1
40
2
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1186/s12873-018-0179-0" target="_blank" rel="noreferrer noopener">http://doi.org/10.1186/s12873-018-0179-0</a>
Pages
27–27
Issue
1
Volume
18
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Delayed intracranial hemorrhage in elderly anticoagulated patients sustaining a minor fall.
Publisher
An entity responsible for making the resource available
BMC emergency medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2018
2018-08
Subject
The topic of the resource
*Delayed intracranial hemorrhage; *Elderly; *Fall; *Head injury; *Intracranial hemorrhage; 80 and over; Accidental Falls/*statistics & numerical data; Aged; Anticoagulants/administration & dosage/*adverse effects; Combination; Drug Therapy; Female; Humans; Intracranial Hemorrhages/diagnostic imaging/*etiology; Male; Platelet Aggregation Inhibitors/administration & dosage/*adverse effects; Retrospective Studies; Tomography; X-Ray Computed
Creator
An entity primarily responsible for making the resource
Mann Nolan; Welch Kellen; Martin Andrew; Subichin Michael; Wietecha Katherine; Birmingham Lauren E; Marchand Tiffany D; George Richard L
Description
An account of the resource
BACKGROUND: Falls are a common cause of hospitalization, morbidity, and mortality among the elderly in the United States. Evidence-based imaging recommendations for evaluation of delayed intracranial hemorrhage (DICH) are not generally agreed upon. The purpose of this project was to evaluate the incidence of DICH detected by head computer tomography (CT) among an elderly population on pre-injury anticoagulant or antiplatelet (ACAP) therapy. METHODS: Data from a Level 1 Trauma Center trauma registry was used to assess the incidence of DICH in an elderly population of patients (\textgreater/=65 years) who sustained a minor fall while on pre-injury ACAP medications. Counts and percentages are reported. RESULTS: Data on 1076 elderly trauma patients were downloaded, of which 838 sustained a minor fall and 513 were found to be using a pre-injury ACAP medication. One patient (0.46%) with a DICH was identified out of 218 patients who received a routine repeat head CT. Aspirin and warfarin were the most common pre-injury ACAP medications and 19.27% (42/218) of patients were found to be using multiple ACAP medications. CONCLUSIONS: Universal screening protocols promote immediate-term patient safety, but do so at a great expense with respect to health expenditures and increased radiation exposure. This analysis highlights the need for an effective risk assessment tool for DICH that would reduce the burden of unnecessary screenings while still identifying life-threatening intracranial hemorrhages in affected patients.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1186/s12873-018-0179-0" target="_blank" rel="noreferrer noopener">10.1186/s12873-018-0179-0</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
*Delayed intracranial hemorrhage
*Elderly
*Fall
*Head injury
*Intracranial hemorrhage
2018
80 and over
Accidental Falls/*statistics & numerical data
Aged
Anticoagulants/administration & dosage/*adverse effects
Birmingham Lauren E
BMC emergency medicine
Combination
Drug Therapy
Female
George Richard L
Humans
Intracranial Hemorrhages/diagnostic imaging/*etiology
Male
Mann Nolan
Marchand Tiffany D
Martin Andrew
Platelet Aggregation Inhibitors/administration & dosage/*adverse effects
Retrospective Studies
Subichin Michael
Tomography
Welch Kellen
Wietecha Katherine
X-Ray Computed
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1097/QMH.0000000000000186" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/QMH.0000000000000186</a>
Pages
199–203
Issue
4
Volume
27
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Using Lean Six Sigma to Improve Delayed Intracranial Hemorrhage Screening in a Geriatric Trauma Population.
Publisher
An entity responsible for making the resource available
Quality management in health care
Date
A point or period of time associated with an event in the lifecycle of the resource
2018
2018-12
Subject
The topic of the resource
Aged; Anticoagulants – Therapeutic Use – In Old Age; Chi Square Test; Descriptive Statistics; Guideline Adherence; Human; Intracranial Hemorrhage – Diagnosis – In Old Age; Logistic Regression; Midwestern United States; Platelet Aggregation Inhibitors – Therapeutic Use – In Old Age; Quality Improvement; Record Review; Tomography; Trauma – Therapy – In Old Age; X-Ray Computed – In Old Age
Creator
An entity primarily responsible for making the resource
Birmingham Lauren E; Sedorovich Ashley; Mann Nolan; George Richard L
Description
An account of the resource
PURPOSE: Geriatric trauma patients taking preinjury anticoagulant or antiplatelet (ACAP) medications are at greater risk for delayed intracranial hemorrhage (DICH), a rare but potentially life-threatening condition. Routine repeat head computed tomography (RRHCT) scans can identify DICH. Our objective was to decrease the rate of missed RRHCT in a level 1 Midwest trauma center geriatric minor trauma population on preinjury ACAP medications. OBJECTIVE: The objective of the quality improvement project was to identify the root cause of the missed RRHCTs and to implement a comprehensive solution to reduce rates of missed RRHCTs. METHODS: Medical records from before and after the intervention were evaluated. Frequencies and percentages were calculated. In addition, chi and logistic regression were utilized. The Lean Six Sigma (LSS) DMAIC (Define, Measure, Analyze, Improve, and Control) process was used to drive process improvement. RESULTS: At baseline, 15% (41 of 267) of RRHCTs were missed. After solution implementation, missed RRHCTs dropped to 4% (2 of 50). Of the 2 that were missed, zero were clinically inappropriate misses, making the postimplementation rate effectively 0%. CONCLUSION: The LSS DMAIC process helped health care professional to facilitate improved adherence to the department's practice guideline with respect to RRHCT. Adherence with this guideline can help providers identify patients with DICH, a potentially life-threatening condition.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/QMH.0000000000000186" target="_blank" rel="noreferrer noopener">10.1097/QMH.0000000000000186</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2018
Aged
Anticoagulants – Therapeutic Use – In Old Age
Birmingham Lauren E
Chi Square Test
Descriptive Statistics
George Richard L
Guideline Adherence
Human
Intracranial Hemorrhage – Diagnosis – In Old Age
Logistic Regression
Mann Nolan
Midwestern United States
Platelet Aggregation Inhibitors – Therapeutic Use – In Old Age
Quality Improvement
Quality management in health care
Record Review
Sedorovich Ashley
Tomography
Trauma – Therapy – In Old Age
X-Ray Computed – In Old Age