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Pre-Hospital Care

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https://www.readbyqxmd.com/read/29453979/toward-a-meaningful-definition-of-recovery-after-hip-fracture-comparing-two-definitions-for-community-dwelling-older-adults
#1
Mohammad Auais, Suzanne N Morin, Lois Finch, Sara Ahmed, Nancy Mayo
OBJECTIVES: To examine the course of recovery and resulting health-related quality of life (HRQL) after low-trauma hip fracture using two different definitions of recovery. DESIGN: Inception cohort with eight assessments over one year. SETTING: Participants were recruited from a tertiary-care hospital and followed in the community. INTERVENTION: Not applicable PARTICIPANTS: 47 (75% of all eligible) community-dwelling hip fracture patients (≥65 years)...
February 14, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29452732/efficacy-of-pre-hospital-rapid-sequence-intubation-in-paediatric-traumatic-brain-injury-a-9-year-observational-study
#2
Stefan Heschl, Ben Meadley, Emily Andrew, Warwick Butt, Stephen Bernard, Karen Smith
INTRODUCTION: Prehospital airway management of the paediatric patient with traumatic brain injury (TBI) is controversial. Endotracheal intubation of children in the field requires specific skills and has potential benefits but also carries potentially serious complications. We aimed to compare mortality and functional outcomes after six months between children with TBI who either underwent prehospital rapid sequence intubation (RSI) by trained Intensive Care paramedics (ICP) or received no intubation...
February 12, 2018: Injury
https://www.readbyqxmd.com/read/29452599/feasibility-and-acceptability-of-pre-operative-physical-activity-to-improve-patient-outcomes-after-major-cancer-surgery-study-protocol-for-a-pilot-randomised-controlled-trial-pepa-trial
#3
Daniel Steffens, Jane Young, Paula R Beckenkamp, James Ratcliffe, Freya Rubie, Nabila Ansari, Neil Pillinger, Michael Solomon
BACKGROUND: There is a need for evidence of the effectiveness of pre-operative exercise for patients undergoing major cancer surgery; however, recruitment to such trials can be challenging. The PrE-operative Physical Activity (PEPA) Trial will establish the feasibility and acceptability of a pre-operative exercise programme aimed to improve patient outcomes after cytoreductive surgery and pelvic exenteration. The secondary aim is to obtain pilot data on the likely difference in key outcomes (post-operative complications, length of hospital stay, post-operative functional capacity and quality of life) to inform the sample size calculation for the substantive randomised clinical trial...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29449317/it-takes-a-village-to-move-a-hospital-simulation-improves-intensive-care-team-preparedness-for-a-move-to-a-new-site
#4
Conall Francoeur, Sarah Shea, Margaret Ruddy, Patricia Fontela, Farhan Bhanji, Saleem Razack, Ronald Gottesman, Tanya Di Genova
OBJECTIVES: To evaluate in-situ simulation to prepare a PICU to move to a new, redesigned unit. METHODS: The study setting is an academic PICU. This is a cross-sectional study using in-situ simulations of common PICU admissions. Postsimulation, participants completed a survey comparing the perception of preparedness pre- and postsimulation (via a 10-point Likert scale). Participants were resurveyed 6 months postmove to assess whether effects persisted. Qualitative data were obtained via thematic review of the survey comment section and from postsimulation debriefing...
February 15, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29447789/comprehensive-electrocardiogram-to-device-time-for-primary-percutaneous-coronary-intervention-in-st-segment-elevation-myocardial-infarction-a-report-from-the-american-heart-association-mission-lifeline-program
#5
Jay S Shavadia, William French, Anne S Hellkamp, Laine Thomas, Eric R Bates, Steven V Manoukian, Michael C Kontos, Robert Suter, Timothy D Henry, Harold L Dauerman, Matthew T Roe
BACKGROUND: Assessing hospital-related network-level primary percutaneous coronary intervention (PCI) performance for ST-segment elevation myocardial infarction (STEMI) is challenging due to differential time-to-treatment metrics based on location of diagnostic electrocardiogram (ECG) for STEMI. METHODS: STEMI patients undergoing primary PCI at 588 PCI-capable hospitals in AHA Mission: Lifeline (2008-2013) were categorized by initial STEMI identification location: PCI-capable hospitals (Group 1); pre-hospital setting (Group 2); and non-PCI-capable hospitals (Group 3)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447402/intraoperative-endotracheal-cuff-pressure-study-how-education-and-availability-of-manometers-help-guide-safer-pressures
#6
Gregory J Stevens, Joel W Warfel, James K Aden, Scott D Blackwell
Introduction: Endotracheal intubation is a medical procedure that is often indicated in both the perioperative and critical care environments. Cuffed endotracheal tubes (ETT) allow for safer and more efficient delivery of positive pressure ventilation, as well as create a barrier to reduce the risk of micro-aspiration and anesthetic pollution in the operating room environment. Over-inflation of the endotracheal cuff can lead to serious and harmful sequelae. This study aimed to assess if departmental education paired with ready access to a manometer to assess cuff pressure would result in an improvement in the proportion of ETT cuff pressures in the goal range...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29447352/improvement-of-emergency-department-patient-flow-using-lean-thinking
#7
Miquel Sánchez, Montse Suárez, María Asenjo, Ernest Bragulat
Objective: To apply lean thinking in triage acuity level-3 patients in order to improve emergency department (ED) throughtput and waiting time. Design: A prospective interventional study. Setting: An ED of a tertiary care hospital. Participants: Triage acuity level-3 patients. Intervention(s): To apply lean techniques such as value stream mapping, workplace organization, reduction of wastes and standardization by the frontline staff...
February 13, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29447196/nasopharyngeal-carriage-of-streptococcus-pneumoniae-among-hiv-infected-and-uninfected-children-5-years-of-age-before-introduction-of-pneumococcal-conjugate-vaccine-in-mozambique
#8
Jennifer R Verani, Sérgio Massora, Sozinho Acácio, Rita Teresa Dos Santos, Delfino Vubil, Fabiana Pimenta, Iaci Moura, Cynthia G Whitney, Maria Helena Costa, Eusébio Macete, Maria Benigna Matsinhe, Maria da Gloria Carvalho, Betuel Sigaúque
Nasopharyngeal carriage is a precursor for pneumococcal disease and can be useful for evaluating pneumococcal conjugate vaccine (PCV) impact. We studied pre-PCV pneumococcal carriage among HIV-infected and -uninfected children in Mozambique. Between October 2012 and March 2013, we enrolled HIV-infected children age <5 years presenting for routine care at seven HIV clinics in 3 sites, including Maputo (urban-south), Nampula (urban-north), and Manhiça (rural-south). We also enrolled a random sample of HIV-uninfected children <5 years old from a demographic surveillance site in Manhiça...
2018: PloS One
https://www.readbyqxmd.com/read/29446494/prepared-for-surgery-communication-in-nurses-pre-operative-consultations-with-patients-undergoing-surgery-for-colorectal-cancer-after-a-person-centred-intervention
#9
M Pettersson, J Öhlen, F Friberg, L C Hydén, C Wallengren, E Sarenmalm, E Carlsson
AIMS AND OBJECTIVES: To describe preoperative communication after a person-centred intervention in nurses' consultations with patients undergoing surgery for colorectal cancer. BACKGROUND: Patients all over the world scheduled for surgery are referred for preoperative consultations with health care professionals. The goal is to assess the risk for perioperative complications, improving quality of care and enabling patients to be prepared for surgery and recovery...
February 15, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29445631/effects-of-negative-emotions-and-life-events-on-women-s-missed-miscarriage
#10
Huilin Xing, Yaping Luo, Shouying Wang
Background: To investigate the effects of negative emotions and life events on women's missed miscarriage. Methods: Overall, 214 women diagnosed with a missed miscarriage by prenatal examination from 2016-2017 in Xiamen Maternal and Child Health Care Hospital, Xiamen, China were selected as the observation group compared to 214 women as control group. The general data of the patients were investigated by self-programmed questionnaires. Zung Self-Rating Anxiety Scale, Center Epidemiological Studies Depression Scale; Life Events Scale for Pregnant Women were used conduct the study...
February 2018: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/29445061/the-prophylactic-effect-of-anti-influenza-agents-for-an-influenza-outbreak-in-a-university-hospital
#11
Mao Hagihara, Yukiko Kato, Ai Kurumiya, Tomoko Takahashi, Miki Sakata, Hideo Kato, Daisuke Sakanashi, Atsuko Yamada, Hiroyuki Suematsu, Jun Hirai, Naoya Nishiyama, Yusuke Koizumi, Yuka Yamagishi, Hiroshige Mikamo
Objective From November 24 to December 9, 2013, an outbreak of the influenza (flu) A (H3) virus occurred in a tertiary-care university hospital (1,014 beds). We herein report the prophylactic effect of anti-flu agents for controlling the flu outbreak. Methods We administered pre- or post-exposure prophylaxis with anti-flu agents in flu outbreak. To test the effectiveness of prophylaxis in a flu outbreak, we used the posterior mean of the reproductive value during the pre- and post-intervention period. We also simulated the probability distribution of new flu cases...
2018: Internal Medicine
https://www.readbyqxmd.com/read/29444787/randomised-controlled-pragmatic-clinical-trial-evaluating-the-effectiveness-of-a-discharge-follow-up-phone-call-on-30-day-hospital-readmissions-balancing-pragmatic-and-explanatory-design-considerations
#12
Maame Yaa A B Yiadom, Henry Domenico, Daniel Byrne, Michele Marie Hasselblad, Cheryl L Gatto, Sunil Kripalani, Neesha Choma, Sarah Tucker, Li Wang, Monisha C Bhatia, Johnston Morrison, Frank E Harrell, Tina Hartert, Gordon Bernard
INTRODUCTION: Hospital readmissions within 30 days are a healthcare quality problem associated with increased costs and poor health outcomes. Identifying interventions to improve patients' successful transition from inpatient to outpatient care is a continued challenge. METHODS AND ANALYSIS: This is a single-centre pragmatic randomised and controlled clinical trial examining the effectiveness of a discharge follow-up phone call to reduce 30-day inpatient readmissions...
February 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29444195/decrease-in-inpatient-telemetry-utilization-through-a-system-wide-electronic-health-record-change-and-a-multifaceted-hospitalist-intervention
#13
Karli Edholm, Polina Kukhareva, Claire Ciarkowski, Jason Carr, David Gill, Austin Rupp, Jack Morshedzadeh, Nathan Wanner, Kensaku Kawamoto
BACKGROUND: Unnecessary telemetry monitoring contributes to healthcare waste. OBJECTIVE: To evaluate the impact of 2 interventions to reduce telemetry utilization. DESIGN, SETTING, PATIENTS: A 2-group retrospective, observational pre- to postintervention study of 35,871 nonintensive care unit (ICU) patients admitted to 1 academic medical center. INTERVENTION: On the hospitalist service, we implemented a telemetry reduction intervention including education, process change, routine feedback, and a financial incentive between January 2015 and June 2015...
February 8, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29443860/a-novel-rat-model-of-extremity-trauma-for-pre-hospital-pain-management-research
#14
Lusha Xiang, Harold G Klemcke, Nathan A Wienandt, Kathy L Ryan, Carmen Hinojosa-Laborde
BACKGROUND: Pain management is important in pre-hospital care of patients with extremity trauma (ET). The goal of this study was to establish a rat model of ET for pre-hospital pain research, and validate it using pain behaviors and analgesics. METHODS: Rats were anesthetized using isoflurane and ET was induced in one hindlimb via clamping retrofemoral tissues for 30 sec, followed by closed fibula fracture. Rats regained consciousness after ET. Pain responses in the injured hindlimb to thermal hyperalgesia (paw withdrawal latency, PWL), mechanical allodynia (paw withdrawal pressure, PWP), and weight bearing (WB) were determined before and 90 minutes after ET...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29441123/circulation-first-the-time-has-come-to-question-the-sequencing-of-care-in-the-abcs-of-trauma-an-american-association-for-the-surgery-of-trauma-multicenter-trial
#15
Paula Ferrada, Rachael A Callcut, David J Skarupa, Therese M Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M Nygaard, Martin A Schreiber, Toby Enniss, Michelle McNutt, Herb Phelan, Kira Smith, Forrest O Moore, Irene Tabas, Joseph Dubose
Background: The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that patients in hypovolemic shock would have comparable outcomes with initiation of bleeding treatment (transfusion) prior to intubation (CAB), compared to those patients treated with the traditional ABC sequence. Methods: This study was sponsored by the American Association for the Surgery of Trauma multicenter trials committee...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29438637/population-attributable-fractions-of-perinatal-outcomes-for-nulliparous-women-associated-with-overweight-and-obesity-1990-2014
#16
Kate Cheney, Rachel Farber, Alexandra L Barratt, Kevin McGeechan, Bradley de Vries, Robert Ogle, Kirsten I Black
OBJECTIVE: To examine the prevalence across 25 years of overweight and obesity among nulliparous Australian women during early pregnancy; to estimate the proportions of adverse perinatal outcomes attributable to overweight and obesity in this population. DESIGN: Cohort study; retrospective analysis of electronic maternity data. Setting, participants: 42 582 nulliparous women with singleton pregnancies giving birth at the Royal Prince Alfred Hospital, an urban teaching hospital in Sydney, January 1990 - December 2014...
February 19, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29437308/presenteeism-among-emergency-health-care-staff
#17
Marta Sánchez-Zaballos, María Baldonedo-Mosteiro, Mª Pilar Mosteiro-Díaz
OBJECTIVES: To estimate the prevalence of presenteeism among different categories of hospital and pre-hospital emergency health care professionals in the Principality of Asturias, Spain, and to define the sociodemographic characteristics and workplace factors associated with presenteeism in all categories. MATERIAL AND METHODS: Cross-sectional descriptive study carried out during the last half of 2014 and first half of 2015. A self-administered questionnaire was used to collecta data on sociodemographic and work-related variables and perception of work as stressful...
February 2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29436260/treatment-patterns-and-associated-health-care-costs-before-and-after-treatment-initiation-among-pulmonary-arterial-hypertension-patients-in-the-united-states
#18
Charles D Burger, A Burak Ozbay, Howard M Lazarus, Ellen Riehle, Leslie B Montejano, Gregory Lenhart, R James White
BACKGROUND: Despite multiple treatment options, the prognosis of pulmonary arterial hypertension (PAH) remains poor. PAH patients experience a high economic burden due to comorbidities, hospitalizations, and medication costs. Although combination therapy has been shown to reduce hospitalizations, the relationship between treatment, health care utilization, and costs remains unclear. OBJECTIVE: To provide a characterization of health care utilization and costs in real-world settings by comparing periods before and after initiating PAH-specific treatment...
February 13, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29435627/wide-surgical-margin-improves-the-outcome-for-patients-with-gastrointestinal-stromal-tumors-gists
#19
Jan Åhlén, Fredrik Karlsson, Johan Wejde, Inga-Lena Nilsson, Catharina Larsson, Robert Bränström
BACKGROUND: Surgical resection is still the main treatment for gastrointestinal stromal tumor (GIST), and R0 excision, regardless of surgical margins, is considered sufficient. METHODS: A cohort of 79 consecutive GIST cases treated at the Karolinska University Hospital, who were without metastasis at diagnosis and who had not received any pre-or postoperative treatment with tyrosine kinase inhibitors, was included. Surgical margins were evaluated at the time of surgery and classified as wide, marginal or intralesional...
February 12, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29433471/mortality-estimates-among-adult-patients-with-severe-acute-respiratory-infections-from-two-sentinel-hospitals-in-southern-arizona-united-states-2010-2014
#20
Steve R Barnes, Zimy Wansaula, Kristen Herrick, Eyal Oren, Kacey Ernst, Sonja J Olsen, Mariana G Casal
BACKGROUND: From October 2010 through February 2016, Arizona conducted surveillance for severe acute respiratory infections (SARI) among adults hospitalized in the Arizona-Mexico border region. There are few accurate mortality estimates in SARI patients, particularly in adults ≥ 65 years old. The purpose of this study was to generate mortality estimates among SARI patients that include deaths occurring shortly after hospital discharge and identify risk factors for mortality. METHODS: Patients admitted to two sentinel hospitals between 2010 and 2014 who met the SARI case definition were enrolled...
February 12, 2018: BMC Infectious Diseases
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