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[PMID]:29432461
[Au] Autor:Weenk M; van Goor H; van Acht M; Engelen LJ; van de Belt TH; Bredie SJH
[Ad] Endereço:Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
[Ti] Título:A smart all-in-one device to measure vital signs in admitted patients.
[So] Source:PLoS One;13(2):e0190138, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Vital sign measurements in hospitalized patients by nurses are time consuming and prone to operational errors. The Checkme, a smart all-in-one device capable of measuring vital signs, could improve daily patient monitoring by reducing measurement time, inter-observer variability, and incorrect inputs in the Electronic Health Record (EHR). We evaluated the accuracy of self measurements by patient using the Checkme in comparison with gold standard and nurse measurements. METHODS AND FINDINGS: This prospective comparative study was conducted at the Internal Medicine ward of an academic hospital in the Netherlands. Fifty non-critically ill patients were enrolled in the study. Time-related measurement sessions were conducted on consecutive patients in a randomized order: vital sign measurement in duplicate by a well-trained investigator (gold standard), a Checkme measurement by the patient, and a routine vital sign measurement by a nurse. In 41 patients (82%), initial calibration of the Checkme was successful and results were eligible for analysis. In total, 69 sessions were conducted for these 41 patients. The temperature results recorded by the patient with the Checkme differed significantly from the gold standard core temperature measurements (mean difference 0.1 ± 0.3). Obtained differences in vital signs and calculated Modified Early Warning Score (MEWS) were small and were in range with predefined accepted discrepancies. CONCLUSIONS: Patient-calculated MEWS using the Checkme, nurse measurements, and gold standard measurements all correlated well, and the small differences observed between modalities would not have affected clinical decision making. Using the Checkme, patients in a general medical ward setting are able to measure their own vital signs easily and accurately by themselves. This could be time saving for nurses and prevent errors due to manually entering data in the EHR.
[Mh] Termos MeSH primário: Desenho de Equipamento
Monitorização Fisiológica/instrumentação
Admissão do Paciente
Sinais Vitais
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Seres Humanos
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190138


  2 / 890 MEDLINE  
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[PMID]:29386438
[Au] Autor:Niki K; Takemura M; Kitagawa K; Shimizu R; Takahashi Y; Hatabu A; Uejima E
[Ad] Endereço:Department of Clinical Pharmacy Research and Education, Graduate School of Pharmaceutical Sciences, Osaka University.
[Ti] Título:[The Present Implementation Status and Problems of Vital-signs Measurement by Community Pharmacists in Home Medical Care in Osaka].
[So] Source:Yakugaku Zasshi;138(2):243-250, 2018.
[Is] ISSN:1347-5231
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo: While the community-based integrated care systems are in the process of being structured currently, more and more community pharmacists want to learn physical assessment skills. However, no large-scale survey focusing on present implementation status and problems of physical assessment by community pharmacists has been conducted yet. Osaka has the 2nd highest number of community pharmacies in Japan now, and the population aged ≥65 years will be expected to become the 3rd highest in 2025. Thus, Osaka can become a national leading model case for community pharmacists' activity in future home medical care. Therefore, this study aimed to reveal the present implementation status and problems of physical assessment by community pharmacists in Osaka, especially focusing on vital-signs. The questionnaires were sent to all the 3571 insurance pharmacies belonging to the Osaka Pharmaceutical Association and 871 pharmacies responded. Many pharmacists recognized the necessity for vital-signs measurement by pharmacists in home medical care (81.5% of pharmacies that offered home medical care and 75.4% of pharmacies that did not offer one). However, the proportion of pharmacies that conduct vital-signs measurement in home medical care was 18.7%, therefore, it was suggested that the present problem is "many pharmacists cannot conduct vital-signs measurement, although they think it should be conducted". Moreover, the most common reason for not measuring vital-signs was the lack of instruments, such as stethoscopes and sphygmomanometer (43.2%). This is the latest report with a large-scale sample, thus, it can serve as valuable knowledge in considering what pharmacists do for the future.
[Mh] Termos MeSH primário: Serviços Comunitários de Farmácia
Serviços de Assistência Domiciliar
Farmacêuticos
Papel Profissional
Sinais Vitais
[Mh] Termos MeSH secundário: Competência Clínica
Serviços Comunitários de Farmácia/tendências
Serviços de Assistência Domiciliar/tendências
Seres Humanos
Japão
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180202
[St] Status:MEDLINE
[do] DOI:10.1248/yakushi.17-00152


  3 / 890 MEDLINE  
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[PMID]:29185658
[Au] Autor:Flores JR
[Ti] Título:The Importance of Vital Signs.
[So] Source:Dent Today;35(12):88-91, 2016 Dec.
[Is] ISSN:8750-2186
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Sinais Vitais
[Mh] Termos MeSH secundário: Assistência Odontológica
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


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[PMID]:29304160
[Au] Autor:Chong SL; Ong GY; Chin WYW; Chua JM; Nair P; Ong ASZ; Ng KC; Maconochie I
[Ad] Endereço:Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore, Singapore.
[Ti] Título:A retrospective review of vital signs and clinical outcomes of febrile infants younger than 3 months old presenting to the emergency department.
[So] Source:PLoS One;13(1):e0190649, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Febrile infants younger than 3 months old present a diagnostic dilemma to the emergency physician. We aim to describe a large population of febrile infants less than 3 months old presenting to a pediatric emergency department (ED) and to assess the performance of current heart rate guidelines in the prediction of serious infections (SI). MATERIALS AND METHODS: We performed a retrospective review of febrile infants younger than 3 months old, between March 2015 and Feb 2016, in a large tertiary pediatric ED. We documented the primary outcome of SI for each infant, as well as the clinical findings, vital signs, and Severity Index Score (SIS). We assessed the performance of the Paediatric Canadian Triage and Acuity Scale (PaedCTAS), Advanced Pediatric Life Support (APLS) guidelines and Fleming normal reference values, using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under receiver operating characteristics curve (AUC). RESULTS: 1057 infants were analyzed, with 326 (30.6%) infants diagnosed with SI. High temperature, tachycardia, and low SIS score were significantly associated with SI. Item analysis showed that the SIS performance was driven by the presence of mottling (p = 0.003) and high temperature (p<0.001). The APLS guideline had the highest sensitivity (66.0%, 95% CI 60.5-71.1%), NPV (73.3%, 95% CI 69.7-76.5%) and AUC (0.538), while the PaedCTAS (2 standard deviation from normal) had the highest specificity (98.5%, 95% CI 97.3-99.3%) and PPV (55.2%, 95% CI 32.7-71.0%). CONCLUSIONS: Current guidelines on infantile heart rates have a variable performance. In our study, the APLS heart rate guidelines performed with the highest sensitivity, but no individual guideline predicted for SIs satisfactorily.
[Mh] Termos MeSH primário: Serviço Hospitalar de Emergência/utilização
Febre/fisiopatologia
Avaliação de Resultados (Cuidados de Saúde)
Sinais Vitais
[Mh] Termos MeSH secundário: Seres Humanos
Lactente
Recém-Nascido
Masculino
Estudos Retrospectivos
Singapura
Triagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190649


  5 / 890 MEDLINE  
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[PMID]:29240391
[Au] Autor:Chung C; Cooper S; Kinsman L; Evans L; Cahill A
[Ti] Título:RESEARCH: PATIENT DETERIORATION -- PATIENT SAFETY.
[So] Source:Aust Nurs Midwifery J;24(2):41, 2016 08.
[Is] ISSN:2202-7114
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Inadequate management of deteriorating patients is of international concern. In order to tackle this issue there has been an increasing effort to upskill nursing and medical staff (Australian Commission on Safety and Quality in Healthcare, 2012).
[Mh] Termos MeSH primário: Competência Clínica
Educação Continuada em Enfermagem
Avaliação em Enfermagem
Segurança do Paciente
[Mh] Termos MeSH secundário: Progressão da Doença
Fidelidade a Diretrizes
Seres Humanos
Vitória
Sinais Vitais
[Pt] Tipo de publicação:RESEARCH SUPPORT, NON-U.S. GOV'T; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  6 / 890 MEDLINE  
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[PMID]:29206011
[Au] Autor:Heightman AJ
[Ti] Título:Santa's Sepsis Summit: A thermic analysis from the man who sees everything.
[So] Source:JEMS;41(12):6-8, 2016 12.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Serviços Médicos de Emergência
Tratamento de Emergência
Sepse/diagnóstico
Sepse/terapia
[Mh] Termos MeSH secundário: Congressos como Assunto
Seres Humanos
Termometria/instrumentação
Sinais Vitais
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


  7 / 890 MEDLINE  
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[PMID]:29182235
[Au] Autor:Baez AA
[Ti] Título:Miami Sepsis Score: New evidence-based prehospital sepsis identification tool.
[So] Source:JEMS;41(9):35, 2016 09.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Serviços Médicos de Emergência/organização & administração
Sepse/diagnóstico
Sepse/terapia
[Mh] Termos MeSH secundário: Florida
Seres Humanos
Índice de Gravidade de Doença
Sinais Vitais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29182233
[Au] Autor:Banarjee PR; Vittone R; Criss R; Gonzalez R
[Ti] Título:On the Front Line of Sepsis: Lifesaving sepsis identification and hospital alerts in Polk County, Fla.
[So] Source:JEMS;41(9):29-34, 2016 09.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Serviços Médicos de Emergência/organização & administração
Sepse/diagnóstico
Sepse/terapia
[Mh] Termos MeSH secundário: Técnicas de Apoio para a Decisão
Florida
Seres Humanos
Guias de Prática Clínica como Assunto
Sinais Vitais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29189678
[Au] Autor:Davis JW; Dirks RC; Sue LP; Kaups KL
[Ad] Endereço:From the Department of Surgery (J.W.D., R.C.D., L.P.S., K.L.K.), UCSF Fresno, Fresno, California.
[Ti] Título:Attempting to validate the overtriage/undertriage matrix at a Level I trauma center.
[So] Source:J Trauma Acute Care Surg;83(6):1173-1178, 2017 Dec.
[Is] ISSN:2163-0763
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The Optimal Resources Document mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the overtriage/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different, and Matrix does not discriminate the needs or outcomes of these different groups of patients. METHODS: Trauma registry data, from January 2013 to December 2015, at a Level I trauma center, were reviewed. Overtriage and undertriage rates were calculated by Matrix. Patients with Injury Severity Score (ISS) of 16 or greater were classified by activation level (full, limited, consultation), and triage category by Matrix. Patients in the limited activation and consultation groups were compared with patients with full activation by demographics, injuries, initial vital signs, procedures, delays to procedure, intensive care unit admission, length of stay, and mortality. RESULTS: Seven thousand thirty-one patients met activation criteria. Compliance with American College of Surgeons tiered activation criteria was 99%. The Matrix overtriage rate was 45% and undertriage was 24%. Of 2,282 patients with an ISS of 16 or greater, 1,026 were appropriately triaged (full activation), and 1,256 were undertriaged. Undertriaged patients had better Glasgow Coma Scale score, blood pressure, and base deficit than patients with full activation. Intensive care unit admission, hospital stays, and mortality were lower in the undertriaged group. The undertriaged group required fewer operative interventions with fewer delays to procedure. CONCLUSION: Despite having an ISS of 16 or greater, patients with limited activations were dissimilar to patients with full activation. Level of activation and triage are not equivalent. The American College of Surgeons Committee on Trauma full and tiered activation criteria are a robust means to have the appropriate personnel present based on the available prehospital information. Evaluation of the process of care, regardless of level of activation, should be used to evaluate trauma center performance. LEVEL OF EVIDENCE: Therapeutic and care management, level III.
[Mh] Termos MeSH primário: Fidelidade a Diretrizes
Melhoria de Qualidade
Sistema de Registros
Tempo para o Tratamento/normas
Centros de Traumatologia/organização & administração
Triagem/normas
Ferimentos e Lesões/diagnóstico
[Mh] Termos MeSH secundário: Adulto
California/epidemiologia
Feminino
Seguimentos
Mortalidade Hospitalar/tendências
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Taxa de Sobrevida/tendências
Fatores de Tempo
Sinais Vitais
Ferimentos e Lesões/mortalidade
Ferimentos e Lesões/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180103
[Lr] Data última revisão:
180103
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1097/TA.0000000000001623


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[PMID]:29132579
[Au] Autor:Hruska K; Ruge T
[Ad] Endereço:Department of Emergency Medicine, Karolinska University Hospital, Huddinge, Sweden. Electronic address: katrin.hruska@sll.se.
[Ti] Título:The Tragically Hip: Trauma in Elderly Patients.
[So] Source:Emerg Med Clin North Am;36(1):219-235, 2018 Feb.
[Is] ISSN:1558-0539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Old age is a risk factor for poor outcome in trauma patients, as a result of undertriage and the presence of occult life-threatening injuries. The mechanisms of injury for geriatric trauma differ from those in younger patients, with a much higher incidence of low-impact trauma, especially falls from a low height. Frailty is a risk factor for severe injury after minor trauma, and caring for these patients require a multidisciplinary team with both trauma and geriatric expertise. With early recognition and aggressive management, severe injuries can still be associated with good outcomes, even in very elderly patients.
[Mh] Termos MeSH primário: Ferimentos e Lesões/terapia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Fragilidade/complicações
Seres Humanos
Equipe de Assistência ao Paciente
Fatores de Risco
Choque
Centros de Traumatologia
Sinais Vitais
Ferimentos e Lesões/diagnóstico
Ferimentos e Lesões/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171115
[St] Status:MEDLINE



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