Acute medicine & surgery
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Acute medicine & surgery · Apr 2017
Inter-rater reliability of the American Society of Anesthesiologists physical status rating for emergency gastrointestinal surgery.
The American Society of Anesthesiologists Physical Status (ASA-PS) classification system is used worldwide and has also been incorporated into various prediction rules. However, concerns have been raised regarding inter-rater agreement in various surgical fields. Although emergency gastrointestinal surgery is relatively common and associated with high postoperative mortality, a reliability study has not yet been undertaken in this field. The aim of the present study was to investigate the inter-rater reliability of ASA-PS for emergency gastrointestinal surgery. ⋯ The results of the present study revealed the consistency of ASA-PS ratings between anesthesiologists for emergency gastrointestinal surgery. The ASA-PS may serve as a reliable variable in the prediction rules for this field.
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Acute medicine & surgery · Jan 2017
ReviewOnline Commentary in Primary Care and Emergency Room Settings.
This paper describes a communication practice called "online commentary" that is in widespread use in primary care in the USA. Online commentary is talk by a clinician that describes what he or she is finding in the course of the physical examination of the patient. ⋯ It then uses data from an emergency room in the western USA to extend the notion of online commentary from primary care to the emergency setting. It proposes that online commentary facilitates effective teamwork by forecasting next actions, allowing members of the emergency team to anticipate probable next steps in the investigation and treatment of patient injuries.
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Acute medicine & surgery · Oct 2016
Targeted age, device deployment, and problems associated with pediatric defibrillation in pediatric prehospital emergency medical care settings in Japan.
The use of automated external defibrillators was expanded to include infants according to the 2010 cardiopulmonary resuscitation guidelines in Japan. However, deployment has been slower for pediatric patients in Japan, because there are fewer appropriate pediatric patients for automated external defibrillators than adults. This study aimed to investigate the targeted age range for pediatric defibrillation and device deployment of defibrillators for pediatric patients in prehospital emergency medical care settings in Japan, and present the issues associated with automated external defibrillators. ⋯ Pediatric prehospital emergency medical care in Japan is inadequately equipped for pediatric defibrillation. It will be necessary to use age-appropriate defibrillators as the targeted age range for automated external defibrillators rapidly expands to include infants.
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Acute medicine & surgery · Oct 2016
A national survey examining recognition, demand for antivenom, and overall level of preparedness for redback spider bites in Japan.
Redback spiders are rapidly becoming a nationwide problem in Japan. The domestic production of antivenom for redback spider bites has been started because of extremely low supply. The purpose of this study was to investigate the ability of emergency physicians to recognize redback spider bites and to examine the demand for antivenom and identify the ideal choice for storage. ⋯ The recognition of redback spider bites was low; however, the demand for antivenom was high. The storage of antivenom within their own prefectures or regions was considered to be the best option for initial supply planning. Emergency medical service centers are also good candidates for storage and safe use of antivenom.
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Acute medicine & surgery · Oct 2016
Analysis of consumption of medical resources in terms of intensive care unit/hospital stay and severity using Japan Trauma Data Bank.
We analyzed the length of intensive care unit or hospital stay of trauma patients to assess the consumption of medical resources using the Japan Trauma Data Bank. ⋯ Based on the Japan Trauma Data Bank data for many trauma patients, there are numerous cases of long-term stay ≥15 days in intensive care in patients who could not be transferred to a general ward and who consumed the medical resources in the critical care department.