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Добірка наукової літератури з теми "Pre-hospital"

Автор: Grafiati

Опубліковано: 4 червня 2021

Оновлено: 9 червня 2025

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Статті в журналах з теми "Pre-hospital"

Reid, C., C. Hayes-Bradley, and B. Burns. "Pre-hospital pre-oxygenation strategies." Anaesthesia 72, no. 8 (July 11, 2017): 1038–39. http://dx.doi.org/10.1111/anae.13949.

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Burrell, Anita, and Anthony Hall. "Pre-Hospital Thrombolysis." PharmacoEconomics 11, no. 6 (June 1997): 608. http://dx.doi.org/10.2165/00019053-199711060-00010.

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Greaves, Ian. "Pre-hospital care." Trauma 18, no. 2 (March 16, 2016): 83–84. http://dx.doi.org/10.1177/1460408616638633.

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Lockey, D. J., K. Crewdson, and H. M. Lossius. "Pre-Hospital Anaesthesia." Survey of Anesthesiology 59, no. 2 (April 2015): 64–65. http://dx.doi.org/10.1097/sa.0000000000000118.

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Chamberlain, Douglas. "Pre-hospital thrombolysis." Current Opinion in Anaesthesiology 12, no. 2 (April 1999): 179–82. http://dx.doi.org/10.1097/00001503-199904000-00012.

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Mackenzie, R., and D. Lockey. "Pre-hospital Anaesthesia." Journal of the Royal Army Medical Corps 147, no. 3 (October 1, 2001): 322–34. http://dx.doi.org/10.1136/jramc-147-03-13.

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Dawes, R., and A. Mellor. "Pre-Hospital Anaesthesia." Journal of the Royal Army Medical Corps 156, Suppl_4 (December 1, 2010): S289–294. http://dx.doi.org/10.1136/jramc-156-04s-04.

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Harrop, Keith. "Pre-hospital chaos." Emergency Medicine 7, no. 1 (August 26, 2009): 48–50. http://dx.doi.org/10.1111/j.1442-2026.1995.tb00193.x.

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Groombridge, C. J., T. Konig, E. Ley, and M. Miller. "Pre-hospital pre-oxygenation strategies: a reply." Anaesthesia 72, no. 8 (July 11, 2017): 1039. http://dx.doi.org/10.1111/anae.13954.

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Branson, R. D., and J. A. Johannigman. "Pre-Hospital Oxygen Therapy." Respiratory Care 58, no. 1 (December 26, 2012): 86–97. http://dx.doi.org/10.4187/respcare.02251.

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Дисертації з теми "Pre-hospital"

Lockey, D. J. "Pre-hospital trauma interventions." Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/1416433/.

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Анотація:

Considerable variation exists in the type and quality of interventions carried out on victims of major trauma in the pre-hospital phase of care. One model of care consists of high level interventions delivered by a doctor-led team. Examining two controversial areas of treatment (traumatic cardiac arrest and advanced airway management), this thesis set out to determine the quality and potential shortfalls of current practice and how they might be improved. A systematic review of traumatic cardiac arrest survival confirmed that outcome was historically very poor. A study of the largest series of traumatic cardiac arrest reported to date then suggested that a doctor –led system was associated with survival rates which were greater, and which were compatible with those after medical cardiac arrest. A significant proportion of survivors were victims of penetrating trauma who had been treated with on-scene thoracotomy. I thus examined the use, success rate and place of this intervention through analysis of the only reported case series. Finally, I considered how new or established interventions might be best applied in the early phase of trauma care to improve outcome, proposing a treatment algorithm to guide current management. Advanced airway management is presented as a controversial subject with uncertainty about who should deliver it and how it should be performed. The data presented demonstrates that, in a UK system ambulance service, interventions fail to deliver adequate airway care to trauma victims. In terms of doctor-delivered care, a meta-analysis is presented which demonstrates that doctors have better intubation success rates than paramedics, even when drug assistance and high levels of training are provided. The largest series of physician-delivered intubation then confirms this position. Lastly, a pre-hospital airway consensus process is described which attempts to improve the quality of data to guide future service development and research.

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Pavlenko, A., and T. Sytnik. "Pre-hospital management of stroke." Thesis, Видавництво СумДУ, 2012. http://essuir.sumdu.edu.ua/handle/123456789/27518.

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Moore, Janet Lynn. "Pre-hospital Pain Assessment of Pediatric Trauma." University of Toledo Health Science Campus / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=mco1147291564.

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Sampalis, John Sotirios. "Evaluation of pre-hospital trauma services in Montreal." Thesis, McGill University, 1990. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=74365.

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Анотація:

The objectives of this observational study were to describe and evaluate the impact of emergency services on trauma mortality in Montreal. Urgences-Sante provides pre-hospital care in the greater Montreal region. Physicians provide on-scene care including advanced life support (ALS). Basic life support (BLS) is provided by emergency medical technicians or physicians. The study was conducted over a one-year period from April 1, 1987 to March 31, 1988. The results of this study showed that the response and total pre-hospital times of Urgences-Sante were similar to those in other North American cities. Pre-hospital time exceeding 60 minutes was associated with increased mortality. A significant trend towards lesser mortality in hospitals with higher level trauma care was observed. The use of ALS by physicians was not associated with reduced mortality. However, ALS and the presence of a physician were significantly associated with increased pre-hospital time.

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Gardner, Lyndsay E. "Advanced Practitioner Provided Pre-Hospital Discharge Asthma Education." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2654.

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Asthma is a leading cause of pediatric hospital admissions. Parents of children under the age of 18 with asthma require education to recognize and manage the signs and symptoms of the disease. Parent education has shown to decrease their children's hospital admission and readmission rates. The purpose of this pilot project was to develop an asthma educational module for the parents of children with asthma and obtain parent feedback on the content. Families with children under the age of 18 who had been admitted to the hospital with a diagnosis of asthma, an asthma exacerbation, or status asthmaticus were invited to participate. A nurse practitioner provided three parents with information on the signs, symptoms, and medication management of asthma, as well as hands-on demonstration of inhaler use. Twenty-eight staff nurses provided verbal feedback on module content, including educational benefit and readability for parents. Parent and staff verbal feedback indicated the module was both a useful and effective tool for asthma education. Clinical leaders plan to expand the pilot study on two additional pediatric units using the same module used in the pilot program with intent to analyze readmission rates. The project promotes social change through parent empowerment to care for their child in the home environment.

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Kulmala, Louise, and Nina Bergqvist. "PATIENTENS UPPLEVELSE AV OMVÅRDNAD PRE-HOSPITALT." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-20264.

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Walters, Geraldine. "Strategies for dealing with pre-hospital cardiac arrest in London." Thesis, University of Surrey, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.305057.

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Whitley, Aaron, and Aaron Whitley. "Pre-Hospital Providers Use of Ketamine for Rapid Sequence Intubation." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/624581.

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Анотація:

Patients are injected with anesthetics to produce analgesia, amnesia, and arreflexia for many different reasons such as surgery, invasive procedures, and emergency interventions; one anesthetic induction technique is rapid sequence intubation (RSI). The RSI technique is performed to safely control the airway in patients needing immediate airway management. A particular induction anesthetic with increased use in the pre-hospital arena is ketamine. In October 2016, Ketamine was added to the RSI protocol of one pre-hospital organization whereby providers can use ketamine as an induction agent. Purpose. The purpose of this project is to determine if there is a relationship between pre-hospital providers (PHPs) choice of using ketamine to facilitate intubation and knowledge about the anesthetic agent in regards to the adult trauma patient. Setting. The setting to this project was a local pre-hospital organization located in Gilbert, Arizona. Participants. The participants of this project are PHPs who maintain an active national and Arizona Department of Health Services (AZDHS) certification as emergency medical technician-paramedics (EMT-P). Method. An online survey was disseminated that included questions regarding frequency of ketamine use, knowledge of ketamine as well as questions regarding their choice of induction agent. Results. The response rate was 32.3%. The majority of PHP's have greater than 10 years experience as a certified emergency paramedic (68.8%) and less than half (38.7%) of the certified emergency paramedics (CEP) have used ketamine for RSI. Of the respondents that have 10 used ketamine as an induction agent, the majority (66.0%) would choose ketamine over another induction agent. While the majority of respondents rate themselves as knowledgeable in the pharmacological profile of ketamine (93.8%), the majority has also had less than five hours of training on ketamine (59.4%). The overwhelming majority agreed that they would benefit from training on aspects of ketamine. Conclusion. The seasoned CEP's would choose ketamine over other induction agents for RSI of the adult patient. The choice to use ketamine is based upon self-reported pharmacological knowledge of the drug. The limited occurrence of RSI and use of ketamine supports continual training on the use of ketamine and the RSI technique.

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Gollan, Srisuda Siera. "A Mixed Methods Examination of Pre-Hospital Trauma Triage Decision Making." Thesis, Augusta University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10634622.

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The objective of pre-hospital trauma care is ensuring that the most severely injured persons are transported to the facility best suited to meet their complex needs (Fitzharris, Stevenson, Middleton, & Sinclair, 2011; Hoff, Tinkoff, Lucke, & Lehr, 1992; Leach et al., 2008; Sasser et al., 2012). To support pre-hospital decision making regarding trauma triage destination determinations, the Guidelines for Field Triage of Injured Patients decision scheme (FTDS) was developed as an algorithmic decision tool (Sasser et al., 2012). The purpose of this study was to examine pre-hospital trauma triage transport decision making by EMS providers from multiple perspectives. This study used a concurrent mixed methods triangulation design (QUAL+QUANT). Mixed methods included: (1) Grounded theory methodology to describe a model of decision making used by EMS providers to make trauma triage determinations and (2) quantitative analysis of secondary data to determine how the FTDS criteria are utilized by EMS providers. The FTDS criteria were also examined relative to trauma outcomes: level of trauma team activation (TTA), patient disposition when leaving the emergency department (ED), and the injury severity score (ISS). A model of Interpreting Trauma into Action was elucidated to describe the processes used by EMS providers. Pre-hospital providers based their trauma transport decisions on the perceived patient level of injury severity. The FTDS criteria were not explicitly used in this study region, but were interwoven into practice through employer policies and other training. The convergence of these findings indicated congruence between the model and trauma outcomes. The quantitative data indicated relationships (p<.05) between 12 of the 29 FTDS criteria and trauma outcomes. Both sources of evidence supported the relationships between the model of Interpreting Trauma into Action, the FTDS criteria, and specific trauma outcomes.

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Oliver, Chantal. "Haemodialysis water pre-treatment plant wireless monitoring system Royal Perth Hospital." Thesis, Oliver, Chantal (2012) Haemodialysis water pre-treatment plant wireless monitoring system Royal Perth Hospital. Other thesis, Murdoch University, 2012. https://researchrepository.murdoch.edu.au/id/eprint/10209/.

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Currently most of the remotely monitored equipment at Royal Perth Hospital is hardwired, but is gradually being replaced with wireless systems with the development of cheaper and more reliable solutions. This thesis tests and compares two wireless systems and analyses which one best fits Royal Perth Hospital’s requirements. Thorough testing and comparison was required because once installed, the selected solution was required to be the main monitoring system used in the future. From there the selected system was installed and commissioned within the Pre-Treatment Plant of Haemodialysis. Commissioning of the chosen software entailed configuring the manufacturers Web Server with required sensor settings, alarm limits and email addresses. In addition to the installation, this thesis briefly investigates the possibility of a fully automated chlorine analyser for the Pre-Treatment Plant. This would create an excellent long term logging solution with the nurses no longer needing to hand test chlorine levels each day. Although the Web Server satisfied the hospitals needs in the short term, a longer term solution needed to be found. Perl script was created to communicate from the Web Servers data tables to Royal Perth Hospitals’ server. This script was able to transfer all required data and pass it through to the new server, Fully Automated Nagios. This new script allows for improved data viewing, emailing capabilities, and longer term data storage. This thesis summarises the work required to install, commission and configure a system that monitors pressures, temperature and contact switches, as well as educate the reader on the development, implementation and testing of such a system. Since the Technical Services Division has an ISO 9001 accredited QA system, as required a large part of this thesis focused on the development of the project details, such as the development of wiring diagrams, server templates, comment logs, bill of materials and most importantly, the complete service and operator manuals. Through the research and development of this thesis it was found that the project could be used to monitor other wards and so could be repeated in the future within Royal Perth Hospital and possibly Western Australian Health.

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Книги з теми "Pre-hospital"

Lowes, Tim, Amy Gospel, Andrew Griffiths, and Jeremy Henning. Pre-Hospital Anesthesia Handbook. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-23090-0.

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Griffiths, Andrew, Tim Lowes, and Jeremy Henning. Pre-Hospital Anesthesia Handbook. London: Springer London, 2010. http://dx.doi.org/10.1007/978-1-84996-159-2.

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Griffiths, Andrew. Pre-Hospital Anesthesia Handbook. London: Springer-Verlag London Limited, 2010.

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Greaves, Ian, Keith Porter, and Chris Wright, eds. Trauma Care Pre-Hospital Manual. Boca Raton : CRC Press, 2018.: CRC Press, 2018. http://dx.doi.org/10.1201/9781315212821.

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Woollard, Malcolm, Kim Hinshaw, Helen Simpson, and Sue Wieteska, eds. Pre-Hospital Obstetric Emergency Training. Oxford, UK: Wiley-Blackwell, 2009. http://dx.doi.org/10.1002/9781444309805.

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Hodgetts, T. J. The pre-hospital emergency management master. London: BMJ, 1995.

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Greaves, Ian. Oxford handbook of pre-hospital care. Oxford: Oxford University Press, 2006.

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Welfare, Canada Health and. Pre-hospital emergency care services: Guidelines. Ottawa: Health and Welfare, 1985.

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Hodgetts, T. J. Trauma scoring: In pre-hospital care. Ipswich: British Association for Immediate Care, 1993.

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Ireland. Department of Health and Children., ed. Donegal pre-hospital emergency care project. [Ballyshannon]: Public Health Department, North Western Health Board, 1999.

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Частини книг з теми "Pre-hospital"

Macnab, Cara, and Peter F. Mahoney. "Pre-Hospital Planning." In Conflict and Catastrophe Medicine, 177–80. London: Springer London, 2002. http://dx.doi.org/10.1007/978-1-4471-0215-1_13.

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Katz, Laurence. "Pre-hospital Management." In Drowning, 777–79. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-04253-9_119.

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Greaves, Ian, Keith Porter, and Jeff Garner. "Pre-Hospital Care." In Trauma Care Manual, 33–46. 3rd ed. Boca Raton: CRC Press, 2021. http://dx.doi.org/10.1201/9781003197560-4.

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Herlitz, Johan, Leif Svensson, and Per Johansson. "The Pre-Hospital Electrocardiogram." In Specialized Aspects of ECG, 71–96. London: Springer London, 2011. http://dx.doi.org/10.1007/978-0-85729-880-5_2.

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Robertson, C. E., and D. J. Steedman. "Pre-hospital Trauma Care." In Update 1988, 485–88. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-83392-2_60.

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Wallace, Sarah K., and Benjamin S. Abella. "Pre-hospital Therapeutic Hypothermia." In Therapeutic Hypothermia After Cardiac Arrest, 15–24. London: Springer London, 2012. http://dx.doi.org/10.1007/978-1-4471-2951-6_2.

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Lowes, Tim, Amy Gospel, Andrew Griffiths, and Jeremy Henning. "Introduction." In Pre-Hospital Anesthesia Handbook, 1–21. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-23090-0_1.

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Lowes, Tim, Amy Gospel, Andrew Griffiths, and Jeremy Henning. "Indications and Decision Making." In Pre-Hospital Anesthesia Handbook, 23–33. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-23090-0_2.

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Lowes, Tim, Amy Gospel, Andrew Griffiths, and Jeremy Henning. "Pre-hospital Rapid Sequence Intubation (PRSI)." In Pre-Hospital Anesthesia Handbook, 35–83. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-23090-0_3.

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Lowes, Tim, Amy Gospel, Andrew Griffiths, and Jeremy Henning. "Crew Resource Management (CRM)." In Pre-Hospital Anesthesia Handbook, 85–98. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-23090-0_4.

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Тези доповідей конференцій з теми "Pre-hospital"

Ji, Rumei, Min Xu, and Xiaoning Zhang. "Pre-Hospital Patient Dispatch Optimization Model During a Pandemic." In 2024 International Conference on Automation in Manufacturing, Transportation and Logistics (ICaMaL), 1–6. IEEE, 2024. https://doi.org/10.1109/icamal62577.2024.10919826.

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Hu, Xifeng, Jingchuan Wang, Wenmiao Wang, Lei Shi, Xiaoyun Yang, Weifeng Hu, Zhi Liu, and Yujun Li. "Multi-dimensional Spatio-temporal Prediction Network for Pre-hospital Emergency Care." In 2024 IEEE International Conference on Bioinformatics and Biomedicine (BIBM), 1513–16. IEEE, 2024. https://doi.org/10.1109/bibm62325.2024.10822423.

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Li, Xiaocui, Junfeng Zhao, Yasha Wang, Liantao Ma, Junyi Ma, Xin Gao, and Jinhui Zhang. "HealthEdge: A Proactive DRL-Driven Service Reconfiguration Mechanism for Pre-Hospital Emergency Response in Edge Networks." In 2024 IEEE International Conference on Digital Health (ICDH), 237–43. IEEE, 2024. http://dx.doi.org/10.1109/icdh62654.2024.00046.

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Li, Jiexun, Lifan Guo, and Neal Handly. "Hospital Admission Prediction Using Pre-hospital Variables." In 2009 IEEE International Conference on Bioinformatics and Biomedicine (BIBM). IEEE, 2009. http://dx.doi.org/10.1109/bibm.2009.45.

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Sarlan, Aliza, Foo Kian Xiong, Rohiza Ahmad, Wan Fatimah Wan Ahmad, and Ena Bhattacharyya. "Pre-hospital emergency notification system." In 2015 International Symposium on Mathematical Sciences and Computing Research (iSMSC). IEEE, 2015. http://dx.doi.org/10.1109/ismsc.2015.7594047.

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White, Gus Redhouse, Sophie Coates, Sarah Johnson, Stephanie Milne, Emily Reilly, Caitlin Sheehy, and Michael Malley. "485 Improving pre-hospital paediatric care through multidisciplinary feedback: bridging the gap between pre-hospital and hospital care." In Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference, Glasgow, 23–25 May 2023. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2023. http://dx.doi.org/10.1136/archdischild-2023-rcpch.21.

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Lee, Minjung, Eun Jung Kwon, and Hyunho Park. "Development of an Explainable Pre-Hospital Emergency Prediction Model for Acute Hospital Care." In 15th International Conference on Applied Human Factors and Ergonomics (AHFE 2024). AHFE International, 2024. http://dx.doi.org/10.54941/ahfe1004646.

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Анотація:

This study introduces an eXplainable Artificial Intelligence (XAI) designed to predict which emergency patients require acute hospital care in pre-hospital phase and provide explanations for its reasoning. Emergency medical care is broadly divided into two stages: pre-hospital and in-hospital stages. Various information gathered during the emergency activities performed by paramedics in the pre-hospital stage and while transporting patients is crucial in describing the emergency patient’s condition. However, key pre-hospital information, important for the in-hospital medical care of emergency patients, is filtered based on the ambiguous memory of the paramedics, and is verbally shared in a condensed form via phone or radio when transmitted to the hospital. To address this issue, we have developed a model that predicts emergency patients based on pre-hospital information integrating an ensemble model and advanced XAI techniques. This proposed model not only predicts emergency situations requiring acute hospital care but also ensures the model's predictive processes remain transparent and interpretable for medical professionals, addressing the critical need for an information linkage system between the pre-hospital and in-hospital phases.

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Persson, Mikael, Jasila Prabahar Andreas Fhager, Yinan Yu, Tomas McKelvey, Jan-Erik Karlsson, and Mikael Elam. "Pre-hospital care for stroke and trauma." In 2014 IEEE MTT-S International Microwave Workshop Series on RF and Wireless Technologies for Biomedical and Healthcare Applications (IMWS-BIO). IEEE, 2014. http://dx.doi.org/10.1109/imws-bio.2014.7032429.

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Du, Max. "A Novel Pre-Hospital Indoor Rescue Drone." In 2023 IEEE Integrated STEM Education Conference (ISEC). IEEE, 2023. http://dx.doi.org/10.1109/isec57711.2023.10402323.

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Gaynor, Mark, Dan Myung, Raj Patel, and Steve Moulton. "Human Computer Interaction in the Pre-Hospital Setting." In 2007 40th Annual Hawaii International Conference on System Sciences (HICSS'07). IEEE, 2007. http://dx.doi.org/10.1109/hicss.2007.252.

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Звіти організацій з теми "Pre-hospital"

Ciapponi, Agustín. Do pre-hospital trauma systems reduce mortality? SUPPORT, 2017. http://dx.doi.org/10.30846/170512.

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Анотація:

The majority of trauma deaths in low and middle income countries occur outside of hospitals. Improving pre hospital trauma care, such as emergency care through first responders and timely transport to an appropriate facility, has been suggested as a mechanism for reducing mortality and morbidity.

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Solomon, Morton, Kendall Bryant, George Moeller, Bernard Ryack, and David Southerland. A Severity of Illness Index for Evaluation Pre-Hospital Care of Submariners with Abdominal Pain. Fort Belvoir, VA: Defense Technical Information Center, August 1988. http://dx.doi.org/10.21236/ada199233.

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Schloss, Howard E. Pre-Admission Patient Treatment Times in The Emergency Room Silas Beach Hays Army Community Hospital. Fort Belvoir, VA: Defense Technical Information Center, August 1992. http://dx.doi.org/10.21236/ada261660.

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Ndwiga, Charity, Alfred Osoti, Pooja Sripad, George Odwe, Omondi Ogutu, and Charlotte Warren. Retrospective cohort study: Clinical presentation and outcomes of pre-eclampsia and eclampsia at Kenyatta National Hospital, Nairobi, Kenya. Population Council, 2018. http://dx.doi.org/10.31899/rh11.1012.

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Kinkler, Jr, Convertino E. S., Gordon Victor A., Holcomb Donald J., Salinas John B., and Jose. Continuous Pre-hospital Data as a Predictor of Outcome Following Major Trauma: A Study Using Improved and Expanded Data. Fort Belvoir, VA: Defense Technical Information Center, September 2008. http://dx.doi.org/10.21236/ada578482.

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Kinkler, Jr, Convertino Ernest S., Gordon Victor A., Holcomb Donald J., Salinas John B., and Jose. Continuous Pre-Hospital Data as a Predictor of Outcome Following Major Trauma: A Study Using Improved and Expanded Data. Fort Belvoir, VA: Defense Technical Information Center, June 2005. http://dx.doi.org/10.21236/ada460773.

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Pu, Fenglan, Tianli Li, Yingqiao Wang, Chunmei Tang, Chen Shen, and Jianping Liu. Cordyceps preparations for preventing contrast-induced nephropathy: A protocol of systematic review of randomized controlled trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, June 2022. http://dx.doi.org/10.37766/inplasy2022.6.0098.

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Review question / Objective: To systematically evaluate the efficacy and safety of cordyceps preparations as a complementary preventive therapy for Contrast-induced nephropathy (CIN). Condition being studied: At present, contrast agents are widely used in diagnostic and interventional radiology examinations worldwide. However, they can affect kidney function and cause a risk of renal impairment. Contrast-induced nephropathy (CIN) is defined as a rise in serum creatinine (SCr) levels by ≥ 25% of baseline or 44 µmol/l from the pre-contrast value within 72 h of intravascular administration of a contrast agent in the absence of an alternative etiology. The incidence of CIN varies widely among studies depending on study population and baseline risk factors, as for high-risk groups such as pre-existing renal insufficiency, diabetes, advanced age, or receiving nephrotoxic agents, the incidence is up to 30–50%. To date, CIN has been the third most common cause of hospital-acquired renal failure, after impaired renal perfusion and nephrotoxic medications, which can lead to longer hospital stay, increased costs and higher mortality.

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W, Nedra, Laura B. Strange, Sara M. Kennedy, Katrina D. Burson, and Gina L. Kilpatrick. Completeness of Prenatal Records in Community Hospital Charts. RTI Press, February 2018. http://dx.doi.org/10.3768/rtipress.2018.rr.0032.1802.

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We describe the completeness of prenatal data in maternal delivery records and the prevalence of selected medical conditions and complications among patients delivering at community hospitals around Atlanta, Georgia. Medical charts for 199 maternal-infant dyads (99 infants in normal newborn nurseries and 104 infants in newborn intensive care nurseries) were identified by medical records staff at 9 hospitals and abstracted on site. Ninety-eight percent of hospital charts included prenatal records, but over 20 percent were missing results for common laboratory tests and prenatal procedures. Forty-nine percent of women had a pre-existing medical condition, 64 percent had a prenatal complication, and 63 percent had a labor or delivery complication. Missing prenatal information limits the usefulness of these records for research and may result in unnecessary tests or procedures or inappropriate medical care.

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Aranco, Natalia, Sebastian Bauhoff, Natalie Vanessa Schwarz, and Marco Stampini. Are Long Hospitalizations Substituting Primary and Long-term Care?: Evidence from Brazil and Mexico. Inter-American Development Bank, August 2024. http://dx.doi.org/10.18235/0013126.

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Prolonged hospital stays, or hospital stays that are longer than medically necessary, are a major concern for patients, payers, and providers. We conceptualize and empirically estimate the prevalence and cost of prolonged stays among elderly hospital patients (65 years and older) in Brazil and Mexico. We develop a continuum-of-care conceptual framework based on prior literature and insights obtained through interviews and focus group discussions with experts from Mexico, Argentina, and Colombia. In this framework, hospitals are part of a wider system. This system involves both pre-admission and post-discharge medical and social care services. There are three main sources of prolonged stays: (i) lack of appropriate primary healthcare that leads to more complex admissions; (ii) hospital inefficiency; and (iii) lack of rehabilitation, social, and long-term care at discharge. We estimate the count and share of inappropriate hospital days due to prolonged stays overall and for each source. This estimation is based on administrative records on discharges from public sector hospitals in 2019. Our results show that hospital days due to prolonged stays account for approximately half of all hospital days. Although most of the inappropriate days can be attributed to hospital inefficiency (36% in Brazil and 49% in Mexico), an important share is linked to the lack of rehabilitation, social, and long-term care. Lack of these services accounts for 12% of total hospital days in Brazil and 7% in Mexico. In a back-of-the-envelope calculation, we estimate that providing six weeks of long-term care services to address the care needs brought about by only thirteen causes of admission would generate annual net savings of approximately US$174 million per year in Brazil and US$45 million in Mexico.

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Moore, Gabriel, Anton du Toit, Susie Thompson, and Jillian Hutchinson. Effectiveness of secondary triage models for residents of aged care facilities. The Sax Institute, March 2021. http://dx.doi.org/10.57022/uvfy9478.

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This Evidence Snapshot provides a rapid review of the evidence around the effectiveness of secondary triage models for residents of aged care facilities. Models analysed included those with or without medical support, those with additional intervention in the residential aged care facilities (RACFs), and those with referral to vs collaboration with alternative services. Outcomes included were ED presentations, hospital admissions and ambulance demand. While the strength of the overall evidence is low, the strongest evidence was found for interventions in RACFs and a community-based early pre-hospital assessment model. The authors also looked at other outcomes of interest including cost-effectiveness; staffing, training and qualifications; and resident and patient participation in decision-making.

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