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Find video protocols related to scientific articles indexed in Pubmed.
Identification of a Neurologic Scale That Optimizes EMS Detection of Older Adult Traumatic Brain Injury Patients Who Require Transport to a Trauma Center.
Prehosp Emerg Care
PUBLISHED: 10-08-2014
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Abstract Objective. We sought to identify a scale or components of a scale that optimize detection of older adult traumatic brain injury (TBI) patients who require transport to a trauma center, regardless of mechanism. Methods. We assembled a consensus panel consisting of nine experts in geriatric emergency medicine, prehospital medicine, trauma surgery, geriatric medicine, and TBI, as well as prehospital providers, to evaluate the existing scales used to identify TBI. We reviewed the relevant literature and solicited group feedback to create a list of candidate scales and criteria for evaluation. Using the nominal group technique, scales were evaluated by the expert panel through an iterative process until consensus was achieved. Results. We identified 15 scales for evaluation. The panel's criteria for rating the scales included ease of administration, prehospital familiarity with scale components, feasibility of use with older adults, time to administer, and strength of evidence for their performance in the prehospital setting. After review and discussion of aggregated ratings, the panel identified the Simplified Motor Scale, GCS-Motor Component, and AVPU (alert, voice, pain, unresponsive) as the strongest scales, but determined that none meet all EMS provider and patient needs due to poor usability and lack of supportive evidence. The panel proposed that a dichotomized decision scheme that includes domains of the top-rated scales -level of alertness (alert vs. not alert) and motor function (obeys commands vs. does not obey) -may be more effective in identifying older adult TBI patients who require transport to a trauma center in the prehospital setting. Conclusions. Existing scales to identify TBI are inadequate to detect older adult TBI patients who require transport to a trauma center. A new algorithm, derived from elements of previously established scales, has the potential to guide prehospital providers in improving the triage of older adult TBI patients, but needs further evaluation prior to use.
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The Use of Prehospital Ketamine for Control of Agitation in a Metropolitan Firefighter-based EMS System.
Prehosp Emerg Care
PUBLISHED: 08-25-2014
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Abstract Introduction. Prehospital personnel frequently encounter agitated, combative, and intoxicated patients in the field. In recent years, ketamine has been described as an effective sedative agent to treat such patients; however, a paucity of research exists describing the use of prehospital ketamine. The objective of this study was to provide a descriptive analysis of the Columbus Division of Fire's experience with utilizing ketamine in the prehospital setting. We hypothesized that ketamine administration improves patient condition, is effective at sedating patients, and does not result in endotracheal intubation in the prehospital setting or in the emergency department (ED). Methods. We conducted a retrospective cohort chart review of Columbus Division of Fire patient care reports and hospital records from destination hospitals in the central Ohio region between October 2010 and October 2012. All patients receiving ketamine administered by Columbus Division of Fire personnel for sedation were included. Patients 17 years and younger were excluded. The primary outcome was the percentage of patients noted to have an "improved" condition recorded in the data field of the patient care report. The secondary outcomes were the effectiveness of sedation and the performance of endotracheal intubation. Results. A total of 36 patients met inclusion criteria over the study period. Data were available on 35 patients for analysis. The mean IV dose of ketamine was 138 mg (SD = 59.5, 100-200). The mean IM dose of ketamine was 324 mg (SD = 120, 100-500). Prehospital records noted an improvement in patient condition after ketamine administration in 32 cases (91%, 95% CI 77-98%). Six patients required sedation post-ketamine administration either by EMS (2) or in the ED (4) (17%, 95% CI 6.5-34%). Endotracheal intubation was performed in eight (23%, 95% CI 10-40%) patients post-ketamine administration. Conclusion. We found that in a cohort of patients administered ketamine, paramedics reported a subjective improvement in patient condition. Endotracheal intubation was performed in 8 patients.
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Optimal older adult emergency care: introducing multidisciplinary geriatric emergency department guidelines from the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine.
Acad Emerg Med
PUBLISHED: 08-12-2014
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In the United States and around the world, effective, efficient, and reliable strategies to provide emergency care to aging adults is challenging crowded emergency departments (EDs) and a strained health care system. In response, geriatric emergency medicine (EM) clinicians, educators, and researchers collaborated with the American College of Emergency Physicians (ACEP), American Geriatrics Society (AGS), Emergency Nurses Association (ENA), and the Society for Academic Emergency Medicine (SAEM) to develop guidelines intended to improve ED geriatric care by enhancing expertise, educational, and quality improvement expectations; equipment; policies; and protocols. These "Geriatric Emergency Department Guidelines" represent the first formal society-led attempt to characterize the essential attribute of the geriatric ED and received formal approval from the boards of directors for each of the four societies in 2013 and 2014. This article is intended to introduce EM and geriatric health care providers to the guidelines, while providing proposals for educational dissemination, refinement via formal effectiveness evaluations and cost-effectiveness studies, and institutional credentialing.
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Optimal older adult emergency care: introducing multidisciplinary geriatric emergency department guidelines from the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine.
J Am Geriatr Soc
PUBLISHED: 06-02-2014
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In the United States and around the world, effective, efficient, and reliable strategies to provide emergency care to aging adults is challenging crowded emergency departments (EDs) and strained healthcare systems. In response, geriatric emergency medicine clinicians, educators, and researchers collaborated with the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine to develop guidelines intended to improve ED geriatric care by enhancing expertise, educational, and quality improvement expectations, equipment, policies, and protocols. These Geriatric Emergency Department Guidelines represent the first formal society-led attempt to characterize the essential attributes of the geriatric ED and received formal approval from the boards of directors of each of the four societies in 2013 and 2014. This article is intended to introduce emergency medicine and geriatric healthcare providers to the guidelines while providing recommendations for continued refinement of these proposals through educational dissemination, formal effectiveness evaluations, cost-effectiveness studies, and eventually institutional credentialing.
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Emergency department and outpatient treatment of acute injuries in older adults in the United States: 2009-2010.
J Am Geriatr Soc
PUBLISHED: 06-02-2014
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We sought to describe epidemiological patterns of acute injuries treated in emergency department (ED) and outpatient primary care settings in the United States.
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Geriatric-Specific Triage Criteria Are More Sensitive Than Standard Adult Criteria in Identifying Need for Trauma Center Care in Injured Older Adults.
Ann Emerg Med
PUBLISHED: 02-25-2014
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We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults.
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Emergency department recidivism in adults older than 65 years treated for fractures.
Am J Emerg Med
PUBLISHED: 02-11-2014
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Fractures in older adults are a commonly diagnosed injury in the emergency department (ED). We performed a retrospective medical record review to determine the rate of return to the same ED within 72 hours (returns) and the risk factors associated with returning.
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Discordance between patient report and chart review of risk factors for antimicrobial resistance in ED patients.
Am J Emerg Med
PUBLISHED: 03-19-2013
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The objective of this study is to identify the level of agreement between patient self-report and chart review for presence of antimicrobial resistance (AR) risk factors in emergency department (ED) patients.
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Emergency department observation units and the older patient.
Clin. Geriatr. Med.
PUBLISHED: 03-06-2013
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An increasing number of emergency departments (EDs) are providing extended care and monitoring of patients in ED observation units (EDOUs). EDOUs can be useful for older adults as an alternative to hospitalization and as a means of risk stratification for older adults with unclear presentations. They can also provide a period of therapeutic intervention and reassessment for older patients in whom the appropriateness and safety of immediate outpatient care are unclear. This article discusses the general characteristics of EDOUs, reviews appropriate entry and exclusion criteria for older adults in EDOUs, and discusses regulatory implications of observation status for patients with Medicare.
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Medical student self-assessment narratives: perceived educational needs during fourth-year emergency medicine clerkship.
Teach Learn Med
PUBLISHED: 01-22-2013
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The educational needs of medical students in the 4th-year of training are not well defined in the literature.
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Evaluating current patterns of assessment for self-harm in emergency departments: a multicenter study.
Acad Emerg Med
PUBLISHED: 01-14-2013
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The objective was to describe self-harm assessment practices in U.S. emergency departments (EDs) and to identify predictors of being assessed.
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Development of statewide geriatric patients trauma triage criteria.
Prehosp Disaster Med
PUBLISHED: 11-24-2011
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The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims.
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Modification of Glasgow Coma Scale criteria for injured elders.
Acad Emerg Med
PUBLISHED: 09-26-2011
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An abnormal field Glasgow Coma Scale (GCS) score of ?13 has been used in our emergency medical services (EMS) system to prompt transport to a trauma center. For elders, Ohio has recently adopted a GCS of ?14 to prompt EMS transport to a trauma center, as older patients respond differently to trauma and may benefit from a different GCS threshold. This study sought to determine if a field GCS of 14 is an appropriate cutoff to initiate transport to a trauma center among injured elders.
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The prehospital simplified motor score is as accurate as the prehospital Glasgow coma scale: analysis of a statewide trauma registry.
Emerg Med J
PUBLISHED: 07-27-2011
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The simplified motor score (SMS) is a three-point measure of traumatic brain injury (TBI) severity, which is easier to calculate than the 15-point Glasgow coma scale (GCS). Using a state trauma registry, the accuracy of the emergency medical services (EMS)-obtained SMS was compared with the GCS for predicting neurological outcomes and mortality.
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Medical student professionalism narratives: a thematic analysis and interdisciplinary comparative investigation.
BMC Emerg Med
PUBLISHED: 02-14-2011
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Professionalism development is influenced by the informal and hidden curriculum. The primary objective of this study was to better understand this experiential learning in the setting of the Emergency Department (ED). Secondarily, the study aimed to explore differences in the informal curriculum between Emergency Medicine (EM) and Internal Medicine (IM) clerkships.
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Predictors of acute decompensation after admission in ED patients with sepsis.
Am J Emerg Med
PUBLISHED: 03-25-2010
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The aim of the study was to identify predictors of acute decompensation within 48 hours of admission among infected emergency department (ED) patients admitted to a regular nursing floor.
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Identification of an age cutoff for increased mortality in patients with elderly trauma.
Am J Emerg Med
PUBLISHED: 02-18-2010
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The chosen age cutoff for considering patients with trauma to be "elderly" has ranged from 55 to 80 years in trauma guidelines and studies. The goal of this study was to identify at what age mortality truly increases for older victims of trauma.
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Risk factors for death in elderly emergency department patients with suspected infection.
J Am Geriatr Soc
PUBLISHED: 06-03-2009
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To identify independent risk factors for death in elderly emergency department (ED) patients admitted for infection and to derive and validate a mortality-prediction rule for such patients.
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Comparison of balance assessment modalities in emergency department elders: a pilot cross-sectional observational study.
BMC Emerg Med
PUBLISHED: 02-24-2009
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More than one-third of US adults 65 and over fall every year. These falls may cause serious injury including substantial long-term morbidity (due declines in activities of daily living) and death. The emergency department (ED) visit represents an opportunity for identifying high risk elders and potentially instituting falls-related interventions. The unique characteristic of the ED environment and patient population necessitate that risk-assessment modalities be validated in this specific setting. In order to better identify elders at risk of falls, we examined the relationship between patient-provided history of falling and two testing modalities (a balance plate system and the timed up-and-go [TUG] test) in elder emergency department (ED) patients.
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National trends in emergency department antibiotic prescribing for elders with urinary tract infection, 1996-2005.
Acad Emerg Med
PUBLISHED: 02-24-2009
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Given reported increases in antibiotic resistance among elders with urinary tract infection (UTI) and pyelonephritis, the authors identified national rates and trends in emergency department (ED) trimethoprim-sulfamethoxazole (TMP-SMX) and fluoroquinolone prescribing for older adults from 1996 to 2005.
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Age, nursing home residence, and presentation of urinary tract infection in U.S. emergency departments, 2001-2008.
Acad Emerg Med
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Current outpatient diagnostic algorithms for urinary tract infection (UTI) in older adults require the presence of classic signs and symptoms of UTI, such as fever and genitourinary symptoms. However, older adults with UTI may present with atypical signs and symptoms. The objective was to identify the associations of age and nursing home status with the clinical presentation of emergency department (ED) patients diagnosed with UTI.
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Disagreement between emergency physician and inpatient physician diagnosis of infection in older adults admitted from the emergency department.
Acad Emerg Med
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Older adults with infection are at increased risk of misdiagnosis while they are patients in the emergency department (ED) due to the common presence of nonspecific signs and symptoms. The primary objective was to determine the proportion of admitted older adult patients thought by the emergency physician (EP) to be infected, as compared with the diagnostic impression of inpatient physicians. The secondary objective was to determine the agreement between EP and inpatient physician diagnosis of specific infection types.
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Faculty prefer continuity with medical students in the emergency department.
Emerg Med J
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The aim of this investigation was to better understand emergency medicine (EM) faculty opinions as they relate to continuity with students.
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Effect of advanced age and vital signs on admission from an ED observation unit.
Am J Emerg Med
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The primary objective was to determine the relationship between advanced age and need for admission from an emergency department (ED) observation unit. The secondary objective was to determine the relationship between initial ED vital signs and admission.
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Functional status does not predict complicated clinical course in older adults in the emergency department with infection.
J Am Geriatr Soc
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To identify the relationship between functional status and complicated clinical course in older adults in the emergency department (ED) with suspected infection and to identify other independent predictors of complicated clinical course.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.