Nurses effective at treating common arm injury in kids, but docs do it better

Clinical trial

2014-03-24

(Press-News.org) A clinical trial to determine if nurses in the emergency department could reduce "pulled elbows" in children at a rate similar to that of physicians found that althiough nurses were able to treat this common injury 85% of the time, physicians were more effective, with a 97% success rate. The trial is published Mar. 24 in CMAJ (Canadian Medical Association Journal).

Pulled elbow, or radial-head subluxation, is a common arm injury in young children, often resulting in a visit to the emergency department. The injury is easy to diagnose and quick to fix, but children usually wait hours in the emergency department.

Researchers performed an open, cluster-randomized controlled trial to determine whether triage nurses in the emergency department could fix the condition, thereby freeing up valuable resources. The trial involved 268 children at the Children's Hospital of Eastern Ontario in Ottawa, Canada. Children were assigned to be treated by either a physician or a nurse who was trained in treating this injury. On the basis of feedback from a survey of emergency physicians, researchers set a target of 10%, meaning if nurses reduced the injury by rates within 10% of physician rates, the doctors would consider using the protocol at their hospitals.

Nurses had a success rate of 85% in reducing the injury compared with a rate of 97% by physicians, which was 12% below the physician rate.

"Nurses accurately identified and reduced radial-head subluxation in most cases," writes Dr. Andrew Dixon, Department of Pediatrics, University of Alberta, and Stollery Children's Hospital, Edmonton, Alberta, with coauthors. "Children in the nurse-treatment group had a shortened length of stay compared with children in the physician-treatment group, spending an average of 55 minutes less in the emergency department."

Although the nurses did not meet the target for reducing the injury, their success rate was still high, and there could be benefits for using trained nurses to help reduce the injury.

The authors conclude "task-shifting in health care involves trade-offs. Our study provides an informed choice between an immediate treatment that works 7 times out of 10 and a delayed treatment that works 19 times out of 20."

INFORMATION: END

ELSE PRESS RELEASES FROM THIS DATE:

Canadians spend more on private health insurance for smaller payouts

2014-03-24

Spending by Canadians on private health insurance has more than doubled over the past 20 years, but insurers paid out a rapidly decreasing proportion as benefits, according to a study published today in the CMAJ (Canadian Medical Association Journal). The study, by University of British Columbia and University of Toronto researchers, shows that overall Canadians paid $6.8 billion more in premiums than they received in benefits in 2011. Approximately 60 per cent of Canadians have private health insurance. Typically obtained as a benefit of employment or purchased by ...

Bundled payments come to gastroenterology

2014-03-24

Bethesda, MD (March 24, 2014) — Patients want physicians to provide high-quality care and the health system requires good value for physician work. To help gastroenterologists achieve these goals, the American Gastroenterological Association (AGA) has developed a colonoscopy bundled payment model, which has been published in Gastroenterology1, the official journal of the AGA. By developing a framework and educating gastroenterologists about value-based reimbursement, the AGA hopes to inform physicians who wish to consider contracting with payors, purchasers and risk-bearing ...

Researchers issue state-of-the-state on genetic-based testing & treatment for breast cancer

2014-03-24

(Lebanon, NH, 03/24/2014)- Dartmouth researchers at its Norris Cotton Cancer Center have compiled a review of the role that information gathered through genetic testing plays in the diagnosis and treatment of breast cancer. The paper entitled "Personalized Therapy for Breast Cancer" was accepted on March 17, 2014, for publication in Clinical Genetics. The paper discusses targeted therapies, new biomarkers, and the quality of commercially available testing methods. Genomic testing is changing the way breast cancer is diagnosed and treated. By examining a woman's genes ...

Low parking costs may encourage automobile use

2014-03-24

PHILADELPHIA (March 24, 2014)— The low cost of parking in many American cities may contribute to urban development that relies on automobile use and undercuts planners' efforts to increase public transport, according to a new baseline study of comprehensive public parking costs led by the Drexel University School of Public Health. The article, "Public parking fees and fines: a survey of US cities," is now published online ahead of print in the journal Public Works Management and Policy. It reports on downtown public parking costs after surveying public parking agencies ...

NASA spots Tropical Cyclone Gillian's eye closing

2014-03-24

Tropical Cyclone Gillian's eye was starting to "close" or become cloud-filled when NASA's Aqua satellite passed over the Southern Indian Ocean on March 23. On March 23, Gillian's maximum sustained winds peaked near 140 knots/161.1 mph/259.3 kph making it a Category 5 hurricane on the Saffir-Simpson Scale. Fortunately, Gillian pulled away from Indonesia, so all of the regional warnings were canceled on March 23. At 06:45 UTC on March 23, NASA's Aqua satellite flew overhead and the Moderate Resolution Imaging Spectroradiometer or MODIS instrument captured a visible image ...

Computer models solve geologic riddle millions of years in the making

2014-03-24

An international team of scientists that included USC's Meghan Miller used computer modeling to reveal, for the first time, how giant swirls form during the collision of tectonic plates – with subduction zones stuttering and recovering after continental fragments slam into them. The team's 3D models suggest a likely answer to a question that has long plagued geologists: why do long, curving mountain chains form along some subduction zones – where two tectonic plates collide, pushing one down into the mantle? Based on the models, the researchers found that parts of the ...

Motor learning: Lining up our sights

2014-03-24

Neurologists at Ludwig-Maximilians-Universitaet (LMU) in Munich have studied the role of the vestibular system, which controls balance, in optimizing how we direct our gaze. The results could lead to more effective rehabilitation of patients with vestibular or cerebellar dysfunction. When we shift the direction of our gaze, head and eye movements are normally highly coordinated with each other. Indeed, from the many possible combinations of speed and duration for such movements, the brain chooses the one that minimizes the error in reaching the intended line of sight. ...

Glatt Kosher for Passover Seders At Talia's Steakhouse & Bar, A Manhattan Kosher Restaurant - Chol Hamoed and Yom Tov Meals Are Also Available at Talia's During This Popular Jewish Holiday

2014-03-24

If you are looking for a relaxing and stress-free way to celebrate Passover with your loved ones without spending the whole day in the kitchen, consider what has become a tradition for Passover at the popular New York City Glatt Kosher restaurant, Talia's Steakhouse & Bar, located on the Upper West Side of Manhattan, NYC. For over eleven years, Talia's Steakhouse & Bar has been serving the kosher community of the NY Metro area. As the premier Glatt kosher establishment in Manhattan, Talia's is proud to announce that, once again, it will conduct four prepaid ...

Leukemia caused by chromosome catastrophe

2014-03-24

Researchers have found that people born with a rare abnormality of their chromosomes have a 2,700-fold increased risk of a rare childhood leukaemia. In this abnormality, two specific chromosomes are fused together but become prone to catastrophic shattering. Acute lymphoblastic leukaemia, or ALL, is the most common childhood cancer. Scientists previously found that a small subset of ALL patients have repeated sections of chromosome 21 in the genomes of their leukaemia cells. This form of ALL – iAMP21 ALL – requires more intensive treatment than many other types of ALL. ...

Small number of counties leads the way in reducing smoking rates in the US

2014-03-24

SEATTLE — Nationally, smoking rates have decreased since 1996, but the declines have been driven by a relatively small share of counties across the US, according to new research from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. The study, "Cigarette smoking prevalence in US counties: 1996-2012," was published March 24 in the open-access, peer-reviewed journal Population Health Metrics. Total cigarette smoking prevalence – the percentage of the population that smokes – has not decreased significantly in all counties but, because ...

Nurses effective at treating common arm injury in kids, but docs do it better

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: