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Related Concept Videos

Documentation of Nursing Diagnosis01:10

Documentation of Nursing Diagnosis

The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
Formulating and Validating Nursing Diagnosis II01:25

Formulating and Validating Nursing Diagnosis II

Nursing diagnoses represent a problem validated by major defining characteristics. There are four categories of nursing diagnoses: problem-focused, risk, health promotion or wellness, and syndrome. The anatomy of a nursing diagnosis includes three components: problem statement or diagnostic label, defining characteristics, and related factors.
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Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:

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Related Experiment Video

Updated: May 11, 2026

Troubleshooting FoCUS Image Acquisition: Patient Positioning, Transducer Manipulation, and Image Optimization
06:50

Troubleshooting FoCUS Image Acquisition: Patient Positioning, Transducer Manipulation, and Image Optimization

Published on: March 3, 2023

The "found down" patient: a diagnostic dilemma.

Lucy Z Kornblith1, Matthew E Kutcher, Abigail E Evans

  • 1Department of Surgery, San Francisco General Hospital, and University of California, San Francisco, CA 94110, USA.

The Journal of Trauma and Acute Care Surgery
|May 23, 2013
PubMed
Summary

Nearly half of "found down" patients in the emergency department (ED) have injuries, with some diagnoses delayed. Triage discordance is common, necessitating early trauma surgery consultation and flexible triage to prevent missed injuries.

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Area of Science:

  • Emergency Medicine
  • Trauma Surgery
  • Patient Triage

Background:

  • Found down patients present to the emergency department (ED) unconscious, requiring triage for trauma or medical evaluation.
  • Occult injuries are a significant concern in this patient population.
  • Clear triage criteria and timely evaluation are essential for optimal care and resource utilization.

Purpose of the Study:

  • To analyze the incidence of injuries and the effectiveness of triage in "found down" patients.
  • To identify factors associated with injuries and the need for inter-service consultations.
  • To evaluate the impact of triage decisions on diagnosis and patient outcomes.

Main Methods:

  • Retrospective review of 201 "found down" patients from ED triage logs at an urban Level I trauma center (2007-2011).
  • Physician researchers analyzed patient demographics, injuries, medical diagnoses, and mortality.
  • Epidemiological study, level IV.

Main Results:

  • 42.7% of patients had injuries, with 4.5% requiring urgent surgery.
  • Homelessness, psychiatric diagnoses, and substance use were common.
  • 20.4% of patients triaged to trauma were younger, male, and more likely to be intoxicated.
  • 13.4% of patients required consultation by a service other than their initial triage.
  • Delayed diagnosis of occult injuries occurred in both trauma (14.6%) and medical (1.9%) patients.

Conclusions:

  • Nearly half of "found down" patients present with clinically significant injuries.
  • Triage discordance between medical and trauma services is prevalent, leading to potential delays.
  • Early trauma surgery consultation and flexible triage protocols are crucial for accurate diagnosis and management of occult injuries.