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Biomedical subjects

A Price

Publications and source records attributed to A Price.

At least 181 records · Page 10Linked to original sources
PubMed1979

Chest pain.

Explore the source record for details and available documents.

Angina Pectoris↗
PubMed1976

Nosocomial infection with highly resistant, Proteus rettgeri. Report of an epidemic.

Over 22-1/2 months an epidemic of at least 127 cases of nosocomial infection developed from a strain of Proteus rettgeri resistant to all antibiotics commonly tested in hospital laboratories. Although there were at least four cases of septicemia and one related death, the majority of cases consisted of asymptomatic bacteriuria or clinically mild urinary tract infection. Indwelling urinary tract devices and antibiotic therapy were important predisposing factors. Data supported an association between increasing use of gentamicin and increasing rates of resistant infection. No common source was found, and contact spread appeared more likely. Control measures included efforts to reduce unnecessary exposure to the incriminated risk factors and to improve asepsis in the management of catheterized patients. An additional 36 cases and one related death were identified in the 7-1/2 months following the investigation and institution of control measures. Nosocomial infection with extremely resistant organisms may pose a serious hazard wherever indwelling urinary tract devices and antibiotics are used together intensively.

Bacteriuria↗
PubMedDate not supplied

Malignant superior vena cava obstruction: stent placement via the subclavian route.

Over a 3-year period 23 patients with malignant superior vena cava obstruction were referred for interventional management. They underwent repeat localized central venography and deployment of self-expanding Wallstents. All patients (age range 26-89 years) were approached by the subclavian route using 29 stents. The stent was used to exclude thrombus in the contralateral brachiocephalic vein in five patients and histologic information was available in all patients. Retrospective analysis of the clinical records was used to assess symptom-free survival and symptom recurrence. All patients reported an improvement in symptoms within 24 hr of the procedure. There was 100% technical success. Primary clinical success was achieved in 19 of 23 patients followed-up to their death with no symptom recurrence (range 1-34, mean 15 weeks). In four patients symptoms recurred but only one patient was referred for re-intervention, which was successful. Complications included single cases of early post-stent rethrombosis, distal slip on deployment, and distal slip on balloon dilatation. There were no puncture-related complications.

Adult↗
PubMedDate not supplied

Does reduced length of stay decrease the number of emergency department patients who leave without seeing a physician?

Previous studies have suggested that most emergency department (ED) patients who leave without being seen by a physician (LWBS) are nonurgent. Our institution developed a fast-track process to reduce length of stay (LOS) for these patients. The present study was conducted to determine the effect of reducing LOS on the number of ED patients who leave without seeing a physician and the acuity of this subset of ED patients. We retrospectively audited, at a tertiary care teaching hospital, the number of LWBS patients and their triage status over two 1-mo periods. These sampling periods corresponded to immediately before and after implementation of five solutions developed by a continuous quality improvement (CQI) process to facilitate patient flow through the triage and fast-track areas of our ED. Before the CQI process was begun, 2.4% of patients (110/4553) left without being seen in a 1-mo study period. Of these, 82 were nonurgent and 28 were urgent. After implementation of the CQI process, 1.1% of patients (51/4514) left without being seen. Of these, 35 were nonurgent and 16 were urgent. There was a significant decrease in the LWBS proportion after the CQI process was implemented. We conclude that (1) reducing LOS is associated with a decrease in the number of ED patients who leave without seeing a physician and (2) many patients who leave without being seen are classified as urgent at presentation.

Emergencies↗
PubMedDate not supplied

Root cause analysis of laboratory delays to an emergency department.

The Q-Probes study has identified benchmark interinstitutional laboratory median turnaround times (TAT) of 25 min for hemoglobin and 36 min for potassium. Our objectives were to measure the emergency department (ED)/laboratory TAT and other relevant laboratory processing and reporting times, and to identify root causes of laboratory delay. A flow chart was developed for the ordering, collecting, analyzing, and reporting of laboratory results. Time intervals were prospectively recorded for complete blood count (CBC) and K+ in a cross-sectional study, using the flow chart, and defined as follows: TAT was the interval from blood draw (BD) to ED report; BD time was the interval from order processing to BD; and order processing time was the interval from physician ordering to the unit coordinator processing the orders. Median times with interquartile ranges are reported. CBC TAT was 38 min (29-51.5), and K+ TAT 58 min (45-76.5). Order processing time was 7 min (4-15). The laboratory assistant BD time was 17 min (8-30) for CBC and 15 min (7.75-32.25) for K+ as compared to 0 min for a nurse, yet the venipuncture method (laboratory assistant technique) had a recollection rate of 1% (1/93) due to hemolysis vs. 20% (19/95) via the i.v. catheter (nurse technique). Of stat ED blood work, 24% was for admitted patients held in the ED. Laboratory reporting times are delayed with these root causes: laboratory assistant availability; recollection rate; volume of tests for ED admitted patients; and order processing time.

Benchmarking↗
PubMedDate not supplied

Problem-based learning in clinical practice facilitating critical thinking.

Problem-based learning has established a strong reputation within education programs delivered to a wide variety of healthcare professionals. Nevertheless, most accounts of problem-based learning relate to classroom settings, where issues of patient safety and competing demands upon time are not a primary concern. The authors explore ways in which problem-based learning may be utilized within clinical practice to enhance the professional development of nurses. A framework for thinking about problems and professional responses is outlined, and illustrations are drawn from the maternal-child health practice setting.

Attitude of Health Personnel↗
PubMedDate not supplied

Sustained nonischemic ventricular tachycardia during dobutamine stress echocardiography.

Dobutamine stress echocardiography has become widely accepted as a safe, reliable and cost effective modality for the evaluation of patients with suspected myocardial ischemia or for prognostic stratification and outcome assessment in patients with known coronary artery disease. while the benefits of this means of cardiovascular testing are very clearly apparent, it is important to understand and recognize possible complications. This paper discusses the occurrence of sustained, nonischemic ventricular tachycardia during dobutamine stress echocardiography in the absence of functional, physiologic or anatomic evidence of coronary artery disease or cardiomyopathy.

Adrenergic beta-Agonists↗