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.

scholarly journals EMERGENCY DEPARTMENT OCCUPANCY ASSESSMENT IN LITHUANIA

2017 ◽  
Vol 39 (4) ◽  
pp. 537-551
Author(s):  
Gintautas Virketis ◽  
Vinsas Janušonis
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Intensive Care ◽  
Patient Care ◽  
Waiting Time ◽  
Negative Consequences ◽  
Number Of Patients ◽  
Quality Of Patient Care ◽  
Patient Health

Emergency department (ED) occupancy can cause many negative consequences for the quality of patient care. The purpose was to find out the reasons for the increased occupancy of the ED, to determine the appropriate criteria for the assessment of ED occupancy and the limits of waiting queues or waiting time. The heads and managers of Lithuanian in-patient health care institutions and ambulance services, in-patient reanimation and intensive care units and emergency departments were interviewed. The reasons for the increased waiting time of the ED and the appropriate criteria for the assessment of ED occupancy were determined: "the number of patients waiting in the queue" and “the estimated waiting time before doctor examination”.

scholarly journals Smart Glasses for Caring Situations in Complex Care Environments: Scoping Review

10.2196/16055 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e16055
Author(s):  
Charlotte Romare ◽  
Lisa Skär
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
High Tech ◽  
Anesthesia Care ◽  
Complex Care ◽  
Smart Glasses

Background Anesthesia departments and intensive care units represent two advanced, high-tech, and complex care environments. Health care in those environments involves different types of technology to provide safe, high-quality care. Smart glasses have previously been used in different health care settings and have been suggested to assist health care professionals in numerous areas. However, smart glasses in the complex contexts of anesthesia care and intensive care are new and innovative. An overview of existing research related to these contexts is needed before implementing smart glasses into complex care environments. Objective The aim of this study was to highlight potential benefits and limitations with health care professionals' use of smart glasses in situations occurring in complex care environments. Methods A scoping review with six steps was conducted to fulfill the objective. Database searches were conducted in PubMed and Scopus; original articles about health care professionals’ use of smart glasses in complex care environments and/or situations occurring in those environments were included. The searches yielded a total of 20 articles that were included in the review. Results Three categories were created during the qualitative content analysis: (1) smart glasses as a versatile tool that offers opportunities and challenges, (2) smart glasses entail positive and negative impacts on health care professionals, and (3) smart glasses' quality of use provides facilities and leaves room for improvement. Smart glasses were found to be both a helpful tool and a hindrance in caring situations that might occur in complex care environments. This review provides an increased understanding about different situations where smart glasses might be used by health care professionals in clinical practice in anesthesia care and intensive care; however, research about smart glasses in clinical complex care environments is limited. Conclusions Thoughtful implementation and improved hardware are needed to meet health care professionals’ needs. New technology brings challenges; more research is required to elucidate how smart glasses affect patient safety, health care professionals, and quality of care in complex care environments.

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.  

THE IMPORTANCE OF BIG DATA AND ARTIFICIAL INTELLIGENCE FOR EFFECTIVE HEALTHCARE INSURANCE PLANS

2021 ◽  
Author(s):  
Mihajlo RABRENOVIC ◽  
◽  
Usman IQBAL ◽  
Keyword(s):  
Health Care ◽  
Big Data ◽  
Multidisciplinary Approach ◽  
Business Activity ◽  
Health Care Insurance ◽  
Quality Of Information ◽  
Healthcare Insurance ◽  
Managing Risk ◽  
Organizational Science

Big data is a complex noun that marks sets of data in various formats. Th ere are a lot of challenges in dealing with them, including how to store, search, analyze and share them. In this paper, co-authors deal with relation of big data and artifi cial intelligence and eff ective healthcare insurance plans. In the analysis is taken into account that insurance as a business activity is critically connected to managing risk. In the paper is tested hypothesis: the quality of understanding risks in health care insurance is directly connected to the quality of information. Th is subject requires multidisciplinary approach that includes: informatics, legal and organizational science as well as insurance in health care.

Two Alternatives to Intensive Care

2017 ◽  
Vol 42 (1) ◽  
pp. 3-4
Author(s):  
Alex Fleming ◽  
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Health Care Providers ◽  
Hospice Care ◽  
Treatment Options ◽  
Care Providers ◽  
Health Care Decisions ◽  
Care Facilities ◽  
The Many

The overall quality of life in palliative and hospice care facilities differs greatly from that in intensive care units. For example, the use of mechanical ventilation and powerful anesthetics and sedatives in the ICU can often leave otherwise informed patients incapacitated and unable to make their own health care decisions. Thus, discussions between patients and families about treatment options can be difficult, and families and surrogates are often left to do this on their own Treatments performed in the ICU are likely to be disproportionate to their needs, adding to suffering and distrust on the part of family members. To avoid this, it is important for health care providers to assess patients early and often and to discuss the proportionality of different treatments with their families and surrogates. Additionally, providers should encourage palliative and hospice care as alternatives to the many costly and likely disproportionate interventions taken in the ICU.

scholarly journals Relationship Between Intensive Care Unit Delirium Severity and 2-Year Mortality and Health Care Utilization

2020 ◽  
Vol 29 (4) ◽  
pp. 311-317
Author(s):  
Patricia S. Andrews ◽  
Sophia Wang ◽  
Anthony J. Perkins ◽  
Sujuan Gao ◽  
Sikandar Khan ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Health Care Utilization ◽  
Mortality Risk ◽  
Hazard Ratio ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
Increased Risk

Background Critical care patients with delirium are at an increased risk of functional decline and mortality long term. Objective To determine the relationship between delirium severity in the intensive care unit and mortality and acute health care utilization within 2 years after hospital discharge. Methods A secondary data analysis of the Pharmacological Management of Delirium and Deprescribe randomized controlled trials. Patients were assessed twice daily for delirium or coma using the Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Delirium severity was measured using the CAM-ICU-7. Mean delirium severity (from time of randomization to discharge) was categorized as rapidly resolving, mild to moderate, or severe. Cox proportional hazards regression was used to model time to death, first emergency department visit, and rehospitalization. Analyses were adjusted for age, sex, race, Charlson Comorbidity Index, Acute Physiology and Chronic Health Evaluation II score, discharge location, diagnosis, and intensive care unit type. Results Of 434 patients, those with severe delirium had higher mortality risk than those with rapidly resolving delirium (hazard ratio 2.21; 95% CI, 1.35-3.61). Those with 5 or more days of delirium or coma had higher mortality risk than those with less than 5 days (hazard ratio 1.52; 95% CI, 1.07-2.17). Delirium severity and number of days of delirium or coma were not associated with time to emergency department visits and rehospitalizations. Conclusion Increased delirium severity and days of delirium or coma are associated with higher mortality risk 2 years after discharge.

scholarly journals Nutritional interventions among old people receiving support at home

2018 ◽  
Vol 77 (3) ◽  
pp. 265-269 ◽  
Author(s):  
Anne Marie Beck
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Multidisciplinary Approach ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Old People ◽  
Nutritional Interventions ◽  
Care Costs ◽  
At Home

With the focus of care shifting from the hospital to the community, supportive nutritional care to old people is to become an important issue to address in the community, since undernutrition has serious consequences, both for the quality of life and for the health care costs. Several modifiable nutritional risk factors relate to undernutrition. Unfortunately, the problem with (risk of) undernutrition is aggravated due to a lack of alertness among e.g. health care staff, leading to insufficient attention for systemic screening and nutritional care. Only a few of the existing screening tools have been validated among old people receiving support at home. Few studies have assessed the beneficial effect of nutritional support among old people in their own home, and recently, it was concluded that such have shown limited effects. One reason may be that the nutritional interventions performed have not taken the multiple nutritional risk factors afore-mentioned into consideration when formulating the action/treatment plan and hence not used a multidisciplinary approach. Another reason may be that the intervention studies have not used validated screening tools to identify those old people most likely to benefit from the nutritional support. However, three recent studies have used a multidisciplinary approach and two have proven a beneficial effect on the quality of life of the old people and the health care costs. These findings suggest that when planning nutritional intervention studies for old people receiving support at home, modifiable nutritional risk factors should be taken into consideration, and a multidisciplinary approach considered.

Partnering with Parents: Establishing Effective Long-Term Relationships with Parents in the NICU

2006 ◽  
Vol 25 (5) ◽  
pp. 329-337 ◽  
Author(s):  
Mary McAllister ◽  
Kim Dionne
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Parental Role ◽  
Parent Perspectives ◽  
Duration Of Hospitalization ◽  
Newborn Intensive Care

Advances in health care have led to unprecedented innovation in the care provided to critically ill newborns. One outcome of this new reality is that newborn intensive care units have become “homes” for fragile infants who require long-term hospitalization. Clearly, NICUs were never so envisioned; thus, this reality has resulted in challenges for families and health professionals alike. As the duration of hospitalization increases, relationships between families and health care professionals become increasingly important. Parents of hospitalized newborns face fear, anxiety, and frustration as they struggle to cope with an ill child while developing their parental role. The quality of relationships established between families and health care professionals is crucial to their coping and adaptation. This article addresses challenges faced by families whose infants experience extended hospitalization, applies a model to help health care professionals understand parent perspectives, and proposes strategies to promote effective partnerships and alliances with families.

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