Articles: patients.
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To identify the rate of treatment failure in emergency department patients with cellulitis. ⋯ The treatment of cellulitis with daily emergency department-based intravenous antibiotics has a failure rate of more than 25% in our centre. Cellulitis patients with a larger surface area of infection and previous (failed) oral therapy are more likely to fail treatment. Further research should focus on defining eligibility for treatment with emergency department-based intravenous antibiotics.
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Acta Anaesthesiol Scand · Jul 2005
ReviewAftermath of an adverse event: supporting health care professionals to meet patient expectations through open disclosure.
An important element of how adverse events are handled is effective communication between health care providers and patients and their families. This review addresses the main questions: What do patients expect in the aftermath of an adverse event? What is known about the practice of open disclosure? How can organizations support health care providers in the aftermath of an adverse event, both professionally and personally? Patients clearly expect open disclosure to include an explanation of what happened, an apology for harm done, that appropriate remedial action will be taken and an explanation of what will be done to learn from the event and to prevent recurrence. Research has found that open disclosure is not very common although the ethical duty to disclose is widely acknowledged. ⋯ Significant commitment is required from health care organizations and managers to develop frameworks for open disclosure to occur, to assure its quality and to support health care providers in this process. Organizations also need to address the emotional needs of health care professionals in the aftermath of an adverse event. Last but not least, adequate systems for debriefing and incident analysis need to be in place to learn from adverse events and to avoid recurrence.
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A comparison of head movement during back boarding by motorized spine-board and log-roll techniques.
In a patient with a potential cervical spine injury, minimizing or eliminating movement at the head and neck during stabilization and transport is paramount because movement can exacerbate the condition. Any equipment or technique creating less movement will allow for a more effective and safe stabilization of an injured patient, reducing the likelihood of movement and potential secondary injury. ⋯ The MSB created less movement at the head than did the log roll in 2 planes of motion and created slightly more motion in 1 plane, although this difference was not significant. The MSB may provide emergency responders with an appropriate alternative method for stabilizing and transporting a supine injured athlete without requiring a log roll.
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Meralgia paresthetica is a clinical syndrome of pain, dysesthesia or both, in the anterolateral thigh. It is associated with an entrapment mononeuropathy of the lateral femoral cutaneous nerve. Diagnosis of meralgia paresthetica is typically made clinically and is based on the characteristic location of pain or dysesthesia, sensory abnormality on exam, and absence of any other neurological abnormality in the leg. The majority of patients with meralgia paresthetica respond well to conservative treatment. ⋯ An implanted spinal cord stimulator may be an ideal treatment for intractable meralgia paresthetica after conservative treatments have failed because it is not destructive and can always be explanted without significant permanent adverse effects.
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Sedation is commonly provided for patients undergoing interventional pain management procedures. Although many pain management interventionalists have trained in anesthesiology, the use of sedatives, analgesics and hypnotics, as well as monitoring techniques, may vary considerably between practices. This review provides an update on recent advances in the pharmacology of drugs commonly used for sedation, anxiolysis and analgesia. ⋯ In addition to providing the right drug for the procedure, patient monitoring must be appropriate for the patient and the clinical circumstances. Undertaking a sedation analgesic course of therapy in support of an interventional procedure will require that patients are monitored appropriately during the course of treatment. Guidelines for monitoring patients during sedation are available.