scholarly journals P035: Continuous intravenous low-dose ketamine infusion for managing pain in the emergency department

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S69-S69
Author(s):  
J. Drapkin ◽  
S. Motov ◽  
A. Likourezos ◽  
T. Beals ◽  
R. Monfort ◽  
...  
Keyword(s):  
Emergency Department ◽  
Age Groups ◽  
Analgesic Efficacy ◽  
Secondary Data ◽  
Retrospective Chart Review ◽  
Primary Data ◽  
Ketamine Infusion ◽  
Wide Range ◽  
Post Infusion ◽  
Analgesic Administration

Introduction: To describe dosing, duration, and pre- and post-infusion analgesic administration of continuous intravenous sub-dissociative dose ketamine (SDK) infusion for managing a variety of painful conditions in the emergency department (ED). Methods: Retrospective chart review of patients aged 18 and older presenting to the ED with acute and chronic painful conditions who received continuous SDK infusion in the ED for a period over 6 years (2010-2016). Primary data analyses included dosing and duration of infusion, rates of pre- and post-infusion analgesic administration, and final diagnoses. Secondary data included pre- and post-infusion pain scores and rates of side effects. Results: 104 patients were enrolled in the study. Average dosing of ketamine infusion was 11.26 mg/hr, the mean duration of infusion was 135.87 minutes with 38% increase in patients not requiring post-infusion analgesia. The average decrease in pain score was 5.04. There were 12 reported adverse effects with nausea being the most prevalent. Conclusion: Continuous intravenous SDK infusion has a role in controlling pain of various etiologies in the ED with a potential to reduce need for co-analgesics or rescue analgesic administration. There is a need for more robust, prospective, randomized trials that will further evaluate the analgesic efficacy and safety of this modality across wide range of pain syndromes and different age groups in the ED.

scholarly journals Analisis Tingkat Penerapan Manajemen Pengetahuan Dalam Membangun Organisasi Berbasis Pengetahuan (Studi Kasus PT Trubus Mitra Swadaya SE-JABODETABEK)

2016 ◽  
Vol 2 (2) ◽  
pp. 134
Author(s):  
Raniasari Bimanti Esthi ◽  
Anggraini Sukmawati
Keyword(s):  
Knowledge Management ◽  
Descriptive Analysis ◽  
Secondary Data ◽  
Sampling Technique ◽  
Primary Data ◽  
Chi Square ◽  
Average Value ◽  
Wide Range ◽  
Chi Square Analysis ◽  
Calculation Analysis

<p>PT Trubus Mitra Swadaya is a company engaged in the agribusiness industry that sells a wide range of agricultural goods. The development of the agribusiness industry, particularly agricultural stores are now increasing to fiercer competition. The objectives of this research were (1) Identify the level of knowledge management at PT Trubus Mitra Swadaya, (2) Identify the level of the activities associated with knowledge management at PT Trubus Mitra Swadaya, and (3) Analyzing the perceptions of employees regarding the application of knowledge management at PT Trubus Mitra Swadaya. The data that used in this research were primary data and secondary data. Collecting the respondences was done by quota sampling technique, database examine was done by descriptive analysis, average value calculation analysis, and chi-square analysis.<br />The result of average value calculation analysis showed level implementation of knowledge management was excellent (67,01%), represented from strongly agree answered 20,75% and agree answered 46,26%. Moreover, employees said bad, represented from less agree answered 19,97% and disagree 13,02%. In this research, found at least two components which employees feel valued and still yet to be repaired, that was 1) knowledge and 2) work time. The result average value calculation showed level of activity associated with knowledge management was less good (42,78%), represented five to ten times answered 22,78% and more than ten times 20%. Moreover, employees answered never 30% and less than five times 20%. The result chi-square showed employees’ perception about knowledge management based on employee characteristics where the majority of employees agreeing with the implementation of knowledge management.</p>

scholarly journals P077: The health inequalities among foreign patients visiting the emergency room with injury: a nationwide population-based study in South Korea, 2013-2015

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S84-S84
Author(s):  
S. Jung ◽  
H. Lim ◽  
J. Kwon ◽  
N. Kim ◽  
D. Seo
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Emergency Room ◽  
Health Inequalities ◽  
Personal Information ◽  
Age Groups ◽  
Population Based ◽  
Emergency Rooms ◽  
Wide Range ◽  
Region Length

Introduction: Foreign patients often do not receive appropriate treatment in the emergency room as compared to locals. This is due to various causes such as language, insurance, and cultural differences. The purpose of this study was to investigate whether there is a wide range of health inequalities among foreigners who visited the emergency room with injury and to find out what causes it. Methods: We analyzed clinical data from the National Emergency Department Information System(NEDIS) database, which visited the emergency room from January 1, 2013 to December 31, 2015, in all age groups. Foreigners are classified based on the personal information described in the NEDIS. We analyzed the number of injuries, serious cases(death, operation, ICU admission), length of stay in ER, and transfer ratio. Results: A total of 4,464,603 cases of injured patients were included, of whom 67,683 were foreign patients. The incidence rate per 100,000 people per year was 2960.5 from locals and 1659.8 from foreigners. Serious outcomes were higher for foreigners than for locals(31.0% versus 23.2%, p<0.001). There was a further difference in the rural region. Length of stay was longer for foreigners(72 versus 69 minutes, median, p<0.001). The transfer rate was also higher for foreigners(1.9% versus 1.6%, p<0.001). Daegu had the highest ratio of foreigners’ injury compared to locals(ratio=0.998). Jeonnam(0.073) was the highest serious outcome rate in Korea, and Jeonbuk(0.070) was the second. The area with the longest length of stay in the Emergency department was the median 139 minutes for locals and 153 minutes for foreigners in Daegu. The more patients per day, the shorter the time spent in the emergency rooms(Spearman correlation coefficient=-0.388). This phenomenon was more prominent in locals(-0.624 versus -0.175). Multivariable logistic regression was used as a dependent variable for the serious outcomes of foreign patients. The foreign patients(OR=1.413, p<0.001), intention, no insurance, age, sex, urban area, low blood pressure, decreased consciousness, transfer, acuity, and length of stay were statistically significant. Conclusion: This study showed that there is a health inequality for foreigners who came to the emergency room due to injury in Korea. Also, serious outcomes from injury in foreigners have been shown to be related to various causes including factors of the foreigner.

scholarly journals Frequency and Management of Acute Poisoning Among Children Attending an Emergency Department in Saudi Arabia

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 189
Author(s):  
Mansour Tobaiqy ◽  
Bandar A. Asiri ◽  
Ahmed H. Sholan ◽  
Yahya A. Alzahrani ◽  
Ayed A. Alkatheeri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Saudi Arabia ◽  
Age Groups ◽  
Retrospective Chart Review ◽  
Evidence Base ◽  
Acute Poisoning ◽  
Chi Square ◽  
Jeddah City ◽  
Policy And Strategy ◽  
Poisoning In Children

Background: Acute poisoning is one of the common medical emergencies in children that leads to morbidity and mortality. Medications and chemical agents play a major role in these adverse events resulting in social, economic, and health consequences. Aims of the study: This study aimed to evaluate the frequency and management of acute poisoning among children attending the emergency room at East Jeddah Hospital, Jeddah city, Saudi Arabia. Methods: This study was a retrospective chart review of all acute pediatric poisoning incidences in children (0–16 years of age) from October-21-2016 to March-03-2020 who were attending the emergency department. Data were analyzed via SPSS software. Results: A total of 69 incidences of acute poisoning in children who attended the emergency department at East Jeddah Hospital; males (n = 38, 55.1%). Most children were aged 5 years or younger (n = 41, 59.4%). Unintentional poisoning occurred among 56.5% of observed cases of which 52.2% occurred in children younger than 5 years; 7.20% (n = 5) of patients were 12 to 16 years of age and had deliberate self-poisoning. The association between type of poisoning and age groups was statistically significant (chi-square = 28.5057, p = 0.0001). Most incidences occurred at home (n = 64, 92.8%). Medicines were the most common cause of poisoning (n = 53, 76.8%). An excessive dose of prescribed medicine poisoning accidents was reported in 10.1% cases. Analgesics such as paracetamol were the most documented medication associated with poisoning (39.1%) followed by anticonvulsants and other central nervous system acting medicines (18.8%). The most common route of poisoning was oral ingestion (81.2%). One mortality case was documented. Conclusion: Although not common, accidental and deliberate acute poisoning in children does occur. More can be done to educate parents on safe storage of medicines, household cleaning and other products associated with acute poisoning in children. Likewise, children can be taught more about the risks of poisoning from an early age. As importantly, clinicians need to include more detailed notes in the electronic medical records (EMR) or the system needs to be improved to encourage completeness to more accurately inform the research evidence-base for future service design, health policy and strategy.

scholarly journals Kesesuaian Operasional Produk Asuransi Syariah dengan Fatwa DSN MUI No:21/DSN-MUI/X/2001 (Studi Kasus AJB Bumiputera 1912 Cabang Surabaya)

2015 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Rian Rahmat Hidayat ◽  
Irham Zaki
Keyword(s):  
Rapid Development ◽  
Secondary Data ◽  
Primary Data ◽  
Insurance Company ◽  
Investment Funds ◽  
Wide Range ◽  
Qualitative Descriptive ◽  
Using Data ◽  
Made In

Sharia insurance in Indonesia has experienced a fairly rapid development since the promulgation of MUI fatwa number:21/DSN-MUI/X/2001 about sharia insurance. However, that is still questionable is does the sharia insurance company really run the product operational based on MUI fatwa.This study aims to determine whether product operational of sharia insurance of AJB Bumiputera1912 is in conformity with the sharia rules to follow six indicator akkad, premi, claims, investment, reinsurance, and management of the fund from MUI fatwa or not.The research method is used is a case study with a qualitative descriptive approach. The data used in this study is that the data derived from primary data obtained from fieldwork and secondary data derived from the literature and a wide range of written document. This study using data derived from the management of sharia insurance AJB Bumiputera 1912 in the branch of Surabaya and sharia insurance participants of AJB Bumiputera 1912.The results of this research is operational products of sharia insurance of AJB Bumiputera 1912 were in accordance with Indonesian Ulama Council fatwa DSN Number:21/DSNMUI/X/2001. The suitability reflected from the existence of akkad tabarru’ and akkad tijarah as investment funds (mudharabah), management of premium funds based on sharia, claims fund based on first contract, investment made in accordance with the mandate of participants, then reinsurance process done only to sharia-based reinsurance company.

scholarly journals Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons

2021 ◽  
Vol 12 ◽  
Author(s):  
Lia Gentil ◽  
Guy Grenier ◽  
Xiangfei Meng ◽  
Marie-Josée Fleury
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Disorders ◽  
Service Use ◽  
Negative Binomial ◽  
Age Groups ◽  
Community Treatment ◽  
Care Services ◽  
Wide Range ◽  
Estimated Risk

Background: Patients with mental disorders (MD) are at high risk for a wide range of chronic physical illnesses (CPI), often resulting in greater use of acute care services. This study estimated risk of emergency department (ED) use and hospitalization for mental health (MH) reasons among 678 patients with MD and CPI compared to 1,999 patients with MD only.Methods: Patients visiting one of six Quebec (Canada) ED for MH reasons and at onset of a MD in 2014–15 (index year) were included. Negative binomial models comparing the two groups estimated risk of ED use and hospitalization at 12-month follow-up to index ED visit, controlling for clinical, sociodemographic, and service use variables.Results: Patients with MD, more severe overall clinical conditions and those who received more intensive specialized MH care had higher risks of frequent ED use and hospitalization. Continuity of medical care protected against both ED use and hospitalization, while general practitioner (GP) consultations protected against hospitalization only. Patients aged 65+ had lower risk of ED use, whereas risk of hospitalization was higher for the 45–64- vs. 12–24-year age groups, and for men vs. women.Conclusion: Strategies including assertive community treatment, intensive case management, integrated co-occurring treatment, home treatment, and shared care may improve adequacy of care for patients with MD-CPI, as well as those with MD only whose clinical profiles were severe. Prevention and outreach strategies may also be promoted, especially among men and older age groups.

scholarly journals Hurricane Sandy - Initial Evaluation of Patient Characteristics

2019 ◽  
Vol 34 (s1) ◽  
pp. s7-s7
Author(s):  
Marc Rosenthal ◽  
Robert Dunne
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Vital Signs ◽  
Retrospective Chart Review ◽  
Hurricane Sandy ◽  
System Response ◽  
Medical Needs ◽  
Medical Response ◽  
Wide Range ◽  
National Disaster

Introduction:Disaster medical team response by governmental and non-governmental responders is highly variable and poorly characterized. Each response is unique in terms of caseload, patient demographics, and medical needs encountered. This variability increases the difficulty of determining team member composition as well as supply and equipment needs. In an effort to demonstrate this issue, we have reviewed the National Disaster Medical Response to Hurricane Sandy.Methods:This project was a retrospective chart review of Hurricane Sandy data abstracted from the National Disaster Medical System (NDMS) Health Information Repository (HIR) medical records from the NDMS system response, and were abstracted for data including vital signs, ages, sex, chief complaint, and final impressions. In addition, length of stay among other parameters was abstracted. The data was analyzed using Microsoft Excel and Access with descriptive statistics. In addition, the results were compared to similar indices in a community emergency department and prior NDMS responses.Results:The results indicate a wide range of patient ages, chief complaints, and final impressions. The vast majority of patients seen by Disaster Medical Assistance Teams (DMAT) were stable with relatively low acuity issues. The total number of charts reviewed were 7,905. Respiratory complaints were the most frequent at 845 patients followed by toxicology/injuries at 706 patients and mental health issues at 452 patients. In approximately 3,400 patients, no diagnosis was present in the chart. Length of stay averaged below 1 hour and peak patient ages were between 50-60 with a significant number of infants less than 2 years.Discussion:Characterization of NDMS responses by DMATs and comparison with prior events and community emergency department caseloads can provide an insight into the needs of DMATs and other response organizations in future responses.

Relationship of Environmental Conditions to Health Events

2021 ◽  
pp. 71-79
Author(s):  
Agung Waskito
Keyword(s):  
Environmental Health ◽  
Age Groups ◽  
Secondary Data ◽  
Personal Hygiene ◽  
Primary Data ◽  
P Value ◽  
Clean Water ◽  
Health Events ◽  
Almost All ◽  
Relationship Of

Environmental health is an optimum environmental condition or condition so that it has a positive effect on the realization of optimum health, the environment, and individual health. Diarrhea is currently one of the main causes of morbidity and mortality. Almost all geographic areas of the world and all age groups are attacked by diarrhea, serious illness, and high mortality, especially in infants and children under five. The purpose of this study was to determine the relationship between environmental health and health events which included the characteristics of clean water and sanitation and personal hygiene variables. The method used to collect primary data (interviews using a questionnaire instrument, observation, and measurement), and secondary data (health data). The results of the study concluded thatThe characteristics of clean water that have a relationship with the incidence of diarrhea are in terms of processing drinking water before drinking (p-value = 0.021), while the characteristics of sanitation and personal hygiene in terms of the availability of hand washing places (p-value = 0.073) and the method of disposal of toddler feces ( 0.772) indicates that there is no relationship to the incidence of diarrhea that occurs in Simpang Warga Village, RT.

An Impact of Innovations on Agricultural Production and Malong the Koshi-Highway of Eastern Nepal

2020 ◽  
Vol 4 (1) ◽  
pp. 164-175
Author(s):  
Shyam Prasad Wagle
Keyword(s):  
Agricultural Production ◽  
Crop Production ◽  
New Technologies ◽  
Production Systems ◽  
Secondary Data ◽  
Primary Data ◽  
Innovative Methods ◽  
Wide Range ◽  
The Government ◽  
The Impact

 The study assesses the impact of using new technologies on crop production and marketing of selected crops particularly in the case of the Eastern hills. It also evaluates the role of governmental and non-govrnmental organizations to improve agricultural production systems too. Relevant data have been collected from both primary and secondary sources. Primary data draws from the interview, key informant survey and field observation. For this, 30 percent sample households were selected from three altitude belts (upper, middle and lower belts) ranging from 300 to 2,250 masl along the Koshi-highway. It has a wide range of climates, ranging from sub-tropical to alpine with monsoon precipitation in the summer for three and half months and therefore it has diversity in flora and fauna, and people. Similarly, secondary data havebeen gathered from various books, journals and official records. This paper presented that the crucial impact of acceptance of innovative methods in agriculture in the study area is a combined effort of both local people and government. The government together with the development agencies and non-government organizations has contributed to impart knowledge of the agriculture innovative methods in the local farmers and at the same time, the farmers were enthusiastic to learn and adopt those methods. As a result, one can easily see the remarkable changes in crop production due to the impact of new technologies.

Flying High

2021 ◽  
pp. 1246-1273
Author(s):  
Samarth Khitha ◽  
Karan Castello ◽  
Nihal Saldanha ◽  
Simran Ahluwalia ◽  
Sheena Oberoi
Keyword(s):  
Economic Status ◽  
Age Groups ◽  
Secondary Data ◽  
Primary Data ◽  
Urban India ◽  
Per Se ◽  
Gathering Data ◽  
The Way

The chapter involves the design of a research based on the primary data collected on the airline preferences of individuals in urban India of different age groups from 16-84, belonging to diverse cities from across India. It focusses on gathering data on various aspects of economic status of people and the different flights they prefer based on various amenities like punctuality, pricing of tickets, baggage allowance etc. It also explores respondents' enrolment in reward programmes, their preferred cabin classes, their most frequent means of booking their tickets etc. The chapter has used primary and secondary data to analyse the problem under study. The study seeks to derive the choices of Indians per se about the way to travel by airways.

scholarly journals Epidemiology of burns and scalds in children presenting to the emergency department of a regional burns unit: a 7-year retrospective study

2016 ◽  
Vol 4 ◽  
pp. 1-6 ◽  
Author(s):  
Ceri Elisabeth Battle ◽  
Vanessa Evans ◽  
Karen James ◽  
Katherine Guy ◽  
Janet Whitley ◽  
...  
Keyword(s):  
Emergency Department ◽  
Thermal Injury ◽  
Age Groups ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Accidental Injury ◽  
Chi Square ◽  
Burn Prevention ◽  
South Wales ◽  
Chi Square Test

Abstract Background Variation in the incidence and mechanism of thermal injury has been reported in different age groups in children. The aim of this study was to report the incidence, mechanisms, and environmental factors of all burns presentations to the emergency department (ED) of a regional burns centre over a 7-year period. Methods A retrospective, chart review study of all burns presentations to the ED of a regional burns centre in South Wales was conducted. All children recorded as having sustained a burn or scald, aged less than 16 years were included in the analysis. Subjects’ demographics were analysed using descriptive statistics, and comparisons were made between patients aged less than 5 and patients aged 5–16 using chi-square test and Mann–Whitney U test. Results A total of 1387 cases were included in the final analysis. Scalds were the most common thermal injury with 569 (41.0 %) reported, followed by contact burns in 563 (40.6 %) patients. The patients requiring hospitalisation were significantly younger (2 vs 3 years; p &lt; 0.001) and had a higher rate of non-accidental injury (10 vs 4; p &lt; 0.001). The most commonly injured site in both age groups was a hand or digit. Conclusions Scalds and contact burns were the most commonly reported thermal injury in children aged less than 16. Common mechanisms were hot beverages, hobs and hair straighteners, highlighting further burn prevention strategies are needed and good-quality prospective studies that investigate the effectiveness of such strategies.

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