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https://www.readbyqxmd.com/read/30199391/icu-management-of-trauma-patients
#1
Samuel A Tisherman, Deborah M Stein
OBJECTIVES: To describe the current state of the art regarding management of the critically ill trauma patient with an emphasis on initial management in the ICU. DATA SOURCES AND STUDY SELECTION: A PubMed literature review was performed for relevant articles in English related to the management of adult humans with severe trauma. Specific topics included airway management, hemorrhagic shock, resuscitation, and specific injuries to the chest, abdomen, brain, and spinal cord...
September 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/30189887/assessment-of-laypersons-paediatric-basic-life-support-and-foreign-body-airway-obstruction-management-skills-a-validity-study
#2
Asbjørn Hasselager, Doris Østergaard, Tim Kristensen, Claus Sønderskov, Cathrine Bohnstedt, Torsten L B Lauritsen, Lars Konge, Martin G Tolsgaard
BACKGROUND: Standardised courses for laypeople in Paediatric Basic Life Support (PBLS) and Foreign Body Airway Obstruction Management (FBAOM) teach essential skills for the initiation of resuscitation by bystanders. Performance assessments are necessary to ensure that skills are acquired. We aimed to examine the validity of developed performance assessments and to determine credible pass/fail standards. METHODS: Validity evidence was gathered in a standardised simulated setting by testing participants with three different levels of PBLS/FBAOM experience: untrained laypersons, trained laypersons, and lifeguards...
September 6, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30186519/is-there-room-for-further-innovation-in-inhaled-therapy-for-airways-disease
#3
REVIEW
Martyn F Biddiscombe, Omar S Usmani
Inhaled medication is the cornerstone in the treatment of patients across a spectrum of respiratory diseases including asthma and chronic obstructive pulmonary disease. The benefits of inhaled therapy have long been recognised but the most important innovations have occurred over the past 60 years, beginning with the invention of the pressurised metered dose inhaler. However, despite over 230 different device and drug combinations currently being available, disease control is far from perfect. Here we look at how innovation in inhaler design may improve treatments for respiratory diseases and how new formulations may lead to treatments for diseases beyond the lungs...
September 2018: Breathe
https://www.readbyqxmd.com/read/30171286/-update-mallampati-theoretical-and-practical-knowledge-of-european-anesthetists-on-basic-evaluation-of-airways
#4
H Ilper, C Franz-Jäger, C Byhahn, M Klages, H H Ackermann, K Zacharowski, T Kunz
In 1985 Mallampati et al. published a non-invasive score for the evaluation of airways (Mallampati grading scale, MGS), which originally consisted of only three different classes and has been modified several times. At present it is mostly used in the version of Samsoon and Young consisting of four different classes. Class I: soft palate, fauces, uvula, palatopharyngeal arch visible, class II: soft palate, fauces, uvula visible, class III: soft palate, base of the uvula visible and class IV: soft palate not visible...
August 31, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/30161119/pre-post-effects-of-a-tetanus-care-protocol-implementation-in-a-sub-saharan-african-intensive-care-unit
#5
Riaz Aziz, Soledad Colombe, Gibonce Mwakisambwe, Solomon Ndezi, Jim Todd, Samuel Kalluvya, Halinder S Mangat, Reed Magleby, Arndt Koebler, Bernard Kenemo, Robert N Peck, Jennifer A Downs
BACKGROUND: Tetanus is a vaccine-preventable, neglected disease that is life threatening if acquired and occurs most frequently in regions where vaccination coverage is incomplete. Challenges in vaccination coverage contribute to the occurrence of non-neonatal tetanus in sub-Saharan countries, with high case fatality rates. The current WHO recommendations for the management of tetanus include close patient monitoring, administration of immune globulin, sedation, analgesia, wound hygiene and airway support [1]...
August 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/30119989/out-of-hospital-cardiac-arrest-outcomes-with-pit-crew-resuscitation-and-scripted-initiation-of-mechanical-cpr
#6
Louis Gonzales, Brandon K Oyler, Jeff L Hayes, Mark E Escott, Jose G Cabanas, Paul R Hinchey, Lawrence H Brown
OBJECTIVE: To compare OHCA outcomes in patients managed with mechanical versus manual CPR in an EMS system with a "pit crew" approach to resuscitation and a scripted sequence for the initiation of mechanical CPR. METHODS: Through a year-long quality improvement effort we standardized the initial resuscitative efforts for OHCA, prioritizing a "pit crew" approach to high quality manual CPR, early defibrillation and basic airway management ahead of a scripted sequence for initiating mechanical CPR...
August 11, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30112623/paediatric-airway-management-and-concerns-a-survey-of-advanced-paramedics-in-ireland
#7
Neil Coleman, Tomas Barry, Helen Tobin, Niall Conroy, Gerard Bury
BACKGROUND: Paediatric airway management is of fundamental importance in the critically unwell child. Pre-hospital paediatric airway management especially endotracheal intubation is however controversial. AIM: To explore Irish Advanced Paramedics (APs) training, experience and clinical practice in paediatric airway management as well as to examine clinician attitudes toward this topic. METHODS: An anonymous online survey of all graduates of the University College Dublin AP training program (N = 453)...
August 15, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/30111343/airway-and-ventilation-management-during-cardiopulmonary-resuscitation-and-after-successful-resuscitation
#8
REVIEW
Christopher Newell, Scott Grier, Jasmeet Soar
After cardiac arrest a combination of basic and advanced airway and ventilation techniques are used during cardiopulmonary resuscitation (CPR) and after a return of spontaneous circulation (ROSC). The optimal combination of airway techniques, oxygenation and ventilation is uncertain. Current guidelines are based predominantly on evidence from observational studies and expert consensus; recent and ongoing randomised controlled trials should provide further information. This narrative review describes the current evidence, including the relative roles of basic and advanced (supraglottic airways and tracheal intubation) airways, oxygenation and ventilation targets during CPR and after ROSC in adults...
August 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/30096080/comparison-of-a-novel-cadaver-model-fix-for-life-with-the-formalin-fixed-cadaver-and-manikin-model-for-suitability-and-realism-in-airway-management-training
#9
Michael W van Emden, Jeroen J Geurts, Patrick Schober, Lothar A Schwarte
BACKGROUND: Manikins are widely used in airway management training; however, simulation of realism and interpatient variability remains a challenge. We investigated whether cadavers embalmed with the novel Fix for Life (F4L) embalmment method are a suitable and realistic model for teaching 3 basic airway skills: facemask ventilation, tracheal intubation, and laryngeal mask insertion compared to a manikin (SimMan 3G) and formalin-fixed cadavers. METHODS: Thirty anesthesiologists and experienced residents ("operators") were instructed to perform the 3 airway techniques in 10 F4L, 10 formalin-fixed cadavers, and 1 manikin...
October 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/30054079/principles-of-urgent-management-of-acute-airway-obstruction
#10
REVIEW
Erkan Yildirim
Recognizing and acting early on airway compromise reduces morbidity and mortality in patients with airway obstruction. Causes include foreign bodies, toxic/hot fumes, difficult intubation, laryngeal spasm, and tumors. Before definitive control of the airway is possible, provide 100% oxygen with a tightly fitting mask to optimize body oxygen stores. Pulse oximetry is a poor indicator of airway compromise; a decreasing arterial hemoglobin oxygen saturation is a late sign of impending hypoxemia. Basic airway maneuvers improve the patency of an obstructed airway...
August 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/30011222/nasal-positive-airway-pressure-and-sleep-apnea-reflections-on-an-experimental-method-that-became-a-therapy
#11
Colin E Sullivan
No abstract text is available yet for this article.
September 1, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/30009152/the-determination-of-an-appropriate-time-for-placement-of-the-classic-laryngeal-mask-airway-in-patients-undergoing-general-anesthesia
#12
Naghi Abedini, Masoud Parish, Haleh Farzin, Hojjat Pourfathi, Masume Akhsham
Background: The management of the airways is an essential component of anesthesia planning. Laryngeal mask airway (LMA) plays an important role in modern anesthesia, however, intubation by LMA has some complications. It may cause inadequate anesthesia depth, which can lead to adverse events. The aim of this study was to evaluate the optimal time for intubation by LMA under general anesthesia. Methods: This study was conducted on 96 patients, who underwent operation and were appropriate candidates for intubation with appropriate LMA...
April 2018: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29973963/inhalation-techniques-used-in-patients-with-respiratory-failure-treated-with-noninvasive-mechanical-ventilation
#13
REVIEW
Patrycja Rzepka-Wrona, Szymon Skoczynski, Dawid Wrona, Adam Barczyk
The administration of aerosolized medication is a basic therapy for patients with numerous respiratory tract diseases, including obstructive airway diseases (OADs), cystic fibrosis (CF), and infectious airway diseases. The management and care for patients requiring mechanical ventilation remains one of the greatest challenges for medical practitioners, both in intensive care units (ICUs) and pulmonology wards. Aerosol therapy is often necessary for patients receiving noninvasive ventilation (NIV), which may be stopped for the time of drug delivery and administered through a metered-dose inhaler or nebulizer in the traditional way...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29927812/managing-the-airway-in-acute-care-patients
#14
Heather Meissen, Laura Johnson
Understanding how to assess, secure, and manage an airway can save a patient's life in an emergent situation. This article briefly describes the basics of airway management in the acute care setting.
July 2018: Nurse Practitioner
https://www.readbyqxmd.com/read/29907602/improvised-first-aid-techniques-for-terrorist-attacks
#15
EDITORIAL
Andrew Loftus, Harvey Pynn, Paul Parker
Terrorist acts occur every day around the world. Healthcare professionals are often present as bystander survivors in these situations, with none of the equipment or infrastructure they rely on in their day-to-day practice. Within several countries there has been a move to disseminate the actions to take in the event of such attacks: in the UK, Run, Hide, Tell , and in the USA, Fight Back This paper outlines how a very basic medical knowledge combined with everyday high-street items can render highly effective first aid and save lives...
August 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29851190/choosing-wisely-in-pediatric-anesthesia-an-interpretation-from-the-german-scientific-working-group-of-paediatric-anaesthesia-wakka
#16
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
July 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29716705/evaluation-for-airway-obstruction-in-adult-patients-with-stable-ischemic-heart-disease
#17
M Mahendra, Sunil Kumar S, Nagaraj Desai, Jayaraj Bs, Mahesh Pa
BACKGROUND: Ischemic heart disease (IHD) and chronic airway disease (COPD and Asthma) are major epidemics accounting for significant mortality and morbidity. The combination presents many diagnostic challenges. Clinical symptoms and signs frequently overlap. There is a need for airway evaluation in these patients to plan appropriate management. METHODS: Consecutive stable IHD patients attending the cardiology OPD in a tertiary care centre were interviewed for collecting basic demographic information, brief medical, occupational, personal history and risk factors for coronary artery disease and airway disease, modified medical research centre (MMRC) grade for dyspnea, quality of life-St...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29676534/consensus-based-european-guidelines-for-treatment-of-atopic-eczema-atopic-dermatitis-in-adults-and-children-part-i
#18
A Wollenberg, S Barbarot, T Bieber, S Christen-Zaech, M Deleuran, A Fink-Wagner, U Gieler, G Girolomoni, S Lau, A Muraro, M Czarnecka-Operacz, T Schäfer, P Schmid-Grendelmeier, D Simon, Z Szalai, J C Szepietowski, A Taïeb, A Torrelo, T Werfel, J Ring
This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus-based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This first part of the guideline covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy, whereas the second part covers antimicrobial therapy, systemic treatment, allergen-specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions...
May 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29644401/-skill-retention-using-extraglottic-airways-in-out-of-hospital-emergencies-efficacy-and-long-term-results-of-simulator-based-medical-education-a-prospective-follow-up-study
#19
V Mann, F Limberg, S T W Mann, S Little, M Müller, M Sander, R Röhrig
OBJECTIVE: For emergency medicine personnel (EMP), there is little evidence concerning the adequate timing for refresher courses to maintain routine in the application of extraglottic airways. The aim of this study was to evaluate the efficacy and long-term results of a simulator-based education concept teaching the basic airway management skills with extraglottic airways for EMP and also to draw conclusions concerning the adequate time interval for refresher courses. METHODS: By use of an explorative, prospective simulator-study with nonphysician EMP, airway management skills using the Larynxmaske Supreme® (LMA‑S) after an introduction lecture were examined...
April 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29561288/to-intubate-or-not-to-intubate
#20
Christopher J R Gough, Jerry P Nolan
PURPOSE OF REVIEW: Cardiac arrest mortality remains high, and the impact on outcome of most advanced life support interventions is unclear. The optimal method for managing the airway during cardiac arrest remains unknown. This review will summarize and critique recently published evidence comparing basic airway management with the use of more advanced airway interventions [insertion of supraglottic airway (SGA) devices and tracheal intubation]. RECENT FINDINGS: Systematic reviews generally document an association between advanced airway management and worse neurological outcome but they are subject to considerable bias...
June 2018: Current Opinion in Critical Care
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