Active clinical trials for "Emergencies"

The purpose of this study is to determine if non-dilated retinal photography in the emergency room improves the diagnosis of papilledema (optic nerve swelling) in patients with neurologic disease compared to direct ophthalmoscopy.

For several decades, there is an aging population, particularly in industrialized countries. This lengthening of the duration of life is accompanied by an increase in the number of chronically ill patients. On an estimate of 15 million patients in France today, the figure reported for 2020 would be 20 million patients. Chronic diseases are responsible for functional decompensation and admission responsible autonomy breaks in nursing homes (Accommodation Establishment of People Dependent Elderly). An estimated 700,000 the number of people currently living in retirement homes in France. These residents are mostly dependent and multiple pathologies requiring regular general and specialist medical monitoring . Medical concern demographic outlook and the need for access to quality care across the country leads to the development of telemedicine. The need for telemedicine is not the same throughout the territory. It is less, or different, in highly urbanized areas where the density of health professionals is high, then it can be a new response to the needs of rural, isolated or landlocked. Telemedicine promotes the development of the concept of graduated care sector, especially in the management of patients with chronic diseases. Telemedicine in rural nursing homes and can be a tool for assessing, monitoring and coordination to avoid decompensation of chronic conditions and rehospitalization. This organization can afford to break the isolation of general practitioners and EHPAD coordinators physicians in rural areas and provide access to several specialties.

The purpose of this study is to compare clinical outcomes in patients with acute COPD treated with a vibrating mesh nebuliser (VMN) versus a current standard jet nebuliser (JN), in the Emergency Department (ED). Participants will be those who meet the inclusion criteria and have a primary diagnosis of COPD, and consent to take part in the study. Operators will be clinical staff including doctors and nurses who will be trained in the use of the nebulisers. Delivery of current treatment standards utilising a VMN compared to a JN will improve symptom scores in patients attending ED with COPD exacerbations.

Patients who suffer hypoglycaemia in the community requiring the services of an ambulance are known to have a high short term mortality based on previous work. What is not known is the demographics of this group and also what the cause of death was for individuals whom unfortunately passed away in the time following ambulance callout. Importantly, studies looking at interventions to reduce poor outcomes in this group are lacking. The investigators conducted a pilot trial with the main goals to: Characterise this group in more detail and ascertain what was recorded as cause of death in those whom passed away in the months/years following community hypoglycaemia Ascertain if a simple nurse led intervention, focusing on educating participants on avoidance of hypoglycaemia, could improve outcome.

Saint Luke Home (SLH) is a home for low-income seniors who are ≥ 55 years and in need of basic living help in Tucson, Arizona. Reports shows that emergency calls are made from SLH (64 residents) around 60 times each year with emergency department (ED) visits and hospital admissions that follow. In 2014, a total of 70 calls were made, and in 2015, 49 calls. The Director, who is a nurse by training, and staff report that many of these calls are related to medications and may be avoidable. Therefore, we believe we can make a difference and decrease emergency calls, ED visits and hospitalizations that can be avoided with a program to teach the elders and staff at SLH. The program is called Preventing Avoidable Admissions Among Assisted Living Elders (PA4LE) and will consist of a 2-hour session every two weeks including home or clinic visits (elder preference), educational sessions, and staff training.

Older adults living in subsidized housing report poorer health. Their low income and age make it harder for them to use community services. Many older adults have heart disease and diabetes, which lead to frequent emergency calls and hospital admissions. To decrease the costs of treating heart disease and diabetes through emergency and hospitalization, improved screening and health education is needed. The Community Health Assessment Program through Emergency Medical Services (CHAP-EMS) program will take place in communal areas within housing buildings of older adults and deliver a heart disease, diabetes, and falls risk check-up with health education. This is expected to improve the health of older adults leading to fewer emergency calls and hospital visits. Paramedics on modified duties (e.g. injured) will conduct weekly, one-on-one drop-in sessions for seniors in a common area of one subsidized apartment building in Hamilton, Ontario.

The Swiss Emergency Triage Scale (SETS) in used for triage in emergency departments in Switzerland, France and Belgium. No validated triage scale is actually used by Emergency Medical Service (EMS) providers. The objective of this project is to evaluate the reliability and performance of triage by EMS providers with the SETS.

Pediatric emergency medicine (PEM) physicians are increasingly utilizing point-of-care ultrasound (POCUS). There is currently limited data regarding POCUS evaluation for intussusception in pediatric patients. To better understand the role of POCUS for identification of intussusception, the investigators plan to conduct a randomized, noninferiority study comparing POCUS and radiology-performed ultrasound (RADUS), utilizing experienced sonographers across multiple institutions.

To investigate which shapes of stylet, hand techniques and possible condition that improve intubation successful rate and reduce the elapsed intubation time.

The proposed pilot research has three aims: 1) to determine the feasibility and acceptability of provision of HIV self-testing kit in order to increase uptake and engagement of HIV testing among emergency department patients who decline conventional emergency department HIV testing and to increase the engagement of HIV testing at a regular basis for those with an increased risk for HIV (the index participants); 2) to determine the uptake and engagement of HIV testing by provision of HIV self-testing kit; and 3) to determine the feasibility and acceptability of HIV self-testing kit referral among partners or peers of the index participants. The investigators will conduct a pilot randomized study at Johns Hopkins Hospital emergency department on (1) patients who decline routine HIV testing offer and (2) patients who are at an increased risk for HIV. The consented patient will be randomized to HIV self-testing kit group which the investigators will provide a free Food and Drug Administration-approved HIV self-testing home kit for the participant to take it home or to reference group which the investigators will not provide the self-testing kit. Consented patients in both groups will fill out a short survey regarding their socio-demographic information as well as their experience and perceptions regarding HIV testing. For patients who are in the HIV self-testing kit group, they will be asked if they would like to take a free HIV self-testing home kit home. Participants in this group will also receive information regarding how to access "I Want The Kit" website to report the completion of HIV self-testing at home. For patients who are in the reference group, a standard pamphlet regarding the importance of HIV testing and HIV testing venues in Baltimore City used by emergency department-based HIV testing program will be provided to the patients. Follow-up questionnaires will inquire regarding the patient's experience regarding HIV testing since their index visit. When the participants in the HIV self-testing kit group in Aim 1, they will also be provided 5 referral cards for their partners and peers for them to request a free HIV self-testing kit from the "I Want The Kit" website. At the 1-month phone follow-up, the investigators will ask participants if they are able to give the referral cards to their partner(s) or friend(s), how they think if their partner(s) and/or friend(s) will request an HIV self-testing kit from the "I Want The Kit" website.