Nurses' accuracy and self-perceived ability using the Emergency Severity Index triage tool: a cross-sectional study in four Swiss hospitals.

Background: The Emergency Severity Index (ESI) is an English language emergency department patient triage tool. After translation, it has been adapted for use to triage patients in growing numbers of emergency departments in non-English-speaking countries. Few reports of the proficiency of triage nurses to score an ESI exist.

Responses of advanced directives by Jehovah's Witnesses on a gynecologic oncology service.

Objectives: To review the responses of advance directives signed by Jehovah's Witness patients prior to undergoing surgery at a gynecologic oncology service.

Study Design: A retrospective chart review of gynecologic oncology patients undergoing surgery at a bloodless surgery center from 1998-2007 was conducted. Demographic, pathologic, and clinical data were recorded.

Inpatient rehabilitation outcomes of patients with apraxia after stroke.

Background: Stroke-induced paresis commands much attention during rehabilitation; other stroke-related consequences receive less consideration. Apraxia is a stroke disorder that may have important implications for rehabilitation and recovery.

Objective: To investigate association of apraxia with stroke rehabilitation outcomes during inpatient rehabilitation.

Soft tissue sarcomas: current management and future directions.

This article reviews the current state of diagnosis and treatment of soft tissue sarcomas. Etiology, staging, imaging, tissue sampling, and current treatment are all reviewed using updated references. Current standards for surgical treatment are emphasized and the future directions of treatment addressed.

Orbital Roof "Blow-in" Fracture: A Case Report and Review.

We report a relatively rare case of an essentially isolated orbital roof "blow-in" fracture in a pediatric patient. A 13-year-old male presented with headache and nausea following blunt facial trauma sustained during a skate boarding accident. CT head revealed soft tissue swelling and an abnormal bony density in the superior, posterior right orbital region.

Metabolic and biochemical responses of the healthy human lung to nonthoracic surgery.

The objective of this study was to evaluate and assign numbers to biochemical or cellular entities in lung-healthy patients that change immediately postsurgery compared with the same parameters immediately presurgery, with the hypothesis that biochemical markers with significant change could be the basis of tests to predict postoperative respiratory complications. Thirty lung-healthy adults who were to undergo elective surgical procedures requiring general anesthesia participated. The population included sequential persons that met inclusion criteria and gave consent.

Toward improved implementation of evidence-based clinical algorithms: clinical practice guidelines, clinical decision rules, and clinical pathways.

This is a summary of the consensus-building workshop entitled "Guideline Implementation and Clinical Pathways," convened May 15, 2007, at the Academic Emergency Medicine Consensus Conference, "Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Uptake." A new term, "evidence-based clinical algorithms" is suggested to encompass evidence-based information codified into clinical pathways, clinical practice guidelines, and clinical decision rules. Examples of poor knowledge translation (KT) relevant to the specialty of emergency medicine are identified, followed by brief descriptions of important research and concepts that inform the research recommendations.

Detection, evaluation, and management of anemia in the elective surgical patient.

The prevalence of anemia in elective surgical patients may be as frequent as 75% in certain populations. A national audit demonstrated that 35% of patients scheduled for joint replacement therapy have a hemoglobin <13 g/dL on preadmission testing. Standard practice currently consists of preadmission testing 3 to 7 days before an elective operative procedure, precluding the opportunity to effectively evaluate and manage a patient with unexpected anemia.

Anti-tumor necrosis factor (TNF) therapy in rheumatoid arthritis: correlation of TNF-alpha serum level with clinical response and benefit from changing dose or frequency of infliximab infusions.

Objective: To determine the relationship between serum TNF-alpha level and clinical response in rheumatoid arthritis patients treated by infliximab. This could be of value to predict clinical response to infliximab and to determine the optimal dose and interval between dosing of infliximab. RA patients who did not respond adequately to conventional doses (3 mg/kg) of infliximab were studied to see if increasing the dose or frequency of infliximab infusions would be more effective.

Stress echocardiography: technical considerations.

Stress echocardiography has evolved into a widely practiced and accepted method for the noninvasive assessment of the status of the coronary anatomy. Furthermore, this modality incorporates the ability to assess left ventricular function, valvular structure and function, intracardiac masses, the pericardium, and hemodynamics. The extent to which this tool can reliably provide useful clinical information is dependent, in part, on optimal performance.

The role of angioplasty for non-Q wave myocardial infarction: the impact of diabetes on outcomes.

Understanding of the mechanisms, outcomes and treatment of non-Q wave myocardial infarction (NQMI) has evolved. Coexisting diabetes poses additional challenges. We studied baseline characteristics, in-hospital and one-year outcomes for NQMI patients having percutaneous transluminal angioplasty.

Mechanism of action of 5-HT3 receptor antagonists: clinical overview and nursing implications.

Research has shown that the emetic response is linked to serotonin and the stimulation of the 5-HT3 receptors located in several areas of the body. Consequently, 5-HT3 receptor antagonists have been developed, and many studies have demonstrated their efficacy in controlling chemotherapy-induced nausea and vomiting. Oral formulations of 5-HT3 receptor antagonists are often equally or more effective than i.

Umbilical cord blood gas analysis.

Umbilical cord blood gas and pH values should always be obtained in the high-risk delivery and whenever newborn depression occurs. This practice is important because umbilical cord blood gas analysis may assist with clinical management and excludes the diagnosis of birth asphyxia in approximately 80% of depressed newborns at term. The most useful umbilical cord blood parameter is arterial pH.

Significance of retroperitoneal air after endoscopic retrograde cholangiopancreatography with sphincterotomy.

Objective: We designed a prospective study to determine the frequency of retroperitoneal air after endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy. We sought to elucidate the relationship of retroperitoneal air with endoscopic maneuvers, clinical findings, the length of sphincterotomy, and the time spent during the procedure. We also endeavored to determine the importance of retroperitoneal air and its most appropriate clinical management.

Perceptions and practices of registered nurses regarding pastoral care and the spiritual need of hospital patients.

Reports the findings of a questionnaire survey designed to examine the impact of pastoral care on patient care and job satisfaction of registered nurses (N-280) employed in a metropolitan hospital. Suggests that educational strategies be explored as a way of broadening the perspectives of nurses regarding reasons for consulting pastoral care departments.

The affinity between continuous quality improvement and epidemic surveillance.

Objective: To discuss the close affinity between the continuous quality improvement (CQI) concept of monitoring a process for the introduction of special causes and epidemic surveillance.

Design: A case study of a CQI tool for infection control epidemic surveillance.

Setting And Patients: A 668-bed acute care hospital with 5 intensive care units supporting heart, liver transplant, and trauma teams.

Exercise echocardiography after coronary artery bypass grafting.

Exercise echocardiography was used to assess the adequacy of regional myocardial perfusion in 125 patients who had undergone coronary artery bypass grafting. There were 108 men and 17 women (mean age 65 years) evaluated from 6 weeks to 16 years (mean 7 years) after surgery. Resting parasternal long- and short-axis and apical 4- and 2-chamber echocardiograms were recorded, digitized and stored.

Primary pancreatic tuberculosis.

A 71-year-old man developed weight loss, nausea, and night sweats. A PPD skin test was positive; chest films were normal. Abdominal computerized tomography revealed a mass in the head of the pancreas.

Development of radiation protection standards.

Radiation protection standards are based on the best available knowledge, caution, and perception. Dose limits for occupational exposure have decreased as knowledge was gained about radiation effects: from 0.6 Sv (60 rem)/year for 1900-1930 to 50 mSv (5 rem)/year in 1958 (the level still used as of 1990).