital

2018 ◽  
Vol 12 (2) ◽  
pp. 245 ◽  
Author(s):  
Mridul Dhar ◽  
Srinivas Monangi ◽  
Rangraj Setlur ◽  
Ramprasad Ramanathan ◽  
Sidharth Bhasin
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Code Blue

scholarly journals Knowledge and Practice Gaps among Pediatric Nurses at a Tertiary Care Hospital Karachi Pakistan

2011 ◽  
Vol 2011 ◽  
pp. 1-8
Author(s):  
Rozina Roshan Essani ◽  
Tazeen Saeed Ali
Keyword(s):  
Quantitative Research ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical Science ◽  
Care Hospital ◽  
Pediatric Nurses ◽  
Quality Patient Care ◽  
Code Blue ◽  
Knowledge And Practice ◽  
Nursing Professionals

The advancement in medical science has created health care environments that require nursing professionals who posses specialized clinical knowledge and skills to provide care and deal with critically and acutely ill children. This study explored gaps between knowledge and practice as perceived by the registered nurses of pediatric units by further recommending the changes suggested by them. A descriptive exploratory study design under the quantitative research methodology was utilized using universal sampling of all pediatric nurses working at a tertiary care hospital in Karachi, Pakistan. The gaps between knowledge and practice, as perceived by the participants, were categorized into five major categories: (1) medication (34%), (2) skills (28.3%), (3) knowledge (13.36%), (4) handling of code blue and intubations (12.6%), and (5) operating medical devices (11.58%). As a result, anxiety and incompetency were notably seen in the participants which had great amount of impact on the level of care provided to the patients. The implications of the findings for quality patient care were also analyzed.

scholarly journals Comparison of outcome of milwaukee regimen and 48 hours regimen in diabetic ketoacidosis in a tertiary care hospital in Chitradurga, Karnataka, India

2020 ◽  
Vol 7 (5) ◽  
pp. 1123
Author(s):  
Basavanthappa S. P. ◽  
Srinivasa V. ◽  
Sivachand T.
Keyword(s):  
Diabetic Ketoacidosis ◽  
Tertiary Care Hospital ◽  
Average Length ◽  
Venous Blood ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Pediatric Age Group

Background: Diabetic ketoacidosis (DKA) is an acute life threatening and a medical emergency that accounts for the majority of diabetes related mortality and morbidity in the pediatric age group who are suffering from type 1 Diabetes Mellitus (DM). Objective of this study was to compare the clinical outcome in a patient with DKA who are been treated with Milwaukee regimen (24hours) and 48 hours regimen.Methods: A retrospective study was conducted in PICU of tertiary care hospital in Chitradurga, Karnataka. Data was collected from 2015 to May 2018. Diagnosis of DKA was made by plasma glucose level higher than 200mg/dl, venous blood PH of <7.3 and /or bicarbonate <15 mmol/L, presence of ketonuria. Among 56 cases, 36 cases were treated with 48 hours regimen and 20 cases were treated with Milwaukee regimen and results were compared.Results: The median age of presentation was 7.52 years (Range: 2-14 years) with female: male ratio of 1:1.3. Newly diagnosed type 1 DM cases constituted 80.7%. The most common presenting complaints were hurried breathing and altered sensorium. The average length of stay in the ICU was 3.5 days for 48 hours regimen and 4.5 days for Milwaukee regimen. The mortality rate was 10.71 % (6 cases), among which 15% (3 cases) were patients treated with Milwaukee and 8.3% (3 cases) were patients treated with 48 hours regimen. Cerebral edema was found to be the commonest cause of fatality.Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.

Sign in / Sign up

Export Citation Format

Share Document