scholarly journals Use of Analgesia in an Emergency Department

2013 ◽  
Vol 52 (189) ◽  
pp. 224-228 ◽  
Author(s):  
Rabin Bhandari ◽  
Gyanendra Malla ◽  
Indrajit Prasad Mahato ◽  
Pramendra Gupta
Keyword(s):  
Emergency Department ◽  
Median Time ◽  
Descriptive Statistics ◽  
Emergency Ward ◽  
Record Keeping ◽  
Case File ◽  
Common Presentation ◽  
Pain Descriptor ◽  
Set Up

Introduction: Pain is a common presentation to the emergency department but often overlooked with little research done on the topic in Nepal. We did an observational retrospective study on 301 patients in the emergency ward of BP Koirala Institute of Health Sciences with the objective of finding the practice of analgesia. The specific focus was on the time to analgesia, drugs for analgesia and method of pain assessment. Methods: Case file analysis of patients discharged home after presenting with pain was performed. Time to analgesia and other factors were analyzed with descriptive statistics. Results: Diclofenac injection intramuscular (80%) was the commonest analgesic used. Assessment methods and record keeping were poor. Pain in the abdomen was the commonest. The median time to analgesia from triage was 45 minutes (IQR 30 to 80) and the median time to analgesia from doctor evaluation was 40 minutes (IQR 20 to 70). Conclusions: Time to analgesia from triage and doctors assessment in our set up is comparable to others. The quality of documentation is poor. Problems with pain identification and assessment may lead to inadequate analgesia so reinforcing the use of pain descriptor at triage itself with pain score would be helpful in adopting a protocol based management of pain. Keywords: analgesia; emergency; Nepal.  

scholarly journals Practice of analgesia in an emergency department of eastern Nepal

2003 ◽  
Vol 42 (150) ◽  
Author(s):  
Rabin Bhandari
Keyword(s):  
Emergency Department ◽  
Median Time ◽  
Descriptive Statistics ◽  
Emergency Ward ◽  
Record Keeping ◽  
Case File ◽  
Common Presentation ◽  
Pain Descriptor ◽  
Set Up

Introduction: Pain is a common presentation to the emergency department but often overlooked with little research done on the topic in Nepal. We did an observational retrospective study on 301 patients in the emergency ward of BP Koirala Institute of Health Sciences with the objective of finding the practice of analgesia. The specific focus was on the time to analgesia, drugs for analgesia and method of pain assessment.Method: Case file analysis of patients discharged home after presenting with pain was performed. Time to analgesia and other factors were analyzed with descriptive statistics. Results: Diclofenac injection intramuscular (80%) was the commonest analgesic used. Assessment methods and record keeping were poor. Pain in the abdomen was the commonest. The median time to analgesia from triage was 45 minutes (IQR 30 to 80) and the median time to analgesia from doctor evaluation was 40 minutes (IQR 20 to 70).  Conclusion: Time to analgesia from triage and doctors assessment in our set up is comparable to others. The quality of documentation is poor. Problems with pain identification and assessment may lead to inadequate analgesia so reinforcing the use of pain descriptor at triage itself with pain score would be helpful in adopting a protocol based management of pain.Key Words: Analgesia, Emergency, Nepal

STUDY OF DERMATOLOGICAL EMERGENCIES AT A TERTIARY HEALTH CARE INSTITUTION

2021 ◽  
pp. 12-14
Author(s):  
V. Lakshmi Sarojini ◽  
T. Sahitya ◽  
Ch. Sowjanya
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Intensive Care ◽  
Multidisciplinary Approach ◽  
Morbidity Rate ◽  
Drug Reactions ◽  
Institutional Level ◽  
Study Centre ◽  
Set Up

Introduction:- Dermatological emergencies represent 8-20% of the emergencies presenting to emergency department. There are varying etiologies for these emergencies from neonatal age to adults . Aims and objectives:- To improve awareness of the need for intensive medical care with a multidisciplinary approach by a team of specialist doctors (physicians , intensivists, paediatricians etc., ) along with dermatologists thus to decline the fatality & morbidity rate in dermatological emergencies . Methodology:- All cases presenting to DVL OP , Casuality , intensive care units of the study centre requiring emergency dermatological consultation were included . The results are analysed for age , sex wise distribution and total number of cases as per etiology and outcome of the disease. Results:- Out of the 158 cases studied over a period of 9 months , 88 were males and 70 were females, among which 35 were children. True dermatological emergencies were 46 , other 112 required dermatological consultation on emergency basis . The main etiological factors are infections(34) , drug reactions (27) , vesiculobullous dermatoses(17) etc. Mortality seen in 4 cases . Conclusion:- During the study we learnt that multidisciplinary approach improves the quality of management and nal outcome. Gaining prociency at an institutional level which has a DICU set up with multidisciplinary approach will enable upcoming dermatologists to establish a hospital set up which can manage dermatological emergencies condently instead of limiting to clinical setup.

219 Documentation of Scrotal Examination in Male Children with Abdominal Pain

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K Da Costa ◽  
S Watson ◽  
H Perks ◽  
C Battersby
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Junior Doctor ◽  
Testicular Torsion ◽  
Age Groups ◽  
Common Presentation ◽  
Financial Consequences ◽  
Legal Professional

Abstract Background Abdominal pain is a common presentation in all age groups with 7-10% of emergency department admissions. Method This registered audit looks at male children (aged <16), admitted with abdominal pain during this period. Approximately 2,877 children under the age of sixteen were admitted, 1,582 males. This equates to 55% of children admitted within 3 months. Manual note analysis from ED records identified 53 males <16 years of age with abdominal pain for inspection of documentation. Results 45% of inspected notes had documented genital and scrotal examination, none of which had a documented consent. In addition, 21% had a documented chaperone for the intimate examination. None of the cases had BOTH consent and presence of chaperone documented. Conclusions A common presentation in children lacks significant elements of documentation. This is noted in multiple specialties. Potentially overlooked aspects of examination can lead to missed or delayed identification of time sensitive diagnosis namely testicular torsion, with possible substantial legal, professional, and financial consequences. To improve the quality of documentation, education at junior doctor level has been carried out, with further analysis to take place and with the view to incorporate the three elements of an intimate examination: consent, chaperone, and findings.

scholarly journals 680 A Virtual Stone Clinic Using an Electronic Database Streamlines the Patient Pathway

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R X N Lee ◽  
T C R Heng ◽  
J A Raju ◽  
D Bodiwala ◽  
S D Scriven
Keyword(s):  
Median Time ◽  
Waiting Times ◽  
Renal Stones ◽  
Stone Disease ◽  
Electronic Database ◽  
Initial Imaging ◽  
Set Up ◽  
Stone Passage

Abstract Introduction We have set up an electronic database to record patients requiring follow-up, which is reviewed in a virtual stone clinic (VSC). A consultant led VSC is held weekly to review the database and follow-up patients virtually. Method Analysis of patients added over a 15-month period was performed. Outcomes included spontaneous stone passage rates, intervention rates and time from initial imaging to VSC outcomes. Results 615 patients with a median age of 48 years were analysed. Emergency referrals to urology accounted for 85.9% of data. VSC review occurred a median of 5 days after initial imaging. Majority of stones were lower ureteric (64.6%), 28.1% upper ureteric and 7.2% renal stones. Follow up data was available for 557 patients (90.6%). 73.6% of patients passed stones spontaneously. Median time from investigation to imaging was 21 days. 372 patients were discharged following VSC review. 111 patients were listed for surgical intervention. Median time to intervention was 21 days for ESWL, 62 days for ureteroscopy and 202 days for PCNL. Conclusions VSC leads to shorter waiting times for follow-up imaging and interventions in patients with renal stone disease. This is especially evident in the current Covid-19 pandemic, resulting in higher quality of care.

scholarly journals Improving patient waiting times and quality of care by arranging access to notes from a neighbouring trust

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S175-S176
Author(s):  
Georgios Basdanis ◽  
Cormac Fenton
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Quality Of Care ◽  
Median Time ◽  
Discharge Planning ◽  
Waiting Times ◽  
Clinical Information ◽  
North West ◽  
Time Required

AimsWe aim to improve waiting times in the Emergency Department and improve the overall quality of care of out-of-area patients by arranging for the liaison team to have access to the electronic notes system of a neighbouring trust.MethodSt Thomas’ Hospital is located in south London, right opposite the City of Westminster. As a result, approximately 20% of patients we see in mental health liaison are from that locality. Given that they belong to a different trust, we do not have access to their notes, which leads to a delay in trying to establish whether they are known to local mental health services. Often, staff are reluctant to divulge information. When information is shared, it is often late and/or incomplete. We approached the Chief Clinical Information Officer and Head of Information Governance from Central and North West London (CNWL) NHS Foundation Trust. We held weekly meetings which included both IT departments. Our IT had to install the electronic notes application (SystmOne) on our computers and open relevant firewall ports. The information is access through an NHS Smartcard, therefore CNWL had to authorise read-only Smartcard profiles for every member of the liaison team. A quick reference guide was created for all staff that would be using the new application. The system went live on 21 January 2021.ResultWe audited patient outcomes in December 2020 and February 2021 for initial comparison. In December 2020, the median time from referral to discharge was 6 hours 35 minutes. 25% of patients were admitted and 17% discharged with HTT. In February 2021, the median time from referral to discharge was 3 hours 19 minutes. 16% of patients were admitted and 5% discharged with HTT.ConclusionIt is likely that by reducing the time required for collateral information, overall waiting times in the emergency department will be reduced. Clinicians are likely to feel more confident in their discharge planning if they have access to all clinical notes and previous risk assessments, which might in turn reduce referrals to HTT or admission. There should be further attempts by neighbouring NHS trusts, especially in London, to ensure access to their electronic notes system in order to reduce waiting times and improve the quality of patient care. We have already been approached for more information by a trust in North London who are interested in establishing access to a neighbouring trust's notes.

scholarly journals Acute flaccid paralysis: An approach to diagnosis

2017 ◽  
Vol 13 (2) ◽  
pp. 164-169
Author(s):  
Ashok Kumar Yadav ◽  
P Bhattarai ◽  
B Aryal ◽  
PP Gupta ◽  
S Chaudhari ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Flaccid Paralysis ◽  
Expectant Management ◽  
Acute Onset ◽  
The Body ◽  
Flaccid Paralysis ◽  
Emergency Ward ◽  
Common Presentation ◽  
History Of

Acute flaccid paralysis (AFP) is a common presentation to the emergency department and can present with paralysis of single to several limbs. Here is a case with AFP presented to highlight the approach to diagnosis. A 25 years male who recently returned from Malaysia presented to the emergency ward with acute onset of paralysis for two days which was progressive and was gradually involving the chest muscles as well. He had a history of loose mucoid stool since 4-5 days but there were no rashes or exanthema in the body. On complete examination, apart from diminished power in all the limbs, there were no other positive findings. He was started on expectant management and no other medications except multivitamins were prescribed. Patient was discharged home on patient party’s request and on follow-up after 14 days, patient's had improved.Health Renaissance 2015;13(2): 164-169

Quality of medical record keeping: significance difference between types of admissions

Endoscopy ◽  
2006 ◽  
Vol 37 (12) ◽  
Author(s):  
D Debnath ◽  
M Hutcheson ◽  
JK Hussey
Keyword(s):  
Medical Record ◽  
Record Keeping

THE IMPLEMENTATION OF ISO 9001:2015 TO IMPROVE QUALITY OF SERVICE AT PUSAT KESIHATAN UNIVERSITI (PKU), UNIVERSITI UTARA MALAYSIA(UUM)

2018 ◽  
Vol 13 (Number 2) ◽  
pp. 67-77
Author(s):  
Anis Syamimi Abd Rahim ◽  
Mohd Norhasni Mohd Asaad
Keyword(s):  
Quality Of Service ◽  
Customer Satisfaction ◽  
Descriptive Statistics ◽  
Iso 9001 ◽  
Quality Of Services ◽  
Research Questions ◽  
Spss Software ◽  
The Relationship ◽  
Universiti Utara Malaysia

The purpose of this study is to review the implementation of ISO 9001:2015 in order to improve the quality of services at Pusat Kesihatan Universiti (PKU), Universiti Utara Malaysia. The respondents of this study were customers at the PKU, UUM. The questionnaire was distributed to 50 respondents. The data were analyzed using SPSS software version 24. The data were tested using descriptive statistics, and correlation analysis to answer the research questions and to achieve the objectives. The findings show that customers agree that implementation of ISO 9001:2015 give service at PKU, UUM is good and satisfied. Through the correlation test, the results showed that the relationship between the implementation of ISO 9001:2015 has a positive and significant impact on customer satisfaction and the effect of implementing ISO 9001:2015 has a positive and significant impact in improving quality of service at PKU, UUM.Through mean and standard deviation tests, results show that tangible dimensions are the main dimensions of customer satisfaction while dimensions with low values are dimensions of responsiveness.Therefore, all aspects of service in PKU, UUM will be strengthened and all aspects of the weaknesses could be addressed to improve the service in order to maintain good quality services.

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