scholarly journals Not All Patients with Hemiplegia Need Alteplase: A Case of Hemiplegic Migraine

2020 ◽  
Author(s):  
Sumeet Yadav ◽  
Michelle Talukder ◽  
Jacky Duong
Keyword(s):  
Emergency Department ◽  
Early Diagnosis ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Cerebrovascular Accident ◽  
Sensory Impairment ◽  
Hemiplegic Migraine ◽  
Rare Type ◽  
Head Ct ◽  
Work Up

Hemiplegic migraine (HM) is a rare type of migraine which presents with motor and sensory impairment like a cerebrovascular accident (CVA). We present a case of a 36-year-old female, with a prior CVA treated with alteplase, who presented to the emergency department with stroke-like symptoms with a duration of 1 hour. The NIH Stroke Scale score was 22 at presentation. The patient received alteplase under the supervision of a neurologist after head CT confirmed no bleed. Further work-up revealed no acute or remote ischaemia or infarction. This case demonstrates the importance of a thorough history, intercommunication between health systems and integrated Electronic Medical Records (EMR) for early diagnosis and management of HM.

scholarly journals Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study

10.2196/14487 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e14487 ◽  
Author(s):  
Kwang Yul Jung ◽  
SuJin Kim ◽  
Kihyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Care Providers ◽  
Significant Inverse Relationship ◽  
The Relationship

Background Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios. Objective For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use. Methods This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mobile EMR, and we merged data using doctors’ deidentification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests. Results A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=–0.19; 95% CI –0.32 to –0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests (coefficient=–0.18; 95% CI –0.30 to –0.04; P=.009). Conclusions Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.

scholarly journals Acute care in glioblastoma: the burden and the consequences

2017 ◽  
Vol 4 (4) ◽  
pp. 248-254 ◽  
Author(s):  
Andrea Wasilewski ◽  
Jennifer Serventi ◽  
Lily Kamalyan ◽  
Thomas Wychowski ◽  
Nimish Mohile
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Electronic Medical Records ◽  
Acute Care ◽  
Medical Records ◽  
Emergency Department Visits ◽  
Nursing Facility ◽  
Neurosurgical Procedure ◽  
Care Visit ◽  
The University

Abstract Background The utilization of inpatient medical services by patients with glioblastoma (GBM) is not well studied. We sought to describe causes, frequency, and outcomes of acute care visits in GBM. Methods We conducted a retrospective study of 158 GBM patients at the University of Rochester over 5 years. Electronic medical records were reviewed to identify all local and outside acute care visits. Acute care visits were defined as any encounter resulting in an emergency department visit or inpatient admission. Results Seventy-one percent (112/158) of GBM patients had 235 acute care visits corresponding to 163 hospitalizations (69%) and 72 emergency department visits (31%). Sixty-three percent of patients had multiple visits. Admission diagnoses were seizure (33%), neurosurgical procedure (15%), infection (12%), focal neurologic symptoms (9%), and venous thromboembolism (VTE, 9%). Forty-six patients had 1 or more visits for seizures. Median time to first acute care visit was 65.6 days and 22% of patients had an acute care visit within 30 days of diagnosis. Median length of stay was 5 days. Thirty-five percent of admitted patients were discharged home; 62% required a higher level of care than prior to admission (23% were discharged home with services, 17% to a nursing facility, 16% to hospice, 6% to acute rehab) and 3% died. Thirty-eight percent of patients had ACV within 30 days of death. Median survival was 14 months for patients who had acute care visits and 22.2 months for patients who did not. Conclusion The majority of GBM patients utilize acute care, most commonly for seizures. The high number of emergency department visits, short length of stay, and many patients discharged home suggest that some acute care visits may be avoidable.

scholarly journals Computer-facilitated Review of Electronic Medical Records Reliably Identifies Emergency Department Interventions in Older Adults

2013 ◽  
Vol 20 (6) ◽  
pp. 621-628 ◽  
Author(s):  
Kevin J. Biese ◽  
Cory R. Forbach ◽  
Richard P. Medlin ◽  
Timothy F. Platts-Mills ◽  
Matthew J. Scholer ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Electronic Medical Records ◽  
Medical Records

scholarly journals Frequent Mobile Electronic Medical Records (EMR) Users Respond More Quickly to Emergency Department Consultation Requests (Preprint)

2019 ◽  
Author(s):  
Kwang Yul Jung ◽  
Su Jin Kim ◽  
Ki Hyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Significant Inverse Relationship ◽  
Clinical Scenarios ◽  
The Relationship

BACKGROUND Specialty consultation is a critical aspect of an emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen the ED overcrowding. Although mobile electronic medical records (mEMR) are being increasingly utilized and are known to improve the workflow of healthcare providers, limited studies have evaluated its effectiveness in real-life clinical scenarios. OBJECTIVE We aimed to determine the association between response duration to ED specialty consultation request and frequency of mEMR use. METHODS This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mEMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from the PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mEMR. We merged both data using doctors’ de-identification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mEMR usage and time interval from ED request to the completion of the consultation by specialty doctors. Secondary outcome was the relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests. RESULTS A total of 25,454 consultations requests were made for 15,555 patients, and 271 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mEMR, 212 doctors used mEMR in specialty consultation process. According to the mEMR usage pattern, the average usage frequency of all users was 13.3/day, and the average duration of the completion of the specialty consultation was 51.0 min. For 21,885 completed consultations, there was a significant inverse relationship between the frequency of mEMR usage and time interval from ED request to consultation completion by specialty doctors. (Coefficient: -0.19 (-0.32 to -0.06), P<.01) Of 23,692 consultations had response time stamp among inclusions. There was also a significant inverse relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests (coefficient: -0.17 (-0.30 to -0.04), P=.01). CONCLUSIONS Our findings suggest that frequent mEMR usage is associated with quicker response time to ED consultation requests.

scholarly journals Prescribing of Xylometazoline in the Outpatient Department of a Public Hospital

2021 ◽  
pp. 1-4
Author(s):  
Nehad J. Ahmed ◽  
Menshawy A. Menshawy
Keyword(s):  
Emergency Department ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Public Hospital ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Prescription Data ◽  
Sectional Study ◽  
Prescribing Pattern ◽  
Cross Sectional

Objective: The aim of this study is to analyze the prescribing pattern of Xylometazoline in the outpatient department in a public hospital. Methods: This is a retrospective cross-sectional study that was conducted in a public hospital in alkharj. Prescription data was collected from electronic medical records in the outpatient department. Results: A total of 600 patients received xylometazoline during the study time. 55% of them were males and more than 57% of them aged less than 10 years. More than 86% of the prescriptions were prescribe by the emergency department followed by E.N.T department (13%). Most of the patients received xylometazoline for 3 days and 15.17% of them received it for 5 days. Conclusion: Xylometazoline was prescribed commonly in the outpatients department and could cause several adverse events so its prescribing should be assessed continuously to prevent its adverse effects and to decrease its interactions with drugs.

scholarly journals Documentation of Dual Sensory Impairment in Electronic Medical Records

2014 ◽  
Vol 56 (2) ◽  
pp. 313-317 ◽  
Author(s):  
Brittney Dullard ◽  
Gabrielle H. Saunders
Keyword(s):  
Hearing Loss ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Vision Loss ◽  
Clinical Care ◽  
Primary Care Providers ◽  
Sensory Impairment ◽  
Care Providers ◽  
Sensory Impairments ◽  
Dual Sensory Impairment

Abstract Purpose of the Study: To examine the documentation of sensory impairment in the electronic medical records (EMRs) of Veterans with both hearing and vision losses (dual sensory impairment [DSI]). Design and Methods: A retrospective chart review of the EMRs of 20 patients with DSI was conducted. Providers’ documentation of the presence of sensory impairment, the use of assistive technology during clinical appointments, and the content of notes mentioning communication issues were extracted from each chart note in the EMR for the prior 6 years. Results: Primary care providers documented DSI in 50% of EMRs, vision loss alone in 40%, and hearing loss alone in 10% of EMRs. Audiologists documented vision loss in 50% of cases, whereas ophthalmologists/optometrists documented hearing loss in 15% of cases. Examination of two selected cases illustrates that care can be compromised when providers do not take note of sensory impairments during planning and provision of clinical care. Implications: Sensory impairment is poorly documented by most providers in EMRs. This is alarming because vision and hearing affect patient–physician communication and the use of medical interventions. The results of this study raise awareness about the need to document the presence of sensory impairments and use the information when planning treatment for individuals with DSI.

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