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psnet.ahrq.gov/issue/interdisciplinary-collaboration-across-secondary-and-primary-care-improve-medication-safety
December 21, 2022 - medication reconciliation at discharge on 30-day readmission rates of patients with chronic obstructive pulmonary
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psnet.ahrq.gov/issue/increasing-rate-detection-wrong-patient-radiographs-use-photographs-obtained-time-radiography
June 13, 2015 - Cases
The Dropped "No"
October 1, 2011
Time trends in pulmonary
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psnet.ahrq.gov/issue/does-inappropriate-selectivity-information-use-relate-diagnostic-errors-and-patient-harm
July 02, 2014 - Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary
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psnet.ahrq.gov/issue/evaluation-near-miss-wrong-patient-events-radiology-reports
June 13, 2015 - May 23, 2012
Time trends in pulmonary embolism in the United States: evidence of overdiagnosis
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psnet.ahrq.gov/issue/medication-errors-involving-patient-controlled-analgesia
May 24, 2015 - medication reconciliation at discharge on 30-day readmission rates of patients with chronic obstructive pulmonary
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psnet.ahrq.gov/issue/radiologic-safety-events-within-pediatric-emergency-medicine-network
August 01, 2018 - October 4, 2011
Time trends in pulmonary embolism in the United States: evidence of overdiagnosis
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psnet.ahrq.gov/issue/eight-ct-lessons-we-learned-hard-way-analysis-current-patterns-radiological-error-and
September 24, 2018 - March 4, 2015
Time trends in pulmonary embolism in the United States: evidence of overdiagnosis
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psnet.ahrq.gov/node/849679/psn-pdf
June 28, 2023 - tracheostomy placement include diabetes,
tracheomalacia, smoking tobacco products, chronic obstructive pulmonary … psnet.ahrq.gov//#12
https://psnet.ahrq.gov//#12
https://psnet.ahrq.gov//#13
different ways and often include pulmonary … Jstrask@ucdavis.edu
Brooks Thomas Kuhn, MD, MAS
Assistant Professor of Clinical Medicine
Division of Pulmonary
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psnet.ahrq.gov/node/49542/psn-pdf
August 21, 2007 - Her only relevant past medical history included a
postoperative pulmonary embolus after hip surgery. … acute shortness of breath and hypoxia and returned to
the hospital, where she was diagnosed with a pulmonary
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.98_slideshow.ppt
June 01, 2005 - A pulmonary artery catheter was placed, and initial numbers were—surprisingly—more consistent with cardiogenic … Central venous pressure was 13-17 mm Hg, pulmonary capillary wedge pressure 19 mm Hg, cardiac index (
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psnet.ahrq.gov/web-mm/pre-analytical-pitfalls-missing-and-mislabeled-specimens
April 18, 2018 - Emergency Department (ED) with chest pain, shortness of breath, and a history of chronic obstructive pulmonary … Chest, abdominal, and pelvis computerized tomography scans were also negative for pulmonary embolism … the wrong patient. 17 In one reported case, such an error resulted in the wrong patient receiving a pulmonary
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psnet.ahrq.gov/node/49811/psn-pdf
November 01, 2017 - delayed-diagnosis-endocrinologic-emergencies
A 53-year-old woman with a history of chronic obstructive pulmonary … Congestive Heart Failure Score
Absent 0
Mild (pedal edema) 5
Moderate (bibasilar rales) 10
Severe (pulmonary … 30
https://psnet.ahrq.gov//#references
Other ECG changes* 10
Pericardial/pleural effusions 10
Pulmonary
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psnet.ahrq.gov/web-mm/deaths-not-foretold-are-unexpected-deaths-useful-patient-safety-signals
March 01, 2004 - family's request, no autopsy was performed; however, providers felt that the patient suffered a massive pulmonary … thromboembolism prophylaxis at the time of hip fracture surgery (as this patient received) developed a fatal pulmonary … embolism.( 1 ) Even if the patient in this case did not die of pulmonary embolism, she would be considered
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psnet.ahrq.gov/node/49579/psn-pdf
March 21, 2009 - Based on this
vital piece of information, the team became concerned that a pulmonary embolism (blood … The patient was treated with thrombolytics (clot-busters) for presumed
massive pulmonary embolism 5 … community-acquired pneumonia vs. pulmonary embolism, etc.") rather than labeling the patient with a
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psnet.ahrq.gov/node/49774/psn-pdf
November 01, 2016 - Out of
concern for pulmonary embolism, a computed tomography scan was ordered, which showed no evidence … of pulmonary embolism. … maintain her circulation), this finding led
her physicians to focus on other potential diagnoses such as pulmonary
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psnet.ahrq.gov/node/33808/psn-pdf
May 01, 2016 - For example, a
patient with chronic obstructive pulmonary disease (COPD) may have a baseline SpO2 that … parameters by overall patient population—such as
changing the settings for a cardiac step-down unit vs. a pulmonary
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psnet.ahrq.gov/node/49757/psn-pdf
April 01, 2016 - recurrent blood clots and heparin-induced thrombocytopenia, was admitted to the next
room with a new pulmonary … her IV pole was labeled as argatroban—but the name on the label
matched that of the patient with the pulmonary
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psnet.ahrq.gov/issue/older-patients-perceptions-unnecessary-tests-and-referrals-national-survey-medicare
May 25, 2011 - Download Citation
Related Resources From the Same Author(s)
Time trends in pulmonary
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psnet.ahrq.gov/node/50859/psn-pdf
January 31, 2020 - However, they don’t see the one incendiary pulmonary nodule at the
base because they are really busy … pattern recognition, not fatiguing, and not
overlooking binary things that humans might, like is there a pulmonary
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psnet.ahrq.gov/web-mm/under-pressure-tracheostomy-cuff-over-inflation-leading-tissue-necrosis-and-cuff-rupture
March 15, 2023 - tracheostomy placement include diabetes, tracheomalacia, smoking tobacco products, chronic obstructive pulmonary … hospital standards. 13,14 Tracheostomy teams can be structured in different ways and often include pulmonary … Jstrask@ucdavis.edu Brooks Thomas Kuhn, MD, MAS Assistant Professor of Clinical Medicine Division of Pulmonary