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Implementing a Digital Deteriorating Patient Pathway to improve the safety and effectiveness of care of the adult deteriorating patient. 实施 "数字化病情恶化患者路径"，提高对病情恶化的成年患者的护理安全性和有效性。
Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0968
Adrian Jennings, Philip Brammer, Sian Annakin, Helen Bromage, Tom Cook, Michele Hickey, Jagjit Dhami, Fhezan Ashraf, Ravi Sahota-Thandi, Stephen Borrington
{"title":"Implementing a Digital Deteriorating Patient Pathway to improve the safety and effectiveness of care of the adult deteriorating patient.","authors":"Adrian Jennings, Philip Brammer, Sian Annakin, Helen Bromage, Tom Cook, Michele Hickey, Jagjit Dhami, Fhezan Ashraf, Ravi Sahota-Thandi, Stephen Borrington","doi":"10.52964/AMJA.0968","DOIUrl":"https://doi.org/10.52964/AMJA.0968","url":null,"abstract":"<p><p>Identification, escalation and clinical review of the deteriorating patient is essential for a safe and effective hospital. We present a deteriorating patient pathway developed within our electronic patient record, including implementation of a digital escalation and senior review process, triggered from a logic algorithm and vital signs. The pathway is activated by an average 43 patients per day with median mortality of 13.3%. Our Trust has seen a significant improvement in escalation and senior review and increased use of treatment escalation plans. The pathway has facilitated a cultural shift in the Trust towards the deteriorating patient. The new pathway is transferrable to both other digital Trusts as well as maternity and paediatric practice.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating dynamic patterns in mortality before and after reconfiguration of the Danish emergency healthcare system. 评估丹麦急诊医疗系统重组前后死亡率的动态模式。
Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0967
Marianne Fløjstrup, Anna Kollerup, Søren B Bogh, Mickael Bech, Daniel Henriksen, Søren P Johnsen, Mikkel Brabrand
{"title":"Evaluating dynamic patterns in mortality before and after reconfiguration of the Danish emergency healthcare system.","authors":"Marianne Fløjstrup, Anna Kollerup, Søren B Bogh, Mickael Bech, Daniel Henriksen, Søren P Johnsen, Mikkel Brabrand","doi":"10.52964/AMJA.0967","DOIUrl":"https://doi.org/10.52964/AMJA.0967","url":null,"abstract":"<p><strong>Background: </strong>This study explored changes in short-term mortality during a national reconfiguration of emergency care starting in 2007.</p><p><strong>Methods: </strong>Unplanned hospital contacts at emergency departments across Denmark from 2007 to 2016. The reconfiguration was a natural experiment, resulting in individual timelines for each hospital. The outcome was in-hospital and 30-day mortality.</p><p><strong>Results: </strong>Individual patient-level data included 9,745,603 unplanned hospital contacts from 2007 to 2016 at 20 hospitals with emergency departments. We observed a sharp downwards shift in in-hospital mortality and 30-day mortality in three hospitals in relation to the reconfiguration.</p><p><strong>Conclusion: </strong>This nationwide study identified three hospitals where the reconfiguration was closely associated with reduced in-hospital and 30-day mortality. In contrast, no major effects were identified for the remaining hospitals.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thyrotoxic Periodic Paralysis: A Case Report with Patient Perspective. 甲亢性周期性麻痹：带患者视角的病例报告
Acute Medicine Pub Date : 2024-01-01
Aliaksandra Baranskaya, Yimeng Zhang, Brian Lee
{"title":"Thyrotoxic Periodic Paralysis: A Case Report with Patient Perspective.","authors":"Aliaksandra Baranskaya, Yimeng Zhang, Brian Lee","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present a case report on a spot diagnosis of Thyrotoxic Periodic Paralysis (TPP) with a unique first-person account of events from the patient. It illustrates the importance of pattern recognition and exemplifies how timely treatment enables quick resolution of a life-threatening medical emergency. Patient X's account affirms the condition's insidious onset and rapid deterioration. This case highlights the need for raising awareness of diseases that are more prevalent in specific ethnic groups and is particularly crucial for work in culturally diverse environments. We hope by sharing our experience, readers will be prompted to consider TPP as a differential diagnosis for acute limb weakness in an acute setting; with prompt testing of thyroid function and initiation of the appropriate treatments.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emergency Department Treatment of Elevated Blood Pressure in the Headache Patient. 急诊科对头痛患者血压升高的治疗。
Acute Medicine Pub Date : 2024-01-01
Lauren Eberhardt, Michelle Jankowski, Brett Todd
{"title":"Emergency Department Treatment of Elevated Blood Pressure in the Headache Patient.","authors":"Lauren Eberhardt, Michelle Jankowski, Brett Todd","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Headache accounts for 1 - 3% of emergency department (ED) visits globally and is associated with elevated blood pressure (BP). It is unclear if anti-hypertensive therapy provides benefits. This retrospective study assessed effects of anti-hypertensive therapy in ED headache patients on rescue analgesic need, hospital admissions, and length of stay (LOS). 1385 patients were included. 366 received anti-hypertensive therapy. The anti-hypertensive therapy cohort was older (p < 0.001) with increased odds of admission (p < 0.001) and 2.385 hrs longer ED LOS (p < 0.001). No difference in rescue analgesia was found (p < 0.429). Anti-hypertensive therapy in hypertensive ED headache patients is associated with increased hospital admission and ED LOS, but no difference in rescue analgesia utilization.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Crowned Dens Syndrome-Pseudogout of the Neck. 冠状沟综合征--颈部假性痛风。
Acute Medicine Pub Date : 2024-01-01
Benjamin Fox, Tom Jaconelli
{"title":"Crowned Dens Syndrome-Pseudogout of the Neck.","authors":"Benjamin Fox, Tom Jaconelli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This is a case report of a patient who presented with neck pain and intermittent pyrexia as a manifestation of pseudogout of the neck.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimising Cardiology Ambulatory Care Pathways: A Comprehensive Approach to Admission Avoidance and Timely Intervention in a Post-Pandemic Healthcare Landscape. 优化心脏病非住院治疗路径：在大流行后的医疗保健环境中避免入院和及时干预的综合方法。
Acute Medicine Pub Date : 2024-01-01
Ken Teh, Claire MacLeod, Ross T Campbell, David Murdoch, Kenneth Mangion, Faheem Ahmad
{"title":"Optimising Cardiology Ambulatory Care Pathways: A Comprehensive Approach to Admission Avoidance and Timely Intervention in a Post-Pandemic Healthcare Landscape.","authors":"Ken Teh, Claire MacLeod, Ross T Campbell, David Murdoch, Kenneth Mangion, Faheem Ahmad","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular diseases are a substantial burden on healthcare systems, contributing significantly to avoidable hospital admissions. We propose a Cardiology Ambulatory Care Pathway.</p><p><strong>Methods: </strong>Conducted a 1 month study redirecting admission streams from primary and emergency care, into a Cardiology Ambulatory Care Hub providing triage in Hot Clinic, and access to a Multi-Modal Testing Platform.</p><p><strong>Results: </strong>98 patients were referred to the Ambulatory Care Hub, 91 of which avoided admission. 52 patients received care in the cardiology hub, 38 of which required further testing.</p><p><strong>Conclusion: </strong>We successfully streamlined various service streams, reducing admissions, and improving patient outcomes. Outpatient CTCA, ambulatory ECG, and echocardiography proved instrumental. We project a cost saving of £53,379 per month in bed days (£640,556 annual saving).</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ORF disease: a case report with images. ORF 病：附图片的病例报告。
Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0973
Lamis Elyamani, Yousef Almheirat, Kaoutar Belharti, Nassiba Zerrouki, Nada Zizi, Siham Dikhaye
{"title":"ORF disease: a case report with images.","authors":"Lamis Elyamani, Yousef Almheirat, Kaoutar Belharti, Nassiba Zerrouki, Nada Zizi, Siham Dikhaye","doi":"10.52964/AMJA.0973","DOIUrl":"https://doi.org/10.52964/AMJA.0973","url":null,"abstract":"<p><p>This article presents the case of a 25-year-old Moroccan male who contracted Orf disease (Ecthyma contagiosum), a common zoonotic viral infection in sheep and goats. The disease, caused by a parapoxvirus, can be transmitted to humans through contact with infected animals. The patient developed painful lesions on his fingers after interacting with a sheep during the Feast of Sacrifice. Diagnosis was clinically established considering exposure history and lesion characteristics. Treatment involved local antiseptics and 2% fusidic acid cream. The lesions resolved spontaneously over a few weeks without functional impairment.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Guest Editorial - Shifting Dynamics: ICU Admissions in Denmark during the First Wave of the COVID-19 Pandemic. 特邀编辑 - 动态变化：COVID-19 大流行第一波期间丹麦重症监护病房的收治情况。
Acute Medicine Pub Date : 2024-01-01
Christian P Subbe, John Welch, Ramani Moonesinghe
{"title":"Guest Editorial - Shifting Dynamics: ICU Admissions in Denmark during the First Wave of the COVID-19 Pandemic.","authors":"Christian P Subbe, John Welch, Ramani Moonesinghe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The advent of the SARS-CoV-2 pandemic brought unprecedented challenges to healthcare systems worldwide. As the virus spread across continents, hospitals faced a surge in patient admissions, particularly to intensive care units (ICUs). Understanding the impact of the pandemic on the sickest patients admitted to hospital is crucial for enhancing preparedness for future outbreaks. In this edition of the journal, authors from Denmark report on a register-based national observational study that sheds light on the changes in ICU admission rates and demographic profiles of patients during the initial phase of the pandemic.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial Intelligence: its Future and Impact on Acute Medicine 人工智能:未来及其对急症医学的影响
Acute Medicine Pub Date : 2023-07-01 DOI: 10.52964/amja.0950
Michiel Schinkel, Ketan Paranjape, Sheena Charente Bhagirath, Prabath WB Nanayakkara
{"title":"Artificial Intelligence: its Future and Impact on Acute Medicine","authors":"Michiel Schinkel, Ketan Paranjape, Sheena Charente Bhagirath, Prabath WB Nanayakkara","doi":"10.52964/amja.0950","DOIUrl":"https://doi.org/10.52964/amja.0950","url":null,"abstract":"This commentary explores the potential impact of artificial intelligence (AI) in acute medicine, considering its possibilities and challenges. With its ability to simulate human intelligence, AI holds the promise for supporting timely decision-making and interventions in acute care. While AI has significantly contributed to improvements in various sectors, its implementation in healthcare remains limited. The development of AI tools tailored to acute medicine can improve clinical decision-making, and AI’s role in streamlining administrative tasks, exemplified by ChatGPT, may offer immediate benefits. However, challenges include uniform data collection, privacy, bias, and preserving the doctor-patient relationship. Collaboration among AI researchers, healthcare professionals, and policymakers is crucial to harness the potential of AI in acute medicine and create a future where advanced technologies synergistically enhance human expertise.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A case of a diabetic woman with an uncontrollable arm 1例糖尿病妇女手臂无法控制
Acute Medicine Pub Date : 2023-07-01 DOI: 10.52964/amja.0953
Luís Marote Correia, Mariana Bilreiro
{"title":"A case of a diabetic woman with an uncontrollable arm","authors":"Luís Marote Correia, Mariana Bilreiro","doi":"10.52964/amja.0953","DOIUrl":"https://doi.org/10.52964/amja.0953","url":null,"abstract":"We present the case of an 83-year-old female patient with left-side hemichorea and hemiballism associated with poorly controlled type 2 diabetes mellitus. Hyperintensity in the right basal ganglia was evident in T1-weighted brain magnetic resonance. Clinical and radiological findings were consistent with diabetic striatopathy.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135807302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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