scholarly journals Audit of Computed Tomography (Brain) Referrals from the Accident and Emergency Department in a Tertiary Care Hospital

2021 ◽  
Author(s):  
Ravinder Sahdev ◽  
Yashasvi Shukla ◽  
Akhilesh Rao
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Medical Officer ◽  
Central India ◽  
Care Hospital ◽  
Accident And Emergency ◽  
Accident And Emergency Department

Introduction: Non-contrast Computerised Tomography (NCCT) Brain is a common referral made from the Accident and Emergency (A&E) department both for traumatic and non traumatic causes. Aim: To evaluate the veracity of the referrals made by the Accident and Emergency Department clinicians for non-contrast computed tomography Head. Materials and Methods: This was the Retrospective evaluation of diagnostic yield of head Computed Tomography (CT) referrals made from A&E Department of a tertiary care hospital located in northern-central India over three year period between January 2015 to December 2017. CT reports were first grouped into two major group’s trauma and non trauma referrals with further subdivision into positive and negative scan on the basis of presence of abnormality. Subsequently, the positive trauma reports were classified into Major findings (three subgroups extra-axial haemorrhage, brain contusions and other miscellaneous findings) and minor findings like undisplaced fractures of the skull or facial bones with or without subgaleal haematoma. Distribution of trauma cases as per National Institute for Health and Care Excellence (NICE) criteria was then tabulated. Non-trauma reports were also further classified in to the two major clinically important findings of haemorrhage and infarct as well as non-specific minor findings. Results: Of the total data of 2185 head CT (980 trauma cases and 1205 in non trauma cases) referrals done by A&E Department during the study period. The 144 (58.5%) out of trauma cases and 328 (27.2%) out of non trauma cases were with major findings. 788 (80.4%) of trauma cases and 965 (80.1%) out of non trauma cases were referred by Medical Officer (MO)/ Resident as revealed from the audit. Positivity percentages for traumatic and non traumatic causes were 25.1% and 27.2%, respectively. Conclusion: Due to non adherence to existing guidelines or due to poor clinical knowledge, there is poor diagnostic yield of CT referrals made from A&E department. Thus clinical Audit is essential at Department of Radiodiagnosis to streamline the referring protocols and improves the overall efficiency of the healthcare system.

scholarly journals A study on the nature of admissions to accident and emergency department in a tertiary care hospital in Sri Lanka

2019 ◽  
Vol 19 (Suppl 2) ◽  
pp. s42-s42
Author(s):  
Priyamali Jayasekera ◽  
Dasanayake GKG ◽  
Bandara PMK ◽  
Jayawardhena DANL ◽  
Malkanthi KMS
Keyword(s):  
Emergency Department ◽  
Sri Lanka ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Accident And Emergency ◽  
Accident And Emergency Department

scholarly journals LABORATORY TURN AROUND TIME FOR BIOCHEMISTRY INVESTIGATIONS IN EMERGENCY DEPARTMENT OF A TERTIARY CARE HOSPITAL OF NORTH INDIA

2021 ◽  
Vol 9 (01) ◽  
pp. 669-679
Author(s):  
Zaffar N. ◽  
◽  
Rashid H. ◽  
Hussain S. ◽  
Hakeem A ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Turnaround Time ◽  
North India ◽  
Care Hospital ◽  
Time Period ◽  
Accident And Emergency ◽  
Analytical Phase ◽  
Analytical Time

Background: Laboratory turnaround time is considered one of the most important indicators of work efficiency in hospitals, physicians always need timely results to take effective clinical decisions especially in the emergency department where these results can guide physicians whether to admit patients to the hospital, discharge them home or do further investigations. Objectives:1. Calculate the turnaround time for the various biochemical investigations from accident and emergency of a tertiary care institute.2. To find the percentage contribution of pre-analytical, analytical and post analytical phases to TAT. Materials And Methods: This was a prospective, descriptive, single-center study of therapeutic TAT for biochemistry investigations in accident and emergency of a tertiary care hospital. The study was conducted for a period of 3 months from August 2020 to Oct 2020. During the present study period, all biochemistry investigations ordered from emergency department were studied. The Lundberg definition of TAT was used in this study. This means that the pre-analytical TAT used was from the point of order of tests to the receipt of samples at the laboratory. Similarly, the post-analytic phase started from the time results were available at the laboratory to the point where clinicians could access it for action. Results: The turnaround time (TAT) has been monitored in total of 7515 samples for biochemistry evaluation with mean TAT of 169.6 min. It was noted that the mean pre analytical time period was 120.6 min , Analytical time period 34 min while post analytical time period was 15 min. In our study of the pre-analytical phase 37.7%, 39.3%, and 22.9% tests were completed within 60, 60-120 and above 120 minutes, respectively. With respect to the analytical phase, 80.4% and 19.6% tests were completed below 45 minutes and above 45 minutes, respectively. Conclusion: Despite efficient analysis of results, the pre analytic period contributed the most delay in TAT. Collecting the blood samples under standard conditions, filling the test request slips, marking the samples with bar-codes contributed to long TAT.

Sero-Prevalence of Parvovirus B 19 Infection Among HIV Positive Patients Attending Tertiary Care Hospital in Central India

2017 ◽  
Vol 01 (04) ◽  
pp. 127-132
Author(s):  
Bhushan Shrikhande ◽  
Meena Mishra ◽  
Mohiuddin Qazi ◽  
Arvind Kurhade ◽  
Chandrashekhar Unakal ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Central India ◽  
Hiv Positive ◽  
Care Hospital ◽  
Parvovirus B 19

Diagnostic yield of Archer FusionPlex PanHeme and solid panels: two-year experience from a pediatric tertiary care hospital

2021 ◽  
Vol 132 ◽  
pp. S39-S40
Author(s):  
Kathleen Schieffer ◽  
Eileen Stonerock ◽  
Vijayakumar Jayaraman ◽  
Heather Jenkins ◽  
Tim Peterson ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals Pattern of Emergent Head Computed Tomography Findings in a Tertiary Care Hospital during off Working Hours: Retrospective Analysis

2019 ◽  
Vol 10 (02) ◽  
pp. 207-211
Author(s):  
Rajneesh K. Patel ◽  
Amit Kumar Choubey ◽  
Brijesh K. Soni ◽  
Rajeev Sivasankar ◽  
Vikash Chauhan
Keyword(s):  
Computed Tomography ◽  
Health Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Working Hours ◽  
Care Hospital ◽  
Head Ct ◽  
Total Head ◽  
Ct Head ◽  
Head Computed Tomography

ABSTRACT Introduction: Emergency head computed tomography (CT) is rising exponentially during off working hours due to evidence-based medicine, patient’s expectation and desires, easy availability and apprehension of medico-legal cases, thereby raising health-care cost. There is huge gap in demand and supply of radiologist, especially during off working hours. There is need to know the pattern of emergency head findings. Materials and Methods: A retrospective analysis of all emergent noncontrast CT head during off working hours in the Department of Radiodiagnosis of a Tertiary Care Hospital, Mumbai, India, which were performed from June 2017 to May 2018. CT findings of 308 patients were analyzed. Results: About 63.6% of total head CT showed no significant abnormality. The most common abnormality was intracranial hemorrhage which was just 9.1% followed by acute infarct which was 6.2%. Extradural hemorrhage, subdural hemorrhage, and subarachnoid hemorrhage was only 1% each of total head CT findings. No significant abnormality was detected in 74.65%, 70.21%, 89.13%, 31.37%, 100%, and 69.09% in cases of head injury, seizure, giddiness/dizziness/syncope, cerebrovascular accident, transient ischemic attack, and altered sensorium, respectively. Conclusion: Pattern analysis of emergent head CT reveals that most of the emergent CT head shows no significant abnormality. There is a need for stringent guidelines for emergent head CT, training of emergency physician as well as CT technician for common findings to bridge the radiologist demand-supply gap for providing effective health care in peripheral hospitals.

VALIDATION OF QUICK COVID SEVERITY INDEX IN COVID PATIENTS ADMITTED THROUGH EMERGENCY DEPARTMENT OF A PRIVATE TERTIARY CARE HOSPITAL IN WEST BENGAL, INDIA

2021 ◽  
pp. 53-55
Author(s):  
Harsimran Singh Das
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Tertiary Care Hospital ◽  
Clinical Status ◽  
Tertiary Care ◽  
Severity Index ◽  
Adult Patients ◽  
Care Hospital ◽  
Oxygen Requirement ◽  
Clinical Tool

Introduction:qCSI (Quick COVID severity index) is a clinical tool established recently post pandemic to predict respiratory failure within 24 hours of admission in COVID-19 patients; respiratory failure being explain as increased oxygen requirement greater than 6L/min by low ow device, high ow device, noninvasive or invasive ventilation to maintain spO2 of greater than or equal to 94%, or death. Aim:To verify and validate the application of the qCSI in Emergency Department in Indian demographic for evidence-based guidance to aid physician decision making in safely dispositioning adult patients with COVID-19 with oxygen requirement less than or equal to 6L/min via low ow devices including nasal cannula and oxygen mask Materials and methods:This is an observational, retrospective study from Emergency Department in a private tertiary care hospital of admitted adult patients with COVID-19 disease. Clinical parameters in qCSI and disposition of 210 patients admitted through Emergency Department included in this study selected randomly was sought on admission and clinical status with level of care 24 hours following admission was recorded and compared with prediction based on qCSI from a period of 1 May 2020 to 31 October 2020. Result:We found that19(9.0%) patients Initial qCSI Score was Low, 80(38.1%) patients Initial qCSI Score was Low-intermediate, 84(40.0%) patients Initial qCSI Score was High-intermediate and 27(12.9%)patients Initial qCSI Score was High.qCSI Score after 24 hours 16(11.4%) patients were Low, 43(30.7%) patients were Low-intermediate, 63(45.0%) patients was High-intermediate and 18(12.9%) patients was High.Out of 210(100.0%) patients, 70 (33.3%) patients were critically ill. Conclusion:In conclusion these data show that the quick COVID-19 Severity Index provides easily accessed risk stratication relevant to Emergency Department provider.

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