Records Based on Clinical Examination as an Indicator of Alcohol Involvement in Injuries at Emergency Stations

1977 ◽  
Vol 5 (2) ◽  
pp. 91-95 ◽  
Author(s):  
Risto Honkanen
Keyword(s):  
Clinical Examination ◽  
Computer Analysis ◽  
Emergency Services ◽  
Sensitive Indicator ◽  
Blood Alcohol ◽  
Alcohol Involvement ◽  
Clinical Detection

Clinical detection of alcohol involvement (AI) and its recording (ethyl sign) in accident patients was evaluated by comparing the ethyl signs with blood alcohol concentrations (BAC) in 1012 injury victims. Of the 337 BAC-positive cases 50% had a positive ethyl sign, while an additional 13% had some reference to alcohol in their patient notes. Thus, the overall recording rate was 63%. Computer analysis of the statistics from the same emergency station revealed positive ethyl signs in 13.5% of all the 44 372 patients in 1973. The drunken victims of falls (44%) and fights & assaults (26%) formed the main bulk (70%) of all drunken injury patients. Ethyl sign was found to be a specific, though not a sensitive, indicator of AI and a useful device for studying the strain alcohol places upon the emergency services, statistically.

Comparison of routine blood alcohol tests and ICD-10-AM coding of alcohol involvement for major trauma patients

2021 ◽  
pp. 183335832110371
Author(s):  
Georgina Lau ◽  
Belinda J Gabbe ◽  
Biswadev Mitra ◽  
Paul M Dietze ◽  
Sandra Braaf ◽  
...  
Keyword(s):  
Administrative Data ◽  
Major Trauma ◽  
Blood Alcohol Concentration ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Blood Alcohol ◽  
Alcohol Involvement ◽  
Preventable Risk Factor ◽  
Major Trauma Centre ◽  
Icd 10

Background: Alcohol use is a key preventable risk factor for serious injury. To effectively prevent alcohol-related injuries, we rely on the accurate surveillance of alcohol involvement in injury events. This often involves the use of administrative data, such as International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) coding. Objective: To evaluate the completeness and accuracy of using administrative coding for the surveillance of alcohol involvement in major trauma injury events by comparing patient blood alcohol concentration (BAC) with ICD-10-AM coding. Method: This retrospective cohort study examined 2918 injury patients aged ≥18 years who presented to a major trauma centre in Victoria, Australia, over a 2-year period, of which 78% ( n = 2286) had BAC data available. Results: While 15% of patients had a non-zero BAC, only 4% had an ICD-10-AM code suggesting acute alcohol involvement. The agreement between blood alcohol test results and ICD-10-AM coding of acute alcohol involvement was fair ( κ = 0.33, 95% confidence interval: 0.27–0.38). Of the 341 patients with a non-zero BAC, 82 (24.0%) had ICD-10-AM codes related to acute alcohol involvement. Supplementary factors Y90 Evidence of alcohol involvement determined by blood alcohol level codes, which specifically describe patient BAC, were assigned to just 29% of eligible patients with a non-zero BAC. Conclusion: ICD-10-AM coding underestimated the proportion of alcohol-related injuries compared to patient BAC. Implications: Given the current role of administrative data in the surveillance of alcohol-related injuries, these findings may have significant implications for the implementation of cost-effective strategies for preventing alcohol-related injuries.

Alcohol's Role on the Reliability of Clinical Examination to Rule Out Pelvic Fractures

2009 ◽  
Vol 75 (3) ◽  
pp. 257-259 ◽  
Author(s):  
Therèse M. Duane ◽  
Tracey Dechert ◽  
Luke G. Wolfe ◽  
Holly Brown ◽  
Michel B. Aboutanos ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Clinical Examination ◽  
Pelvic Fractures ◽  
Blood Alcohol ◽  
X Rays ◽  
Clinical Factors ◽  
Lower Systolic Blood Pressure ◽  
Subset Analysis ◽  
Prospective Comparison ◽  
Rule Out

The objective of this study was to determine if clinical examination accurately ruled out pelvic fractures in intoxicated patients sustaining blunt trauma A prospective comparison of intoxicated (blood alcohol level [BAL] greater than 0.08 g/dL) to nonintoxicated (BAL less than 0.08 g/dL) patients sustaining blunt trauma was performed between February 2004 and March 2007. Clinical factors were compared and subset analysis performed in which patients with factors known to compromise the clinical examination were excluded. Two hundred ninety-six intoxicated patients were compared with 1071 nonintoxicated patients. Intoxicated patients were younger and more often male. Intoxicated patients had a higher heart rate (97.1 beats/min ± 17.9 vs 91.4 beats/min ± 18.7, P < 0.0001) and lower systolic blood pressure (136.2 mmHg ± 21.2 vs 141.9 mmHg ± 26.6, P = 0.0005) than nonintoxicated patients. Intoxicated patients had a lower incidence of pelvic fracture (6.1 vs 10.6%). In subset analysis, the majority of the intoxicated patients did not have exclusion factors on examination and could be evaluated (66.6%). There were eight pelvic fractures diagnosed in this group and no missed injuries on clinical examination (sensitivity 100%). Clinical examination was not compromised by intoxication. Routine pelvic x-rays are not needed in the alert, intoxicated patient sustaining blunt trauma.

Tumor Diagnosis

1982 ◽  
Vol 40 ◽  
pp. 262-265
Author(s):  
Bruce Mackay
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Differential Diagnosis ◽  
Light Microscopy ◽  
Clinical Examination ◽  
Ultrastructural Study ◽  
Diagnostic Procedures ◽  
Specific Diagnosis ◽  
Transmission Electron ◽  
Microscopic Diagnosis

The broadest application of transmission electron microscopy (EM) in diagnostic medicine is the identification of tumors that cannot be classified by routine light microscopy. EM is useful in the evaluation of approximately 10% of human neoplasms, but the extent of its contribution varies considerably. It may provide a specific diagnosis that can not be reached by other means, but in contrast, the information obtained from ultrastructural study of some 10% of tumors does not significantly add to that available from light microscopy. Most cases fall somewhere between these two extremes: EM may correct a light microscopic diagnosis, or serve to narrow a differential diagnosis by excluding some of the possibilities considered by light microscopy. It is particularly important to correlate the EM findings with data from light microscopy, clinical examination, and other diagnostic procedures.

Computer analysis of side-band holography in STEM

1991 ◽  
Vol 49 ◽  
pp. 684-685
Author(s):  
M.A. Gribelyuk ◽  
J.M. Cowley
Keyword(s):  
Interference Pattern ◽  
Computer Analysis ◽  
Side Band ◽  
Diffraction Plane ◽  
Illumination System ◽  
Probe Size

Recently the use of a biprism in a STEM instrument has been suggested for recording of a hologram. A biprism is inserted in the illumination system and creates two coherent focussed beams at the specimen level with a probe size d= 5-10Å. If one beam passes through an object and another one passes in vacuum, an interference pattern, i.e. a hologram can be observed in diffraction plane (Fig.1).

Objective Structured Clinical Examination (OSCE) als kompetenz­orientiertes Prüfungsinstrument in der pflegerischen Erstausbildung

Pflege ◽  
2016 ◽  
Vol 29 (4) ◽  
pp. 193-203 ◽  
Author(s):  
Angelika Beyer ◽  
Adina Dreier ◽  
Stefanie Kirschner ◽  
Wolfgang Hoffmann
Keyword(s):  
Clinical Examination ◽  
Objective Structured Clinical Examination

Zusammenfassung. Hintergrund: Aufgrund der demografischen und epidemiologischen Entwicklung wird die Vermittlung adäquater pflegerischer Kompetenzen in der pflegerischen Ausbildung zunehmend diskutiert. Kompetenzen sind in den Examina angemessen zu überprüfen. Hierfür haben sich international OSCEs bewährt. Ziel: Ziel der vorliegenden Analyse war die Ermittlung von Kompetenzen, die in pflegerischen Erstausbildungen mit OSCEs überprüft werden. Methodik: In internationalen Datenbanken wurden einschlägige Publikationen recherchiert. Analyse-Einschlusskriterium war die Nennung mindestens einer überprüften Kompetenz. Die Kompetenzen wurden – in Anlehnung an den «Fachqualifikationsrahmen Pflege für die hochschulische Bildung» – nach Wissen, Fertigkeiten und Haltung kategorisiert. Ergebnisse: 36 Artikel erfüllten das Einschlusskriterium. Relevante Studien stammen mehrheitlich aus Großbritannien (UK), Kanada und Australien. Es wurden insgesamt n = 166 Kompetenzen in allen Kategorien identifiziert, die anhand verschiedener Methoden gemessen wurden. Am häufigsten wurden Fertigkeiten überprüft. Dabei wurde der sichere Umgang mit Medikamenten am häufigsten thematisiert. Weitere wichtige Themen waren die Kommunikationskompetenz in Bezug auf PatientInnen und die Fähigkeit zur Selbsteinschätzung. Diskussion: Es werden sehr unterschiedliche Kompetenzen mit differenten Formaten per OSCE gemessen. OSCE ermöglichen eine Überprüfung sowohl auf individueller als auch institutioneller Ebene, also sowohl für die Lehre als auch das Gelernte. Weiterer Forschungsbedarf wird festgestellt.

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