European journal of internal medicine
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Eur. J. Intern. Med. · Aug 2011
Comparative StudyA simple tool to improve medication reconciliation at the emergency department.
Medication histories acquired upon admission are often incomplete. Using a standardized approach warrants more complete medication reconciliation, however, this is too time consuming to be performed. Other strategies guaranteeing complete medication histories should be explored. We developed a limited list of standardized questions and assessed its impact on completeness of medication histories. ⋯ Drug omission rate in medication histories can be significantly reduced if a limited list of simple questions is used during anamnesis. Widespread use of this tool should be considered to be implemented.
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Eur. J. Intern. Med. · Aug 2011
Comparative StudyThe prediction of the in-hospital mortality of acutely ill medical patients by electrocardiogram (ECG) dispersion mapping compared with established risk factors and predictive scores--a pilot study.
ECG dispersion mapping (ECG-DM) is a novel technique that analyzes low amplitude ECG oscillations and reports them as the myocardial micro-alternation index (MMI). This study compared the ability of ECG-DM to predict in-hospital mortality with traditional risk factors such as age, vital signs and co-morbid diagnoses, as well as three predictive scores: the Simple Clinical Score (SCS)--based on clinical and ECG findings, and two Medical Admission Risk System scores--one based on vital signs and laboratory data (MARS), and one only on laboratory data (LD). ⋯ ECG-DM may be a clinically useful predictor of in-hospital mortality. ECG-DM is inexpensive, only takes a few seconds to perform and requires no skill to interpret.
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Eur. J. Intern. Med. · Aug 2011
Multicenter Study Comparative StudyEmergency response time after out-of-hospital cardiac arrest.
To investigate the emergency response time after out-of-hospital cardiac arrest (OHCA) in four cities in Serbia. ⋯ The emergency response time within 4 min was associated with improved survival to ROSC, HD and 1y after OHCA. Despite the fact that our results are in accordance with the findings published in other papers, there is still a need to take all appropriate measures in order to decrease the emergency response time after OHCA.
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Eur. J. Intern. Med. · Aug 2011
ReviewAcute Medicine: triage, timing and teaching in the context of medical emergency admissions.
Acute Medicine has been recognized as a sub-specialty of General Internal Medicine in the UK for 6 years. Acute Medicine aims to streamline diagnostic processes and treatment decisions for patients presenting with an acute illness in Internal Medicine in order to improve safety, patient experience and resource utilization. ⋯ Co-location of patients in Acute Medical Units helps to rationalize logistical processes and supports training of junior doctors in supervised management of both life-threatening and complex medical emergencies. Research is needed to formally evaluate the impact of the format of service delivery on clinical outcomes and length of hospital stay for patients with comparable sickness profiles.