Southern medical journal
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Southern medical journal · Jul 2015
Patient Selection for Drip and Ship Thrombolysis in Acute Ischemic Stroke.
The drip and ship model is a method used to deliver thrombolysis to acute stroke patients in facilities lacking onsite neurology coverage. We sought to determine whether our drip and ship population differs from patients treated directly at our stroke center (direct presenters). ⋯ Our study showed that a smaller proportion of blacks and older adults arrived at our center by the drip and ship model. This may reflect differences in how patients are selected for thrombolysis and transfer to a higher level of care.
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Southern medical journal · Jul 2015
Comparative StudyTwo Types of Prehospital Systems Interventions that Triage Low-Acuity Patients to Alternative Sites of Care.
This study retrospectively compared alternatives for navigating low-acuity patients in two emergency medical services systems. System A involved a response to every 9-1-1 request with an "evaluate, treat, and refer" process, in which paramedics decided whether patients could be treated on-scene and referred to a primary care provider or urgent care center. System B used a "telephone triage and referral" process, in which callers of low severity were diverted from 9-1-1 to call centers where nurses provided advice and/or a referral to a primary care provider/urgent care center. We hypothesized that systems A and B would differ in terms of the percentage of patients following referral instructions and the percentage of patients who were satisfied with their care. ⋯ The odds were lower that callers in system A would follow instructions. Satisfaction rates suggest that people are willing to accept alternatives to transport to the emergency department and high percentages of patients follow the instructions given.
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Within the past 25 years, there has been a dramatic increase in the incidence of pertussis cases in the United States. As such, this investigation reports on the high-risk groups and describes risk factors of pertussis cases in a large Texas county. ⋯ Increasing pertussis vaccination coverage among children, as well as providing booster shots to adults with special attention on the Hispanic population, may prove to be an effective strategy for health departments.