Weakness and fatigue in older ED patients in the United States.
80 and over; 80 and Over; Aged; Cross Sectional Studies; Cross-Sectional Studies; Demography; Fatigue – Diagnosis; Fatigue – Epidemiology; Fatigue/diagnosis/*epidemiology; Female; Health Care Surveys; Human; Humans; Male; Muscle Weakness – Diagnosis; Muscle Weakness – Epidemiology; Muscle Weakness/diagnosis/*epidemiology; Prevalence; Surveys; United States; United States/epidemiology
BACKGROUND: The objectives of this study are to estimate the prevalence of weakness and fatigue visits in older emergency department (ED) patients, to compare demographics and resource use in these patients with those without these complaints, and to determine their ED diagnoses and disposition. METHODS: We performed a cross-sectional cohort analysis of ED visits in patients aged older than 65 years from the 2003 to 2007 National Hospital Ambulatory Medical Care Surveys. Weakness and fatigue visits had a reason for visit code of generalized weakness (1020.0) or tiredness and exhaustion (1015.0); the comparison cohort lacked these codes. Descriptive data are presented as totals, means, and proportions with 95% confidence intervals (CIs). Comparisons between cohorts used chi(2) for proportions and the adjusted Wald test for means. RESULTS: There were an estimated 575 million ED visits, those aged 65 years and older made 14.7% (95% CI, 14.2-15.3) of visits. Overall, 6.0% (95% CI, 5.6-6.4) of these visits had weakness and fatigue; this was the fifth most common primary reason for visit. Weakness and fatigue visits increased with age. Weakness and fatigue visits had longer ED lengths of stay (300 vs 249 minutes, P \textless .001), more diagnostic tests (7.7 vs 5.0, P \textless .001), procedures (5.7 vs 4.7, P \textless .001), and hospital admissions (55% vs 35%, P \textless .001). The most common primary diagnoses for the weakness and fatigue cohort were "other malaise and fatigue," pneumonia, and urinary tract infection. CONCLUSION: Weakness and fatigue are common in older ED patients. These patients undergo more tests and procedures, and most are admitted.
Bhalla Mary Colleen; Wilber Scott T; Stiffler Kirk A; Ondrejka Jason E; Gerson Lowell W
The American journal of emergency medicine
2014
2014-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ajem.2014.08.027" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2014.08.027</a>
Telepresent Focused Assessment With Sonography for Trauma Examination Training Versus Traditional Training for Medical Students: A Simulation-Based Pilot Study.
*Students; *Videoconferencing; Adult; Clinical Competence/*statistics & numerical data; Curriculum; Debriefing Assessment for Simulation in Healthcare; education; Female; Focused Assessment with Sonography of Trauma/*methods; Humans; Male; Medical; Pilot Projects; remote telementored ultrasound; Simulation Training/*methods; teledebriefing; telementor; telepresence; telesonography; Ultrasonics/*education; Young Adult
OBJECTIVES: Telepresent education is becoming an important modality in medical education, as it provides a means for instructors to lead education sessions via videoconferencing technologies. This study aimed to compare the effectiveness of telepresent ultrasound training versus traditional in-person ultrasound training. METHODS: Medical student cohorts were educated by either traditional in-person instruction or telementoring on how to perform a focused assessment with sonography for trauma (FAST) examination. Effectiveness was evaluated by pre- and post-multiple-choice tests (knowledge), confidence surveys, and summative simulation scenarios (hands-on FAST simulation). Formative simulation scenario debriefings were evaluated by each student using the Debriefing Assessment for Simulation in Healthcare student version (DASH-SV). RESULTS: Each method of instruction had significant increases in knowledge, confidence, and hands-on FAST simulation performance (P \textless .05). The collective increase in knowledge was greater for the in-person group, whereas the improvement in FAST examination performance during simulations was greater for the telementored group. Confidence gains were comparable between the groups. The DASH-SV scores were significantly higher for the in-person group for each criterion; however, both methods were deemed effective via median scoring. CONCLUSIONS: Telepresent education is a viable option for teaching the FAST examination to medical students.
Poland Scott; Frey Jennifer A; Khobrani Ahmad; Ondrejka Jason E; Ruhlin Michael U; George Richard L; Gothard M David; Ahmed Rami A
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
2018
2018-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1002/jum.14551" target="_blank" rel="noreferrer noopener">10.1002/jum.14551</a>