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Taking medicines as prescribed (Picture Quiz).
Acute Medicine Pub Date : 2024-01-01
Abdulrahman Al-Mohammad, Dafydd Davies, Sally Hamour
{"title":"Taking medicines as prescribed (Picture Quiz).","authors":"Abdulrahman Al-Mohammad, Dafydd Davies, Sally Hamour","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A man in his 50s with a history of end-stage kidney disease on haemodialysis and chronic mental health issues underwent thoracoabdominal CT to characterise a prolonged lower respiratory tract infection. A single metallic density foreign object was noted within the lower oesophagus. (Figure 1).</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 4","pages":"206"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721828","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 Retrospective Comparison of Emergency Department Throughput Before and After Instituting a Waiting Room Evaluation Process. 实施候诊室评估流程前后急诊科吞吐量的回顾性比较。
Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0987
John Teijido, Benjamin Blackwood, Barry Knapp, Laura Strojny
{"title":"A Retrospective Comparison of Emergency Department Throughput Before and After Instituting a Waiting Room Evaluation Process.","authors":"John Teijido, Benjamin Blackwood, Barry Knapp, Laura Strojny","doi":"10.52964/AMJA.0987","DOIUrl":"https://doi.org/10.52964/AMJA.0987","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has strained the healthcare system with emergency department (ED) boarding and workforce shortages. This prompted the need for strategies to evaluate and treat patients while they waited for an ED room.</p><p><strong>Objectives: </strong>The objective is to describe a waiting room evaluation process and ED throughput in the setting of ED staffing shortages and boarding.</p><p><strong>Methods: </strong>This is a retrospective before and after cohort study evaluating ED throughput before and after initiation of the assessed waiting room (aWR) process. The aWR process is a joint effort by emergency clinicians and ancillary staff to evaluate and treat patients in the ED waiting room when no ED bed is available. Throughput data 6 months before and 6 months after institution of aWR was collected and analyzed.</p><p><strong>Results: </strong>The arrival to provider time and the number of patients who left without being seen (LWBS) decreased with initiation of the aWR process. The remainder of throughput metrics remained unchanged. There was more ED boarding at Wisconsin sites during the aWR process period.</p><p><strong>Conclusions: </strong>The aWR process may minimize LWBS and improve arrival to provider time in the setting of staff shortages and more ED boarders. It may help other ED throughput metrics although numerous confounding factors make it difficult to make definitive conclusions. This process may be trialed during times of challenging healthcare landscape, such as pandemic conditions and with workforce shortages.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"127-131"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606655","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
Research in Acute Medicine. The results of a national survey of Society for Acute Medicine members. 急症医学研究。对急症医学会会员进行的全国性调查的结果。
Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0985
Suzy Gallier, James Hodson, Kum Loon Kwok, Lily Li, Charlotte Morgan, Benjamin Lewis, C Subbe, E Punj, C Atkin, E Sapey
{"title":"Research in Acute Medicine. The results of a national survey of Society for Acute Medicine members.","authors":"Suzy Gallier, James Hodson, Kum Loon Kwok, Lily Li, Charlotte Morgan, Benjamin Lewis, C Subbe, E Punj, C Atkin, E Sapey","doi":"10.52964/AMJA.0985","DOIUrl":"https://doi.org/10.52964/AMJA.0985","url":null,"abstract":"<p><strong>Background: </strong>Medical research improves patient outcomes, patient satisfaction, staff morale and retention. It is unclear what research opportunities and training staff in acute medicine had.</p><p><strong>Methods: </strong>The Society for Acute Medicine supported a survey to assess current research activity, training and perceived opportunities and barriers.</p><p><strong>Results: </strong>292 responses were received from diverse professional backgrounds. Few respondents had formal research qualifications or were undertaking research, but the majority valued research and wanted more research experience including formal training. Barriers included time constraints and perception that research in acute medicine was less valued by healthcare organisations. Preferred mechanisms to increase research included mentorship, advocacy, and increased opportunities.</p><p><strong>Conclusions: </strong>Strategies to increase research in acute medicine should consider these results in forward planning.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"107-117"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606675","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 acute medical service performance against assessment time metrics: the Society for Acute Medicine Benchmarking Audit 2023 (SAMBA23). 根据评估时间指标评估急症医疗服务绩效：急症医学基准审计学会 2023 (SAMBA23)。
Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0984
Catherine Atkin, Chris Subbe, Mark Holland, Ragit Varia, Tim Cooksley, Adnan Gebril, Adrian Kennedy, Thomas Knight, Daniel Lasserson
{"title":"Evaluating acute medical service performance against assessment time metrics: the Society for Acute Medicine Benchmarking Audit 2023 (SAMBA23).","authors":"Catherine Atkin, Chris Subbe, Mark Holland, Ragit Varia, Tim Cooksley, Adnan Gebril, Adrian Kennedy, Thomas Knight, Daniel Lasserson","doi":"10.52964/AMJA.0984","DOIUrl":"https://doi.org/10.52964/AMJA.0984","url":null,"abstract":"<p><p>Performance within acute medicine services is impacted by ongoing pressures on acute care services. Data from the Society for Acute Medicine Benchmarking Audit 2023 (SAMBA23), was used to assess performance of acute medicine services compared to key clinical quality indicators, comparing performance by initial assessment location. Data was analysed for 8213 unplanned attendances across 161 hospitals. Comparing by initial assessment location, performance against the clinical quality indicators was unchanged from 2022. Only 29% of daytime arrivals assessed within the Emergency Department received consultant review within target times. Delays were seen in transfer between acute care locations. 29% of patients requiring admission were not admitted to the AMU. There is ongoing variation in acute medical service performance nationally, with significant delays in patient access to appropriate assessment locations.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"100-106"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606667","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":"23 2","pages":"75-80"},"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
Editorial - Emergency Departments Corridors are the new Acute Medical Units.
Acute Medicine Pub Date : 2024-01-01
Tim Cooksley
{"title":"Editorial - Emergency Departments Corridors are the new Acute Medical Units.","authors":"Tim Cooksley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The NHS and social care services remain under immense pressure. Each part of the system continues to experience demand beyond its capacity which exacerbates the problem. This is most vividly illustrated in urgent and emergency care. Once again, this winter, media is full of pictures of patients in corridors; long queues of ambulances outside of emergency departments and stories of horrific patient experiences: reflecting the appalling situation witnessed and practiced by acute medical teams daily.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 4","pages":"170-171"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721806","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":"23 2","pages":"95"},"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":"23 2","pages":"58-62"},"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
Should respiratory rate be measured on admission over a few seconds by a smartphone application or over 15 minutes by a piezoelectric device? A prospective observational pilot study of acutely ill medical patients admitted to a low-resource Ugandan hospital. 入院时应使用智能手机应用程序测量几秒钟的呼吸频率，还是使用压电设备测量 15 分钟的呼吸频率？一项针对乌干达一家资源匮乏医院急诊病人的前瞻性观察试验研究。
Acute Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0986
Franck Katembo Sikakulya, Immaculate Nakitende, Joan Nabiryo, Sylivia Namuleme, Alfred Lumala, John Kellett
{"title":"Should respiratory rate be measured on admission over a few seconds by a smartphone application or over 15 minutes by a piezoelectric device? A prospective observational pilot study of acutely ill medical patients admitted to a low-resource Ugandan hospital.","authors":"Franck Katembo Sikakulya, Immaculate Nakitende, Joan Nabiryo, Sylivia Namuleme, Alfred Lumala, John Kellett","doi":"10.52964/AMJA.0986","DOIUrl":"10.52964/AMJA.0986","url":null,"abstract":"<p><strong>Background: </strong>the optimal period over which respiratory rate should be measured is uncertain.</p><p><strong>Setting: </strong>medical ward of low resource Ugandan hospital, Methods: comparison of the first respiratory rates measured on admission over seconds using a smartphone application with measurements over 15 minutes using a piezoelectric device.</p><p><strong>Results: </strong>There was a poor correlation between respiratory rates measured by the piezoelectric device and rates measured by a smartphone application. Although the discrimination for mortality of piezoelectric respiratory rates were slightly higher than those derived from the application, there were not statistically significant differences.</p><p><strong>Conclusion: </strong>this study could not demonstrate potential clinical benefits that justify measuring the first respiratory rate after admission over 15 minutes by a device.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"118-126"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606678","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
Acute Medicine Trainee Survey 2024.
Acute Medicine Pub Date : 2024-01-01
G McKinnon, C Mathewson, L R Rahman
{"title":"Acute Medicine Trainee Survey 2024.","authors":"G McKinnon, C Mathewson, L R Rahman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The training of Acute Physicians is crucial for future delivery of high-quality urgent care. The 2024 Acute Medicine Trainee Survey gathered 124 responses, assessing training satisfaction, challenges, and progress since the 2022 curriculum update. Most trainees (66.2%) reported satisfaction, with access to training in Point-of-Care Ultrasound (POCUS) improving (74.7% vs. 63% in 2023). Disparities in training provision and burnout remain significant concerns, with 29.1% experiencing burnout and 40% feeling at risk of this. Key challenges included patient flow issues, rota gaps, and limited respect from colleagues. Despite this, trainee satisfaction is rising, with the majority (88.7%) recommending a career in Acute Medicine. Continued efforts are essential to ensure equitable access to training opportunities and supporting well-being in this demanding specialty.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 4","pages":"191-194"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721800","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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