Journal of general internal medicine
-
To assess whether vital sign measurements could identify internal medicine patients at risk for cardiopulmonary arrest. ⋯ Using elevated respiratory rates as a signal for focused diagnostic studies and therapeutic interventions in internal medicine patients may be useful in reducing the incidence of subsequent cardiopulmonary arrest, and lowering associated morbidity and mortality.
-
Homicide is the leading cause of death in African-American men aged 15-34 years, yet physicians rarely discuss homicide prevention with patients. The authors propose that physicians have a role in preventing homicide similar to their role in other preventive medicine issues. ⋯ While being treated for unrelated problems at a walk-in ambulatory clinic, 53 African-American men patients received brief counseling by the physician about six preventive medicine topics, including firearms. A postvisit interview demonstrated that the discussion of firearms was well received and recalled more than any other preventive medicine issue discussed.
-
To determine patient characteristics associated with the desire for life-sustaining treatments in the event of terminal illness. ⋯ Patients' choices for care in the event of terminal illness relate to an intricate set of demographic, educational, and cultural factors. These results should not be used as a shortcut to determine patient preferences for care, but may provide new insights into the basis for patients' preferences. In discussing choices for future life-sustaining care, physicians need to explore with each individual the basis for his or her choices.
-
To evaluate the incidence and preventability of adverse drug events (ADEs) and to determine the yield of several strategies for identifying them. ⋯ The authors conclude that ADEs are not infrequent, often preventable, and usually caused by physician decisions. In this study, solicited reporting by nurses and pharmacists was inferior to chart review for identifying ADEs, but was effective for identifying potential ADEs. Optimal prevention strategies should cover many types of drugs and target physicians' ordering practices.
-
1) To determine whether the frequencies of panic disorder (PD) and depression (DEP) in an emergency department (ED) population were comparable to those in other primary care groups; 2) to evaluate whether patients without the clinical diagnosis of acute cardiac ischemia (ACI) had higher frequencies of these disorders; and 3) to identify characteristic clinical findings in patients with PD or DEP. ⋯ This study suggests that approximately one in three patients presenting to the ED with acute pain has symptoms consistent with a psychiatric disorder. These disorders occur frequently in both those with and those without acute cardiac ischemia, and clinical variables may help identify these frequent ED utilizers.