3,140 results match your criteria Labor and Delivery in the Emergency Department


User centered clinical decision support to implement initiation of buprenorphine for opioid use disorder in the emergency department: EMBED pragmatic cluster randomized controlled trial.

BMJ 2022 Jun 27;377:e069271. Epub 2022 Jun 27.

Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA.

Objective: To determine the effect of a user centered clinical decision support tool versus usual care on rates of initiation of buprenorphine in the routine emergency care of individuals with opioid use disorder.

Design: Pragmatic cluster randomized controlled trial (EMBED).

Setting: 18 emergency department clusters across five healthcare systems in five states representing the north east, south east, and western regions of the US, ranging from community hospitals to tertiary care centers, using either the Epic or Cerner electronic health record platform. Read More

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Frequency of unscheduled visits to the Obstetrical Triage Assessment unit by pregnant adolescents in an urban Canadian Center compared to a matched cohort of pregnant women.

J Obstet Gynaecol Can 2022 Jun 22. Epub 2022 Jun 22.

Division of Pediatric and Adolescent Gynecology, Department of Surgery, Children's Hospital of Eastern Ontario; University of Ottawa, Department of Obstetrics and Gynecology, Ottawa, Canada; Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.

Objectives: People from marginalized and vulnerable populations present more frequently for unscheduled, emergency obstetrical services at labour and delivery triage units. Based on our clinical experience, pregnant adolescents visit the obstetrical triage assessment units (OTAU) more often than adults do. This study was designed to assess this phenomenon by quantifying and describing the frequency of unscheduled visits to the OTAU by pregnant adolescents (age <20 y) compared with a matched cohort of adult pregnant patients (age ≥20 y). Read More

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Intubation Rate Evaluation of Inborn Versus Outborn Premature Newborns Affected by Respiratory Distress Syndrome: Impact of Neonatal Transport.

Air Med J 2022 Jul-Aug;41(4):346-349. Epub 2022 May 28.

Neonatal Intensive Care Unit, Neonatal Emergency Transport Service, Department Mother and Child, Istituto di Ricovero e Cura a Carattere Scientifico Gaslini Hospital, Genoa, Italy. Electronic address:

Objective: The aim of this study was to compare the management of preterm newborns with respiratory distress both in the delivery room and during transportation.

Methods: We retrospectively evaluated the intubation rate in preterm newborns (inborn vs. outborn), gestational age (GA) < 34 weeks, admitted to the Gaslini neonatal intensive care unit, Genoa, Italy (January 2019-December 2020). Read More

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The Value of Fetal Head Station as a Delivery Mode Predictor in Primiparous Women at Term before the Onset of Labor.

J Clin Med 2022 Jun 8;11(12). Epub 2022 Jun 8.

Department of Obstetrics and Gynecology, University Emergency County Hospital Craiova, 200642 Craiova, Romania.

Objective: Our objective was to demonstrate the role of the clinical determination of fetal head station (FHS) at term to predict the delivery mode in primiparous women before the onset of labor.

Methods: This prospective study included unselected primiparous women at term who presented at our tertiary maternity. We excluded multiparous patients, pregnancies with a planned Cesarean section, non-cephalic presentations, and multiple pregnancies. Read More

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Evaluation of Waste Related to the Admission Process of Low-Complexity Patients in Emergency Services, in Light of the Lean Healthcare Philosophy.

Int J Environ Res Public Health 2022 Jun 8;19(12). Epub 2022 Jun 8.

School of Nursing, University of Campinas, Campinas 13083-887, Brazil.

The adequacy of work processes in healthcare services contributes to the quality of care provided to the patient. However, in emergency units, overcrowding is a constant reality, resulting in the lack of materials and long waiting lines. Taking this into consideration, this study aimed to map and analyze the value stream of patients classified as blue, green, or yellow in a Referral Emergency Unit. Read More

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Maternal childbirth experience and induction of labour in each mode of delivery: a retrospective seven-year cohort study of 95,051 parturients in Finland.

BMC Pregnancy Childbirth 2022 Jun 23;22(1):508. Epub 2022 Jun 23.

University of Helsinki and Helsinki University Hospital, Obstetrics and Gynecology, Helsinki, Finland.

Background: Childbirth experience has been shown to depend on the mode of delivery. However, it is unclear how labour induction influences the childbirth experience in different modes of delivery. Thus, we assessed the childbirth experience among mothers with spontaneous and induced labours. Read More

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Childbirth experience, risk of PTSD and obstetric and neonatal outcomes according to antenatal classes attendance.

Sci Rep 2022 Jun 23;12(1):10717. Epub 2022 Jun 23.

Department Woman-Mother-Child, Lausanne University Hospital (CHUV), Avenue Pierre-Decker 2, 1011, Lausanne, Switzerland.

Antenatal classes have evolved considerably and include now a discussion of the parents' birth plan. Respecting this plan normally results in a better childbirth experience, an important protective factor of post-traumatic stress disorder following childbirth (PTSD-FC). Antenatal class attendance may thus be associated with lower PTSD-FC rates. Read More

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Consensus recommendations for opioid agonist treatment following the introduction of emergency clinical guidelines in Ireland during the COVID-19 pandemic: A national Delphi study.

Int J Drug Policy 2022 Jun 16;106:103768. Epub 2022 Jun 16.

School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland, First Floor, Ardilaun House (Block B), 111 St Stephen's Green, Dublin 2, D02 VN51, Ireland. Electronic address:

Background: Emergency contingency guidelines for opioid agonist treatment (OAT) were introduced in Ireland in March 2020, to ensure rapid and uninterrupted access to treatment while mitigating COVID-19 risk. The contingency guidelines deviated, across multiple clinical domains, from pre-pandemic clinical guidelines published in 2016. The objectives of this study are to (1) identify changes introduced to OAT clinical guidelines in Ireland during the pandemic; and (2) develop consensus on whether the new recommendations should be retained beyond the pandemic, using a national Delphi consensus methodology. Read More

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Healthcare professionals' experiences and attitudes to care coordination across health sectors: an interview study.

BMC Geriatr 2022 Jun 21;22(1):509. Epub 2022 Jun 21.

Department of Public Health, University of Southern Denmark, Degnevej 14, 6705, Esbjerg, Denmark.

Background: The number of older people is increasing, resulting in more people endure chronic diseases, multimorbidities and complex care needs. Insufficient care coordination across healthcare sectors has negative consequences for health outcomes, costs and patient evaluation. Despite introducing initiatives to solve coordination challenges within healthcare, the need remains for more consistent solutions. Read More

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Tranexamic Acid for the Prevention of Blood Loss after Cesarean Among Women With Twins. A Secondary Analysis of the TRAAP2 Randomized Clinical Trial.

Am J Obstet Gynecol 2022 Jun 17. Epub 2022 Jun 17.

Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France.

Background: Although prophylactic tranexamic acid administration at cesarean delivery resulted in a lower incidence of calculated estimated blood loss > 1000 mL or red-cell transfusion by day 2, its failure to reduce the incidence of hemorrhage-related secondary clinical outcomes (TRAAP2 trial) makes its use questionable. The magnitude of its effect may differ in women at higher risk of blood loss, including those with multiple pregnancies.

Objective: To compare the effect of tranexamic acid vs placebo to prevent blood loss at cesarean delivery among women with multiple pregnancies. Read More

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The organization and impacts of clinical research delivery workforce redeployment during the COVID-19 pandemic: a qualitative case study of one research-intensive acute hospital trust.

Health Res Policy Syst 2022 Jun 18;20(1):68. Epub 2022 Jun 18.

King's College London, London, UK.

Background: COVID-19 has tested healthcare and research systems around the world, forcing the large-scale reorganization of hospitals, research infrastructure and resources. The United Kingdom has been singled out for the speed and scale of its research response. The efficiency of the United Kingdom's research mobilization was in large part predicated on the pre-existing embeddedness of the clinical research system within the National Health Service (NHS), a public, free-at-point-of-delivery healthcare system. Read More

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Current status and high-risk factors of blood-borne occupational exposure among midwives in China: A cross-sectional survey.

Am J Infect Control 2022 Jun 12. Epub 2022 Jun 12.

Medical Record Statistics Department, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.

Background: To identify the problems and high-risk factors of blood-borne occupational exposure among midwives in China.

Methods: Midwives from the obstetrics department and delivery room of hospitals in institutions. The self-compiled questionnaire on the current status of blood-borne occupational exposure of Chinese midwives was used for data collection. Read More

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Implementing PrEP Services in Diverse Health Care Settings.

J Acquir Immune Defic Syndr 2022 Jul;90(S1):S114-S128

Departments of Pediatrics and Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Bronx, NY.

Background: Uptake of pre-exposure prophylaxis (PrEP) in the US has been limited. Evidence for why and how PrEP has been successfully integrated into some clinical settings, but not in others is minimal. To address this gap, we conducted a qualitative study to identify contextual factors that facilitated and challenged the implementation of PrEP services. Read More

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Development and Pilot Randomized Trial of a Coping Skills Intervention for Low-SES Latinx Families of Children with Asthma.

Clin Pract Pediatr Psychol 2022 Jun 28;10(2):115-127. Epub 2021 Oct 28.

Department of Educational Psychology, University of Texas at Austin, 1912 Speedway, Stop D5000, Austin, TX 78712.

Objective: Psychosocial stress contributes to asthma disparities for low-SES Latinx children, but primary and secondary control coping by children and parents is associated with better psychosocial and asthma outcomes. Therefore, we developed and pilot tested (A2A), a family-based coping and asthma self-management intervention for low-SES Latinx families.

Methods: Children, parents, and primary care providers (N=16) participated in five focus groups to refine A2A's content and delivery. Read More

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Near-fatal pediatric methemoglobinemia secondary to intentional sodium nitrite ingestion: A case report.

Am J Emerg Med 2022 May 31. Epub 2022 May 31.

Department of Pediatrics (Division of Emergency Medicine), University of Alberta, Canada.

Methemoglobinemia is the result of inappropriate oxidation of hemoglobin iron groups, leading to a failure of oxygen transport and delivery, resulting in a clinical state of refractory hypoxia. Methemoglobin levels above 70% are often considered fatal. Acquired methemoglobinemia can be caused by a variety of substances, including sodium nitrite, a commercially available food preservative and color fixative. Read More

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Impact of multicomponent integrated care on mortality and hospitalization after acute coronary syndrome: a systematic review and meta-analysis.

Eur Heart J Qual Care Clin Outcomes 2022 Jun 10. Epub 2022 Jun 10.

Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Aims: Multicomponent integrated care is associated with sustained control of multiple cardiometabolic risk factors among patients with type 2 diabetes. There is a lack of data in patients with acute coronary syndrome (ACS). We aimed to examine its efficacy on mortality and hospitalization outcomes among patients with ACS in outpatient settings. Read More

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Obstetric Anesthesia Practice in the Tertiary Care Center: A 7-Year Retrospective Study and the Impact of the COVID-19 Pandemic on Obstetric Anesthesia Practice.

J Clin Med 2022 Jun 2;11(11). Epub 2022 Jun 2.

Department of Obstetrics and Gynecology, Jagiellonian University Medical College, Kopernika 23, 31-501 Cracow, Poland.

There are many benefits of neuraxial anesthesia (NA) in the obstetric population. We performed a retrospective analysis of anesthesia provided to obstetric patients in the tertiary care center between 1 January 2014 and 31 December 2020 and the influence of the COVID-19 pandemic on anesthetic practice. A total of 15,930 anesthesia procedures were performed. Read More

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Assessment of electrocardiogram interpretation competency among healthcare professionals and students of Ardabil University of Medical Sciences: a multidisciplinary study.

BMC Med Educ 2022 Jun 9;22(1):448. Epub 2022 Jun 9.

Faculty of Medicine & Paramedical, Ardabil University of Medical Sciences, Ardabil, Iran.

Background: Electrocardiogram (ECG) interpretation is a core clinical skill that helps to rapid diagnosis of potentially life-threatening diseases. Misinterpretation of the electrocardiogram can lead to inappropriate clinical decisions with adverse outcomes. The main aim of this survey was to assess the competency of electrocardiogram interpretation and related factors among healthcare professionals and students of Ardabil University of Medical Sciences. Read More

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Shared Decision-Making for Patients Hospitalized with Acute Myocardial Infarction: A Randomized Trial.

Patient Prefer Adherence 2022 1;16:1395-1404. Epub 2022 Jun 1.

Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.

Objective: Adherence to guideline-recommended medications after acute myocardial infarction (AMI) is suboptimal. Patient fidelity to treatment regimens may be related to their knowledge of the risk of death following AMI, the pros and cons of medications, and to their involvement in treatment decisions. Shared decision-making may improve both patients' knowledge and involvement in treatment decisions. Read More

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Length of Hospital Stay After Cesarean Delivery and Its Determinants Among Women in Eastern Sudan.

Int J Womens Health 2022 31;14:731-738. Epub 2022 May 31.

Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.

Background: There is an increasing caesarean delivery (CD) rate globally. Length of hospital stay (LoS) is longer in CD compared with vaginal delivery. There are few published data on LoS following CD in Africa, including Sudan. Read More

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Evaluation of an EMS-Based Community Paramedic Pilot Program to Reduce Frequency of 9-1-1 Calls among High Utilizers.

Prehosp Emerg Care 2022 Jun 27:1-8. Epub 2022 Jun 27.

Allina Health Emergency Medical Services, St. Paul, Minnesota, USA.

Background: Many community paramedic interventions aim to reduce unnecessary emergency department visits among high utilizers of acute care, but fewer focus specifically on reducing summons for emergency medical services (EMS). We implemented an EMS-based pilot program that identified high utilizers of 9-1-1 and facilitated community paramedic outreach encounters to understand and address potentially unnecessary 9-1-1 calls. This study compares the pre- and post-intervention incidence rate of 9-1-1 calls among program participants. Read More

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From stretcher bearer to practitioner: A brief narrative review of the history of the Anglo-American paramedic system.

Australas Emerg Care 2022 Jun 2. Epub 2022 Jun 2.

Department of Paramedicine, School of Primary and Allied Health Care, Faculty of Medicine, Nursing & Health Science, Monash University, Clayton, Australia.

Background: This narrative review presents a brief chronological history of the Anglo-American paramedic system, combining decades of stories from across ambulance services in western, English-speaking developed countries METHODS: Databases, including Embase, MEDLINE, Web of Science, CINAHL and Google Scholar were searched from the inception of the databases. A grey literature search strategy was conducted to identify non-indexed relevant literature along with forwards and backwards searching of citations and references of included studies. Two reviewers undertook title and abstract screening, followed by full-text screening. Read More

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Medical students' learning experience and participation in communities of practice at municipal emergency care units in the primary health care system: a qualitative study.

BMC Med Educ 2022 Jun 2;22(1):427. Epub 2022 Jun 2.

Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Ålesund, Norway.

Background: Medical education has been criticised for not adapting to changes in society, health care and technology. Internationally, it is necessary to strengthen primary health care services to accommodate the growing number of patients. In Norway, emergency care patients are increasingly treated in municipal emergency care units in the primary health care system. Read More

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Telehealth as a Means of Enabling Health Equity.

Yearb Med Inform 2022 Jun 2. Epub 2022 Jun 2.

School of Health Sciences, University of Canterbury, New Zealand.

Objective: The goal of this paper is to provide a consensus review on telehealth delivery prior to and during the COVID-19 pandemic to develop a set of recommendations for designing telehealth services and tools that contribute to system resilience and equitable health.

Methods: The IMIA-Telehealth Working Group (WG) members conducted a two-step approach to understand the role of telehealth in enabling global health equity. We first conducted a consensus review on the topic followed by a modified Delphi process to respond to four questions related to the role telehealth can play in developing a resilient and equitable health system. Read More

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The evaluation of maternal systemic thiol/disulphide homeostasis for the short-term prediction of preterm birth in women with threatened preterm labour: a pilot study.

J Obstet Gynaecol 2022 Jun 1:1-6. Epub 2022 Jun 1.

Department of Obstetrics and Gynecology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.

The aim of this study was to investigate maternal systemic thiol/disulphide homeostasis (TDH) for the short-term prediction of preterm birth in women with threatened preterm labour (TPL). This prospective study included 75 pregnant women whose pregnancies were complicated by TPL. Thirty-seven of them delivered within 7 days and 38 of them delivered beyond 7 days. Read More

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Investigation and analysis of occupational physical injuries among healthcare staffs during allopatric medical aid for the fight against COVID-19.

Med Pr 2022 Jun 27;73(3):209-218. Epub 2022 May 27.

The Second Hospital of Shanxi Medical University, Taiyuan, China (Department of Vascular Surgery).

Background: Occupational health impairment of medical personnel manifested as a prominent problem in COVID-19. The aim of this study is to investigate the occupational physical injuries of front-line medical staffs in Hubei province during the fight against COVID-19.

Material And Methods: questionnaire survey was conducted among 476 medical staffs from 3 regions of Hubei Province, including general characteristics and the physical discomfort/damage suffered in the isolation wards during working hours. Read More

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A prospective cohort study of the relationship of female genital mutilation with birth outcomes in Somalia.

BMC Womens Health 2022 05 31;22(1):202. Epub 2022 May 31.

Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Background: Female genital mutilation (FGM) is defined as the partial or complete removal of the external female genitalia for non-medical reasons. There are some complications related to childbirth that concern both the mother and the baby. In this study, we aimed to evaluate the birth outcomes of FGM, which is widely applied in Somalia. Read More

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Resilience of Healthcare Systems in the face of COVID-19: an experience report.

Rev Esc Enferm USP 2022 27;56:e20210210. Epub 2022 May 27.

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil.

Objective: to report the professional experience of a nurse manager facing the challenges of restructuring a hospital service in the face of the COVID-19 pandemic.

Method: this is an experience report, based on the perspective of system resilience in a public hospital.

Results: the challenges faced were: internal service flow reorganization to assist suspected cases of COVID-19; institution of structural changes and adaptations, from entry into the emergency room to the wards and intensive care unit; equipment and supply acquisition for patient care with a focus on their quality and functionality; staff training, with the restructuring of work processes; staff sizing, considering the time of exposure to the virus; staff's professional qualification, absenteeism, stress, physical and psychological illness, with a view to safe and quality care; nursing staff leadership to deal with conflicts generated by professionals' stress and illness. Read More

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Emergency medical services in rural and urban Saudi Arabia: A qualitative study of Red Crescent emergency personnel' perceptions of workforce and patient factors impacting effective delivery.

Health Soc Care Community 2022 May 30. Epub 2022 May 30.

Faculty of Medicine and Health, School of Rural Medicine, University of New England, Armidale, New South Wales, Australia.

Individuals who experience a traumatic injury or an acute illness are often reliant on initial healthcare assessment and support from a pre-hospital emergency medical service (EMS). These community-based support models perform a vital role in the provision of life-saving support, but research indicates that the availability, accessibility and resources of EMS are not equivalent in rural and urban areas, and there has been little recognition of the issues facing rural EMS provision outside of the USA, Europe and Australia. The purpose of the current study was to examine the lived experiences of Saudi Arabian EMS personnel, defined as emergency medical technicians, paramedics and local station managers. Read More

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