scholarly journals Profil Kegawatdaruratan Pasien Berdasarkan Start Triage Scale di Instalasi Gawat Darurat RSUP Prof. Dr. R. D. Kandou Manado Periode Januari 2018 sampai Juli 2018

e-CliniC ◽  
2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Muhammad F. Bazmul ◽  
Eka Y. Lantang ◽  
Barry I. Kambey

Abstract: Emergency Department provides first emergency services to patients with threats of death and disability in an integrated manner involving multi disciplines. Patients who come to the Emergency Department are always assessed as 3 priorities, namely priorities 1, 2 and 3. Priority 1 is case/disease with life-threatening emergency or severe emergency; Priority 2 is case/disease with mild emergency; and Priority 3 is non-emergency case/disease. This study was aimed to obtain the Triage profile of patients at Emergency Department of Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective descriptive study using patients’ medical records. Samples were all patients treated at the Emergency Department of Prof. Dr. R. D. Kandou Hospital from January 2018 until July 2018. The results showed that there were 19,229 patients as samples. Based on sex, most patients were male, meanwhile based on age most were 51-70 years, with the highest number of patients in March 2018. There were 6,913 patients (35.9%) in the orange or emergency category (Priority 2) and 6,130 patients (31.8%) in the yellow category (Priority 3). Conclusion: Based on the Start Triage in Emergency Department, the majority of patients were in Priority 2 category, followed by Priority 3 category.Keywords: Emergency Department, Start Triage Abstrak: Instalasi Gawat Darurat (IGD) memberikan pelayanan pertama yang bersifat emergency pada pasien dengan ancaman kematian dan kecacatan secara terpadu dengan melibatkan multi disiplin ilmu. Pasien yang datang di IGD selalu dinilai kegawatannya menja-di 3 prioritas, yaitu prioritas 1, 2, dan 3. Prioritas 1 yaitu kasus/penyakit dengan kegawat-daruratan yang mengancam jiwa atau gawat darurat berat. Prioritas 2 untuk kasus/penyakit dengan gawat darurat ringan. Prioritas 3 untuk kasus/penyakit yang bukan gawat darurat. Penelitian ini bertujuan untuk mengetahui profil skala Triase pasien yang masuk di IGD RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif-retrospektif, menggunakan data rekam medis pasien. Sampel penelitian ialah seluruh pasien yang dirawat di IGD RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2018 sampai Juli 2018. Hasil penelitian mendapatkan data pasien yang masuk ke Ruang IGD RSUP Prof. Dr. R. D. Kandou Manado terhitung sejak Januari hingga Juli 2018 sebanyak 19.229 orang. Distribusi pasien terbanyak berdasarkan jenis kelamin ialah laki-laki, dan berdasarkan usia ialah 51-70 tahun, dengan jumlah pasien terbanyak pada bulan Maret 2018. Pasien IGD terbanyak ialah kategori jingga yaitu emergency (Prioritas 2) berjumlah 6.913 orang (35,9%) serta kategori kuning (Prioritas 3) berjumlah 6.130 orang (31,8%). Simpulan: Berdasarkan skala Triase di IGD, pasien terbanyak ialah Prioritas 2, disusul dengan Prioritas 3.Kata kunci : Instalasi Gawat Darurat, skala Triase

e-CliniC ◽  
2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Muhammad F. Bazmul ◽  
Eka Y. Lantang ◽  
Barry I. Kambey

Abstract: Emergency Department provides first emergency services to patients with threats of death and disability in an integrated manner involving multi disciplines. Patients who come to the Emergency Department are always assessed as 3 priorities, namely priorities 1, 2 and 3. Priority 1 is case/disease with life-threatening emergency or severe emergency; Priority 2 is case/disease with mild emergency; and Priority 3 is non-emergency case/disease. This study was aimed to obtain the Triage profile of patients at Emergency Department of Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective descriptive study using patients’ medical records. Samples were all patients treated at the Emergency Department of Prof. Dr. R. D. Kandou Hospital from January 2018 until July 2018. The results showed that there were 19,229 patients as samples. Based on sex, most patients were male, meanwhile based on age most were 51-70 years, with the highest number of patients in March 2018. There were 6,913 patients (35.9%) in the orange or emergency category (Priority 2) and 6,130 patients (31.8%) in the yellow category (Priority 3). Conclusion: Based on the Start Triage in Emergency Department, the majority of patients were in Priority 2 category, followed by Priority 3 category.Keywords: Emergency Department, Start Triage Abstrak: Instalasi Gawat Darurat (IGD) memberikan pelayanan pertama yang bersifat emergency pada pasien dengan ancaman kematian dan kecacatan secara terpadu dengan melibatkan multi disiplin ilmu. Pasien yang datang di IGD selalu dinilai kegawatannya menja-di 3 prioritas, yaitu prioritas 1, 2, dan 3. Prioritas 1 yaitu kasus/penyakit dengan kegawat-daruratan yang mengancam jiwa atau gawat darurat berat. Prioritas 2 untuk kasus/penyakit dengan gawat darurat ringan. Prioritas 3 untuk kasus/penyakit yang bukan gawat darurat. Penelitian ini bertujuan untuk mengetahui profil skala Triase pasien yang masuk di IGD RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif-retrospektif, menggunakan data rekam medis pasien. Sampel penelitian ialah seluruh pasien yang dirawat di IGD RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2018 sampai Juli 2018. Hasil penelitian mendapatkan data pasien yang masuk ke Ruang IGD RSUP Prof. Dr. R. D. Kandou Manado terhitung sejak Januari hingga Juli 2018 sebanyak 19.229 orang. Distribusi pasien terbanyak berdasarkan jenis kelamin ialah laki-laki, dan berdasarkan usia ialah 51-70 tahun, dengan jumlah pasien terbanyak pada bulan Maret 2018. Pasien IGD terbanyak ialah kategori jingga yaitu emergency (Prioritas 2) berjumlah 6.913 orang (35,9%) serta kategori kuning (Prioritas 3) berjumlah 6.130 orang (31,8%). Simpulan: Berdasarkan skala Triase di IGD, pasien terbanyak ialah Prioritas 2, disusul dengan Prioritas 3.Kata kunci : Instalasi Gawat Darurat, skala Triase


Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.


2019 ◽  
Vol 27 (4) ◽  
pp. 369-373
Author(s):  
Bernard M Chivaurah ◽  
David Lienert ◽  
Dominiek Coates

Objectives: To identify the prevalence and profile of amphetamine-type-substance-related presentations to the Emergency Department Mental Health Team of a local health district in Australia. Methods: Data was collected from medical records of all amphetamine-type-substance presentations to the Emergency Department Mental Health Team over a 1-year period, between 1 January 2015 and 31 December 2015. Results: Of all presentations referred to the Emergency Department Mental Health Team, 0.15% ( N = 189) were amphetamine-type-substance related. Of these, the majority were male, the average age was 32, 19.0% engaged in intravenous drug use, some were aggressive and 15.9% required tranquilisation. The most common presenting issues were psychosis and suicidal threats, intent and behaviour (including intentional overdose). Multiple comorbid conditions were identified. On discharge, 34.4% were admitted into a psychiatric hospital and 32.8% were referred to Community Mental health teams. Conclusions: Amphetamine-type-substance users suffer from multiple comorbidities and pose a significant burden on emergency services.


2021 ◽  
Vol 2 (2) ◽  
pp. 82-89
Author(s):  
Reinhard Wilson Talakua ◽  
Vina Z. Latuconsina ◽  
Siti Hadjar Malawat

Pulmonary tuberculosis (TB) is an infection disease caused by Mycobacterium tuberculosis. Pulmonary TB remain a major health problem and the most common cause of death in the world especially in developing countries. Pulmonary TB infection could cause clinical manifestation, which is haematology disorders like anemia. Many studies has reported anemia as a common complication in patients with pulmonary TB. This research aims to determine haemoglobin levels and erythrocytes index of patients with pulmonary TB at RSUD Dr. M. Haulussy Ambon in the periods from January 2017 - April 2018. This research uses a descriptive study by using medical records of patients with pulmonary TB. Among 65 patients with pulmonary TB, number of patients with anemia are 44 cases (67,7%) and 21 cases (32,3%) are not anemia. Pulmonary TB with anemia most suffered by male as much 24 cases (72,7%). The age group suffered most is 18-30 years old as much 23 cases (69,7%), but the age group suffered most according to percentage is 51-60 years old as much 80%. The most common types of anemia is hipocromic micrositer as much 23 cases (52,3%). Haemoglobin levels in patients with pulmonary TB are found most below the normal value or anemia and the most common types of anemia is hipocromic micrositer. Needs to be done more research on the analysis of the relation between anemia with pulmonary TB. Keywords: pulmonary tuberculosis, haemoglobin, erythrocytes index


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daisy J. M. Ermers ◽  
Marit P. H. van Beuningen-van Wijk ◽  
Evi Peters Rit ◽  
Sonja C. Stalpers-Konijnenburg ◽  
Diana G. Taekema ◽  
...  

Abstract Background In many cases, life-sustaining treatment preferences are not timely discussed with older patients. Advance care planning (ACP) offers medical professionals an opportunity to discuss patients’ preferences. We assessed how often these preferences were known when older patients were referred to the emergency department (ED) for an acute geriatric assessment. Methods We conducted a descriptive study on patients referred to the ED for an acute geriatric assessment in a Dutch hospital. Patients were referred by general practitioners (GPs), or in the case of nursing home residents, by elderly care physicians. The referring physician was asked if preferences regarding life-sustaining treatments were known. The primary outcome was the number of patients for whom preferences were known. Secondary outcomes included which preferences, and which variables predict known preferences. Results Between 2015 and 2017, 348 patients were included in our study. At least one preference regarding life-sustaining treatments was known at referral in 45.4% (158/348) cases. In these cases, cardiopulmonary resuscitation (CPR) policy was always included. Preferences regarding invasive ventilation policy and ICU admission were known in 17% (59/348) and 10.3% (36/348) of the cases respectively. Known preferences were more frequent in cases referred by the elderly care physician than the GP (P < 0.001). Conclusions In less than half the patients, at least one preference regarding life-sustaining treatments was known at the time of referral to the ED for an acute geriatric assessment; in most cases it concerned CPR policy. We recommend optimizing ACP conversations in a non-acute setting to provide more appropriate, desired, and personalized care to older patients referred to the ED.


2019 ◽  
Vol 19 (3) ◽  
pp. 545-555
Author(s):  
Luciana Schuler ◽  
Leila Katz ◽  
Brena Carvalho Pinto de Melo ◽  
Isabela C. Coutinho

Abstract Objectives: to evaluate the modified early obstetric warning system (MEOWS) in women after pregnancies in a tertiary hospital in Brazil. Methods: a descriptive study was conducted with 705 hospitalized women. Vital signs (systolic and diastolic blood pressure, heart rate, respiratory rate, temperature) and lochia were registered on medical records and transcribed into the MEOWS chart of physiological parameters. On this graphic chart, yellow alerts were used to present moderate abnormalities in vital signs, while severe abnormalities were presented in red. The presence of at least one red alert or two yellow alerts were triggered to indicate the need for medical evaluation. Results: although abnormalities were found in the physiological parameters of 49.8% of the women identified from MEOWS triggers, medical evaluation was only requested for three patients (0.8%). Conclusions: in a retrospective application of the use of MEOWS showed a significant number of patients had triggered in which the nursing team did not recognize 99.2% of cases. This finding could be attributed to the fact that MEOWS has not been yet adopted in this service as part of the nursing care. The application of this tool would result in a better care because critical situations would be recognized and corrected quickly, avoiding unfavorable outcomes.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Al-Khazaali

Abstract Background rAAA is a life-threatening emergency. Without early treatment, it can be fatal. Patient &gt; 50 presented with abdominal/back pain &hypotension or collapse a diagnosis of rAAA should be considered. Aortic ultrasound is recommended as it is the standard technique used in clinical practice and the screening program. Objective The project aimed to determine the number of patients who were screened for rAAA according to Royal College of Emergency Medicine (RCEM) guidelines and increase the adherence in clinical practice in the emergency department. Method Retrospective baseline data were obtained for 40 patients &gt;50 with abdominal/back pain, hypotension and collapse between 1st of November to 31st of December 2019. Re-auditing was conducted after the first intervention (phase one), which included informing colleagues about RCEM guidance via emails and paper forms to record the scans’ results. In August 2020, a final cycle (phase two) was performed after educational posters were put up in the department. Results Baseline showed that out of the 40 patients only 10% of them received the U/S scan. After phase one, the audit demonstrated an increase in screening to 42%, and in the final cycle, the percentage improved to 53%. Conclusions Routine screening of rAAA were minimal in the emergency department. As a result of the project, more patients received the U/S screening and adherence to RCEM guidelines improved.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J F Imberti ◽  
F Placentino ◽  
V L Malavasi ◽  
G Demarco ◽  
F Lohr ◽  
...  

Abstract Background The number of patients with cardiac implantable electronic devices (CIED) requiring a radiation therapy (RT) for cancer treatment is increasing over time. Nevertheless, the rate and predictors of CIED malfunctions are still controversial. Purpose The aim of our study is to estimate the prevalence and possible predictors of RT-related CIED malfunctions and to describe malfunction characteristics. Methods We retrospectively reviewed medical records of all pacemaker (PM)/implantable cardioverter defibrillator (ICD) patients who underwent RT at our centre between January 2004 and July 2018. We included data from the CIED interrogation performed before the RT course to the first interrogation after the end of the RT course. As a safety measure, during RT a magnet was applied to every ICD and, in all PM-dependent patients, the device was temporarily reprogrammed in V00. Device relocation from the RT field was performed in 2/150 (1.3%) RT courses. Results One hundred twenty-seven patients were included, who underwent 150 separate RT courses. Eighty one percent of patients had a PM, while 19% had an ICD. Of note 17.4% of patients were PM-dependent. Neutron producing RT was used in 37/139 (26.6%) patients, whereas marginal neutron producing and non-neutron producing RT was used in 9/139 (6.4%) and 93/139 (67%) patients respectively. The cumulative dose (Dmax) delivered to the CIED exceeded 5Gy only in 2/132 (1.5%) cases. Three device-related malfunctions were found (2%). None of them were life-threatening or lead to a clinical event. All dysfunctions were resolved by reprogramming the device and did not require CIED substitution or leads extraction. Details of dysfunctions included: 1) a partial reset of an ICD, leading to self-reprogramming in safety mode, 2) full reset of a PM, which required the re-initialisation of the device and 3) programming change of the magnetic PM frequency to 30bpm (instead of 90 bpm). In all cases the Dmax delivered to the CIED was <1Gy. A neutron producing RT was used in the first two cases, whereas a non-neutron producing RT was used in the last case. Conclusions In accordance with the current literature, our results show that RT in patients with CIED is substantially safe. Malfunctions are uncommon and do not result in clinical events, but can develop even if the Dmax delivered to the CIED is <1 Gy. Device interrogation on a regular basis is advisable to promptly recognise CIED malfunctions.


2019 ◽  
pp. 121-126
Author(s):  
Z. N. Shardanov ◽  
S. A. Artyushkin ◽  
A. A. Krivopalov ◽  
N. A. Shnayder ◽  
A. Yu. Shcherbuk ◽  
...  

Actuality. The growth of inflammatory diseases of ENT organs and associated purulent-septic intracranial complications is an urgent problem of modern otorhinolaryngology. Severe complications associated with sepsis and inflammatory lesions of the membranes and brain matter are life-threatening conditions for otorhinolaryngological patients.Objective. To study the epidemiological situation of inflammatory diseases of the ENT organs and associated purulent-septic intracranial complications in the Kabardino-Balkarian Republic.Materials and methods. Data of official statistics, electronic databases, statistical reports of the Ministry of Health of the KabardinoBalkan Republic, data of outpatient’s medical records and hospital medical records of multidisciplinary medical and preventive institutions, data on the prevalence of diseases of ENT organs in the Kabardino-Balkarian Republic from 2011 to 2018 among adults and children.Results and conclusions. The results obtained reflect a significant increase in inflammatory diseases of the ENT organs in the Kabardino-Balkarian Republic from 2011 to 2018. both in the number of reported cases and in the primary incidence. Despite the decrease in the number of inpatient ENT beds in the Republic in 2013, the number of patients treated increased. The reduction of ENT beds entailed an increase in hospital mortality, which is represented exclusively by ENT-associated intracranial complications. Today, the Republic has a rather high level of ENT-associated intracranial complications associated with low prevention and diagnosis of inflammatory ENT diseases, which dictates the importance of using a multidisciplinary approach (ENT doctor, neurologist, ophthalmologist, resuscitator, therapist, neurosurgeon), the need for review management tactics, development of algorithms for the diagnosis and optimal treatment of patients with ENT-associated HFD. 


2011 ◽  
Vol 7 (2) ◽  
pp. 97 ◽  
Author(s):  
Niels Voigt ◽  
Dobromir Dobrev ◽  
◽  

Atrial fibrillation (AF) is the most common arrhythmia and is associated with substantial cardiovascular morbidity and mortality, with stroke being the most critical complication. Present drugs used for the therapy of AF (antiarrhythmics and anticoagulants) have major limitations, including incomplete efficacy, risks of life-threatening proarrhythmic events and bleeding complications. Non-pharmacological ablation procedures are efficient and apparently safe, but the very large size of the patient population allows ablation treatment of only a small number of patients. These limitations largely result from limited knowledge about the underlying mechanisms of AF and there is a hope that a better understanding of the molecular basis of AF may lead to the discovery of safer and more effective therapeutic targets. This article reviews the current knowledge about AF-related ion-channel remodelling and discusses how these alterations might affect the efficacy of antiarrhythmic drugs.


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