Background: We lack data on the effectiveness of education and the patient's attitude toward different deceased donor kidney types. A prospective study was performed to evaluate patient attitudes, baseline knowledge, and effectiveness of our kidney transplant education process. We also analyzed the knowledge retention of our waitlist patients.
View Article and Find Full Text PDFBackground: Understanding patient outcome data and quality improvement metrics can help the health-care team target interventions to improve patient care and guide practice. Challenges to understanding and use of data include finding time during clinical work, determining meaning, and understanding a connection to practice.
Problem Statement: Acute care nurses who routinely care for organ transplant patients could not speak to transplant quality data or outcomes.
Mayo Clin Proc Innov Qual Outcomes
September 2019
Unlabelled: The best approach to adverse-event review in solid organ transplantation is unknown. We initiated a departmental case review (DCR) method based on root-cause analysis methods in a high-volume multiorgan transplant center. We aimed to describe this process and its contributions to process improvement.
View Article and Find Full Text PDFIntroduction: A dislodged gastrostomy tube (GT) is a common complaint that requires evaluation in the pediatric emergency department (ED) and, on occasion, will require stoma dilation to successfully replace the GT. The objective of this study was to describe the frequency that stoma dilation is required, the success rate of replacement, complications encountered, and the techniques used to confirm placement of the GT after dilation.
Methods: We conducted a retrospective medical record review of children 0-18 years who presented to the pediatric ED from February 2013 through February 2015 with a dislodged GT that required stoma dilation by pediatric emergency physicians with serially increasing Foley catheter sizes prior to successful placement of the GT.
Introduction: A "flipped classroom" educational model exchanges the traditional format of a classroom lecture and homework problem set. We piloted two flipped classroom sessions in our emergency medicine (EM) residency didactic schedule. We aimed to learn about resident and faculty impressions of the sessions, in order to develop them as a regular component of our residency curriculum.
View Article and Find Full Text PDFPediatr Emerg Care
October 2014
Objectives: We sought to describe the doses of propofol used for sedation in our pediatric emergency department, along with the range of procedures performed under propofol sedation. We also planned to describe clinically important physiologic changes seen and physician satisfaction with propofol at the doses observed.
Methods: This was a prospective observational case series.
Objectives: We compared the accuracy of a conceptually simple pediatric weight estimation technique, the finger counting method, with other commonly used methods.
Methods: We prospectively collected cross-sectional data on a convenience sample of 207 children aged 1 to 9 presenting to our pediatric emergency department. Bland-Altman plots were constructed to compare the finger counting method to the Broselow tape method, parental estimate, the Luscombe formula, and the advanced pediatric life support (APLS) formula.
Objectives: This study aimed to compare the differences in the type and location of skin infections, organisms cultured, and antibiotic resistance patterns presenting to the same pediatric emergency department from 2003 to 2008 with specific focus on community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections.
Methods: We performed a retrospective chart review of children younger than 18 years who presented to the pediatric emergency department with a skin or soft tissue infection from January 1 to December 31, 2008, and compared these data to a similar data set collected at the same institution from January 1 to December 31, 2003.
Results: From 2003 to 2008, the proportion of abscesses among all skin or soft tissue infections increased from 14% (95% confidence interval [CI], 8.
Clin Pediatr (Phila)
March 2012
Objective: To describe the incidence of bilious vomiting in infants with infantile hypertrophic pyloric stenosis that presented to a pediatric emergency department.
Methods: A retrospective medical record review included all infants who presented to our level 1 pediatric emergency department from January 1, 2005, through December 31, 2009, who were diagnosed intraoperatively with infantile hypertrophic pyloric stenosis. Emesis was determined to be bilious if the vomit was described as "green," "containing bile," or "bilious.
Objective: To use receiver operator characteristic curve methodology to determine the test characteristics of microscopic hematuria for identifying urologic injuries in children who underwent computed tomography (CT) of the abdomen and pelvis as part of a trauma evaluation.
Methods: We performed a retrospective medical record review of all children from 0 to 12 years of age who presented to our pediatric emergency department within a Level 1 trauma center, had an abdominal and pelvic CT and a microscopic urinalysis as part of an initial evaluation for trauma. Urologic injury was defined as any injury to the kidneys, ureters or bladder.
Ann Emerg Med
February 2011
Study Objective: We validate the use of archiving Internet references by comparing the accessibility of published uniform resource locators (URLs) with corresponding archived URLs over time.
Methods: We scanned the "Articles in Press" section in Annals of Emergency Medicine from March 2009 through June 2010 for Internet references in research articles. If an Internet reference produced the authors' expected content, the Web page was archived with WebCite (http://www.
Am J Emerg Med
October 2011
Objective: We sought to describe the causative organisms and joints involved in cases of pediatric septic arthritis in the post-Haemophilus influenzae type B and post-pneumococcal vaccine age and in the age of increasing infection with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA).
Methods: This was a retrospective chart review of all children younger than 13 years presenting to our tertiary care pediatric emergency department between January 1, 2003, and December 31, 2007, with the diagnosis of septic arthritis. We reviewed the results of synovial fluid Gram stain and synovial fluid and blood culture.
Objective: Vomiting is a common adverse event after emergency department ketamine sedation in children. We sought to determine if the rate of vomiting is dose related to intravenous ketamine.
Methods: Treating physicians administered intravenous ketamine to children requiring sedation for a procedure in a pediatric emergency department using doses of their discretion in this prospective observational study.
Study Objective: We seek to evaluate the accessibility of all Internet references appearing in Annals of Emergency Medicine from 2000, 2003, and 2005. Secondary objectives are to determine whether the number of Internet references is increasing and to describe how Internet references are inaccessible.
Methods: We visually scanned all articles for references made in the printed version of Annals of Emergency Medicine for 2000, 2003, and 2005.
Body piercing has become a fashionable trend in western culture. High ear piercing is common among the adolescent population and complications from this procedure although uncommon can be permanently disfiguring. We describe a case of perichondritis after high ear piercing in an adolescent male.
View Article and Find Full Text PDFFistula formation between the innominate artery and the trachea is a rare but potentially catastrophic complication after tracheostomy. Although surgery is the definitive treatment of tracheoinnominate artery fistula, the responsibility for making the proper diagnosis and stabilizing the patient before surgery often falls on the personnel in the emergency department. We describe the emergency department management of a 14-year-old girl with a tracheoinnominate artery fistula.
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