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Showing results for "pressure injury".
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161. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33588/psn-pdf
     March 15, 2025 - health care providers who are involved in an unanticipated adverse event, medical error, or patient injury … natural-history-recovery-healthcare-provider-second-victim-after-adverse-patient-events Stage of Recovery Summary Moving On Clinicians feel internal and external pressure

162. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49673/psn-pdf
     December 01, 2012 - On physical examination, his initial blood pressure was elevated at 192/100 mm Hg, but his heart rate … Bilateral upper-extremity blood pressures were equal. … oral antacid/anesthetic combination) was given, and the patient reported symptom relief; his blood pressure … ECG interpretation: sinus tachycardia, with posterolateral injury pattern.

163. Remote Patient Monitoring | PSNet
     psnet.ahrq.gov/perspective/remote-patient-monitoring
     March 15, 2023 - We monitored the blood pressures of home peritoneal dialysis patients. … We knew their trends and that some of them had typically higher blood pressures and some of them had … typically lower blood pressures, so we created individual thresholds. 1 , 3 , 4 Sarah Mossburg: It … Historically, these are acute problems that arise where there is illness or injury. … We knew there were hospital capacity problems and a lot of different pressures and stakeholders that

164. In Conversation with... Dr. Neal Sikka and Dr. Colton Hood about Remote Patient Monitoring | PSNet
     psnet.ahrq.gov/perspective/conversation-dr-neal-sikka-and-dr-colton-hood-about-remote-patient-monitoring
     March 15, 2023 - We monitored the blood pressures of home peritoneal dialysis patients. … We knew their trends and that some of them had typically higher blood pressures and some of them had … typically lower blood pressures, so we created individual thresholds. 1 , 3 , 4 Sarah Mossburg: It … Historically, these are acute problems that arise where there is illness or injury. … We knew there were hospital capacity problems and a lot of different pressures and stakeholders that

165. Defensive Medicine: "Glowing" with Pain | PSNet
     psnet.ahrq.gov/web-mm/defensive-medicine-glowing-pain
     November 01, 2012 - medicine can be found in the field of neurosurgery where many hospitals refuse to treat closed head injuries … because of liability concerns.( 13 ) In complex patients, vaginal delivery may increase the risk of injury … to the mother or fetus; injuries in this setting often lead to malpractice claims. … Are evidence-based practices associated with effective prevention of hospital-acquired pressure

166. Doctors With Multiple Malpractice Claims, Disciplinary Actions, and Complaints: What Do We Know? | PSNet
     psnet.ahrq.gov/perspective/doctors-multiple-malpractice-claims-disciplinary-actions-and-complaints-what-do-we-know
     July 01, 2017 - this area from personal acquaintance with physicians and understanding their narratives of how legal pressures … That caring relationship doesn't end when an injury occurs, particularly if the injury is our fault. … They reduce the underlying safety problems that can lead to injuries that lead to claims. … Then, we have a few cases in which EHR systems themselves have had problems that have led to injuries … May 20, 2015 Medical monitoring for pharmaceutical injuries: tort law for the public's

167. Navigating Complications: The Unintended Journey of a Guidewire During Dialysis Catheter Placement | PSNet
     psnet.ahrq.gov/web-mm/navigating-complications-unintended-journey-guidewire-during-dialysis-catheter-placement
     February 23, 2022 - The patient’s blood pressure was 174/101 mmHg, heart rate 126, respiratory rate 26, temperature 37.5 … The patient’s laboratory results were notable for acute kidney injury and metabolic acidosis, with an … only reported in 38 cases, but operator error, distraction, interruption, and emergency or after-hours pressure … December 4, 2024 WebM&M Cases Under Pressure: Tracheostomy

168. Endotracheal Tube Fallout in a Patient with Severe Obesity During Eye Surgery. | PSNet
     psnet.ahrq.gov/web-mm/endotracheal-tube-fallout-patient-severe-obesity-during-eye-surgery
     January 29, 2021 - When continuous positive airway pressure is prescribed for sleep apnea for these patients, it may not … anesthetic with an endotracheal tube was therefore necessary in this case so that positive end expiratory pressure … so quickly. 24 Inserting an airway, applying high flow nasal oxygen or continuous positive airway pressure … April 24, 2024 WebM&M Cases Uterine Artery Injury

169. Fatal Error in Neonate: Does "Just Culture" Provide an Answer? | PSNet
     psnet.ahrq.gov/web-mm/fatal-error-neonate-does-just-culture-provide-answer
     June 24, 2020 - Were there time pressures, organizational or managerial expectations, or protocol or procedures that … October 14, 2009 Laparoscopic bile duct injury: understanding the psychology and heuristics

170. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33578/psn-pdf
     September 15, 2024 - anesthesia were integral to the redesign of anesthesia equipment, significantly reducing the risk of injury … critical system property, reflecting the organization's capacity to bounce back in the face of continuing pressures

171. Code Status Confusion | PSNet
     psnet.ahrq.gov/web-mm/code-status-confusion
     September 01, 2006 - On physical examination, her blood pressure was 145/85, pulse 85, oxygen saturation of 94%, with a respiratory … At this point, the patient’s blood pressure was 90/palpable with a heart rate of 40 and an O2 saturation … s preference to avoid invasive ventilation, she was started on noninvasive bi-level positive airway pressure … with uncertain outcomes, such as successful cardiac resuscitation with resultant severe anoxic brain injury

172. Don't Dismiss the Dangerous: Obstetric Hemorrhage | PSNet
     psnet.ahrq.gov/web-mm/dont-dismiss-dangerous-obstetric-hemorrhage
     August 21, 2024 - hospital course but was ultimately discharged to a rehabilitation facility with no major permanent injuries … from a cervical laceration that extends beyond the vagina into the peritoneal cavity or a vaginal wall injury … 12 ) Furthermore, the operative field may appear dry during the procedure when the patient's blood pressure … is low, only to have significant bleeding later emerge when severe hypertensive pressures return, after

173. A Real Heartache | PSNet
     psnet.ahrq.gov/web-mm/real-heartache
     October 01, 2018 - On physical examination, his initial blood pressure was elevated at 192/100 mm Hg, but his heart rate … Bilateral upper-extremity blood pressures were equal. … oral antacid/anesthetic combination) was given, and the patient reported symptom relief; his blood pressure … ECG interpretation: sinus tachycardia, with posterolateral injury pattern.

174. Second Victims: Support for Clinicians Involved in Errors and Adverse Events | PSNet
     psnet.ahrq.gov/primer/second-victims-support-clinicians-involved-errors-and-adverse-events
     December 15, 2024 - health care providers who are involved in an unanticipated adverse event, medical error, or patient injury … Moving On Clinicians feel internal and external pressure to "move on," and in the study had three forms

175. In Conversation With… Tejal K. Gandhi, MD, MPH | PSNet
     psnet.ahrq.gov/perspective/conversation-tejal-k-gandhi-md-mph
     February 26, 2025 - Does this accelerate the pressure to think about safety more broadly in the ambulatory environment and … That report called out the fact that many physical injuries are happening in the workforce, as well as … psychological injury due to lack of respect, bullying, fear, stress, and productivity pressures.

176. Timely diagnosis of esophageal perforation | PSNet
     psnet.ahrq.gov/web-mm/timely-diagnosis-esophageal-perforation
     September 27, 2023 - re-evaluation of the available information to refine the list of possible diagnoses. 5   Systematic pressures … Even in the absence of a history suggestive of esophageal perforation (instrumentation, injury, vomiting … Utter, MD MSc   Professor of Surgery  Division of Trauma, Acute Care Surgery, and Surgical Critical … 2022 WebM&M Cases Errors in Managing an Open Wound

177. The Dose Makes the Poison: Medication Error During Procedural Sedation in the Pediatric Emergency Department. | PSNet
     psnet.ahrq.gov/web-mm/dose-makes-poison-medication-error-during-procedural-sedation-pediatric-emergency-department
     January 23, 2017 - transferred by ambulance to a tertiary Emergency Department (ED) from a referring hospital due to a left leg injury … holding her left hip flexed with significant tenderness on examination, but there were no other signs of trauma … during a diagnostic or therapeutic procedure.” 4,5 Sedation can also ameliorate the psychological trauma … exist when sedation is urgently needed to prevent harm associated with the underlying condition or injury … Blood pressure should be measured frequently, and the electrocardiogram, heart rate, respiratory rate

178. Missed Diagnosis of Addison’s Disease in Adolescent Presenting with Fatigue. | PSNet
     psnet.ahrq.gov/web-mm/missed-diagnosis-addisons-disease-adolescent-presenting-fatigue
     October 28, 2020 - order of 1 in 10,000 individuals 2-4 – and can be related to autoimmune destruction, infiltration/injury … (hemorrhage, trauma, infection), underlying genetic or metabolic disorders, or medication effects. … Forms of AI that affect mineralocorticoid production can cause low blood pressure or orthostatic hypotension … including gastrointestinal illness as well as any infection, medical/dental procedure, or physical trauma … life-threatening and can occur in patients with AI due to any physiologic stress, including viral illness or injury

179. Inadequate Anesthesia Preparation Leading to Difficult Intubation and Severe Hypoxemia | PSNet
     psnet.ahrq.gov/web-mm/inadequate-anesthesia-preparation-leading-difficult-intubation-and-severe-hypoxemia
     January 29, 2021 - managing the difficult airway. 8 The combination of these devices can also help to prevent airway trauma … this high-risk scenario was, in retrospect, not the most prudent course of action due to the airway trauma … neuromuscular blockade with high dose sugammadex was an essential step that prevented hypoxic brain injury … reversal of neuromuscular blockade made surgical cricothyroidotomy unnecessary, preventing hypoxic brain injury … abdominal contents displacing the diaphragm in a cephalad direction with the positive end expiratory pressure

180. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/846170/psn-pdf
     March 15, 2023 - confusion, the patient ran out of his medication and his daughter and home health nurse noted poor blood pressure … This lapse resulted in poor blood pressure control, but fortunately no harmful outcomes. … errors have the potential to be serious and may result in adverse drug events (ADE), which are patient injuries … What changes you will make to your blood pressure medications?”