Assessment of Neck Lumps in Relation to Dentistry

2017 ◽  
Vol 6 (3) ◽  
pp. 44-50
Author(s):  
Sarah Siddiqui ◽  
Jonas Osher
Keyword(s):  
Care Setting ◽  
Incidental Finding ◽  
Initial Assessment ◽  
Routine Examination ◽  
Fine Needle ◽  
Specialist Referral ◽  
Secondary Care Setting ◽  
Neck Lump ◽  
The Common ◽  
Structured Approach

Neck lumps have a varied aetiology, from a benign inflammatory cause to the first presenting sign of a malignancy. Patients may present to primary care complaining of a neck lump or they may be identified as an incidental finding during routine examination. This article highlights a structured approach to the initial assessment including history taking, risk factor assessment and clinical examination. Further investigations undertaken in a secondary care setting, such as ultrasound and guided fine needle aspirations, are then discussed. The common congenital, inflammatory, infective, vascular and neoplastic causes of neck lumps and their management and specialist referral pathway are discussed.

Assessing the diagnostic capabilities of the app DemDx in an acute care setting (Preprint)

2018 ◽  
Author(s):  
Cian Murphy
Keyword(s):  
Differential Diagnosis ◽  
Care Setting ◽  
Medical Student Education ◽  
Initial Assessment ◽  
Junior Doctors ◽  
Doctor Who ◽  
Clinical Accuracy ◽  
Education Tool ◽  
Clinical Records ◽  
Diagnostic Capabilities

UNSTRUCTURED DemDx is a differential diagnosis app for students and junior doctors. Starting with a patient’s presenting complaint the app goes through a step-by-process through history, examination and investigation findings to an increasingly refined differential diagnosis list until a single most likely diagnosis is reached. The aim of this project was to assess the accuracy of DemDx in an Emergency Department (ED) setting. Anonymised clinical records for 100 patients were retrospectively obtained from the ED in Beth Israel, Boston, USA. This contained the differential diagnoses from the clerking doctor, who performed the initial assessment (D1). The discharge diagnosis was used as the gold standard diagnosis (D2). D1 agreed with D2 in 74.44% of cases while DemDx agreed with D2 in 85.56% of cases (p=0.0003716). When the first, and thus most likely, differential was taken from D1 and DemDx, they agreed with D2 in 20 and 18.8% of cases, respectively (p=0.1428). This demonstration of the clinical accuracy of the app highlights how it can be a useful medical student education tool.

scholarly journals A Longitudinal Assessment of the Quality of Insulin Prescribing with Different Prescribing Systems

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Amandeep Setra ◽  
Yogini Jani
Keyword(s):  
Care Setting ◽  
Electronic Prescribing ◽  
Longitudinal Assessment ◽  
Prescribing Practices ◽  
Record System ◽  
Audit Data ◽  
Core Components ◽  
Secondary Care Setting ◽  
The Impact

Accurate and complete prescriptions of insulin are crucial to prevent medication errors from occurring. Two core components for safe insulin prescriptions are the word ‘units’ being written in full for the dose, and clear documentation of the insulin device alongside the name. A retrospective review of annual audit data was conducted for insulin prescriptions to assess the impact of changes to the prescribing system within a secondary care setting, at five time points over a period of 7 years (2014 to 2020). The review points were based on when changes were made, from standardized paper charts with a dedicated section for insulin prescribing, to a standalone hospital wide electronic prescribing and medicines administration (ePMA) system, and finally an integrated electronic health record system (EHRS). The measured outcomes were compliance with recommended standards for documentation of ‘units’ in full, and inclusion of the insulin device as part of the prescription. Overall, an improvement was seen in both outcomes of interest. Device documentation improved incrementally with each system change—34% for paper charts, 23%–56% for standalone ePMA, and 100% for ePMA integrated within EHRS. Findings highlight that differences in ePMA systems may have varying impact on safe prescribing practices.

Eye emergencies in the deployed setting

2019 ◽  
Vol 105 (2) ◽  
pp. 125-132
Author(s):  
GMC Hunter ◽  
R Ward ◽  
DC Wright
Keyword(s):  
Healthcare Professional ◽  
Initial Assessment ◽  
The Common

AbstractEye emergencies are common on deployed operations. This article aims to describe the common eye presentations and to guide the initial assessment and management of ophthalmic emergencies for a healthcare professional remote from immediate specialist input. Emphasis is placed upon how urgently ophthalmic advice should be sought for certain eye conditions.

scholarly journals Reversal of Ketamine Induced Acute Delirium with Continuous Midazolam Infusion in a Post Extubation Child with Refractory Bronchospasm: A Case Report

2020 ◽  
Vol 26 (2) ◽  
pp. 56-59
Author(s):  
Fahisham Taib ◽  
Laila Ab Mukmin
Keyword(s):  
Low Dose ◽  
Care Setting ◽  
Tertiary Hospital ◽  
Emergence Delirium ◽  
The Past ◽  
First Case ◽  
Midazolam Infusion ◽  
Standardized Treatment ◽  
Life Threatening ◽  
The Common

Continuous ketamine infusion has been used successfully to treat severe refractory bronchospasm in children requiring mechanical ventilation in the intensive care setting. One of the common side effects known is emergence delirium. There is no standardized treatment for the ketamine-induced emergence delirium although benzodiazepine, haloperidol and dexmedetomidine have been reported to be effective in the past. A 7-year-old girl admitted to a tertiary hospital for life-threatening asthma requiring immediate intubation and ventilation. Ketamine was used as sedative and bronchodilator in anticipation of her challenging ventilation strategy. She was successfully extubated on day 8 of admission, however, she developed symptoms associated with the delirium. Successful reversal of the symptoms was achieved after 48-hour use of low dose intravenous midazolam. This was the first case reported on the reversal of ketamine-induced emergence phenomenon using low dose intravenous midazolam infusion.

AACE2021-A-1090: Health Status, of Medical and Allied Health Staff of a Secondary Care Setting in a Developing Country

2021 ◽  
Vol 27 (12) ◽  
pp. S23-S24
Author(s):  
Maryam Batool ◽  
Beenish Khan ◽  
Muhammad Zaka-Ul Haq ◽  
Muhammad Raza-Ul Haq
Keyword(s):  
Health Status ◽  
Developing Country ◽  
Secondary Care ◽  
Allied Health ◽  
Care Setting ◽  
Health Staff ◽  
Secondary Care Setting

General practice

2021 ◽  
pp. 223-244
Author(s):  
Philippa Edwards
Keyword(s):  
Primary Care ◽  
Risk Management ◽  
General Practice ◽  
Patient Compliance ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diagnostic Skills ◽  
The Common

This chapter contains 34 questions that encompass all of the important areas of primary care, with detailed explanations. They will assess your knowledge in the common areas that present, testing diagnostic skills and reasoning. They also test negotiating skills to ensure patient compliance, teamworking within the primary care setting, and risk management. Unique to this series, questions are rated by difficulty and are cross-referenced to the eleventh edition of Oxford Handbook of Clinical Specialties to track revision progress and revise effectively.

Tonic Pupil

2011 ◽  
pp. 158-161
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak ◽  
Robert B. Daroff
Keyword(s):  
Incidental Finding ◽  
Diagnostic Evaluation ◽  
Parasympathetic Innervation ◽  
Blurred Vision ◽  
Tonic Pupil ◽  
Visual Symptoms ◽  
Common Causes ◽  
The Common

A tonic pupil is caused by a lesion affecting the postganglionic parasympathetic innervation of the pupil. It can be an incidental finding on examination or associated with visual symptoms, such as photophobia or blurred vision at near. We discuss the common causes and diagnostic evaluation of a tonic pupil in this chapter.

Etiology and diagnosis of ascites: contemporary cohort study in a secondary care setting

2020 ◽  
Vol 73 ◽  
pp. S764
Author(s):  
Mohsan Subhani ◽  
Peuish Sugathan ◽  
Guruprasad Aithal ◽  
Emilie Wilkes ◽  
Naaventhan Palaniyappan
Keyword(s):  
Cohort Study ◽  
Secondary Care ◽  
Care Setting ◽  
Secondary Care Setting
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