Articles: emergency-department.
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Assessment of patients with suspected non-ST elevation myocardial infarction (NSTEMI) is based on cardiac troponin (cTn) levels with the 99th percentile as cut-off. However, cardiovascular risk starts already at lower troponin concentrations. We therefore, aimed to investigate the utility of 2-hour algorithms using the high-sensitivity cardiac troponin I (hs-cTnI) 97.5th percentile as cut-off which corresponds to the standard URL for most biomarkers. ⋯ The hs-cTnI 97.5th percentile integrated into 2-hour algorithms provided high diagnostic estimates and could, due to better prognostic properties serve as an alternative to the 99th percentile.
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Beginning October 2015, the Center for Medicare and Medicaid Services will require medical providers to use the vastly expanded International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) system. Despite wide availability of information and mapping tools for the next generation of the ICD classification system, some of the challenges associated with transition from ICD-9-CM to ICD-10-CM are not well understood. ⋯ We then analyzed the convoluted transitions and found that 8% of total visit encounters (23% of the convoluted transitions) were clinically incorrect. The ambiguity and inaccuracy of these mappings may impact the workflow associated with the translation process and affect the potential mapping between ICD codes and Current Procedural Codes, which determine physician reimbursement.
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Australas Emerg Nurs J · May 2015
Multicenter Study Observational StudyUnderstanding the patient journey to the Emergency Department - A South Australian study.
To determine patients' points of contact prior to or decision making processes before presenting to an Emergency Department for treatment. To obtain data that may inform future exploration of targeted Emergency Department avoidance strategies. ⋯ The study showed 39.8% had sought advice from other health care professionals prior to presenting to the Emergency Department and that 60.2% of patients were self-referred. This study has not revealed any new pathways that warrant targeting for Emergency Department avoidance strategies. The focus still needs to target primary care referrals, ambulance service transports and smaller hospital transfers.