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https://www.readbyqxmd.com/read/28285866/obstructed-infradiaphragmatic-total-anomalous-pulmonary-venous-return-in-a-13-day-old-infant-presenting-acutely-to-the-emergency-department-a-case-report
#1
Elizabeth A Siacunco, Garrett S Pacheco, Dale P Woolridge
BACKGROUND: Total anomalous pulmonary venous return (TAPVR) is an uncommon congenital heart defect. Obstructed forms are more severe, and typically present earlier in life, usually in the immediate newborn period, with symptoms of severe cyanosis and respiratory failure. CASE REPORT: A 13-day-old boy presented to the emergency department (ED) with respiratory extremis. He appeared cyanotic and limp, and was found to have significant hypoxia with oxygen saturation of 40%...
March 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28268159/protective-lung-strategies-a-cross-sectional-survey-of-nurses-knowledge-and-use-in-the-emergency-department
#2
Sarah Cornish, Rochelle Wynne, Sharon Klim, Anne-Maree Kelly
BACKGROUND: Mechanical ventilation (MV) is commonly used in emergency departments (EDs). Protective lung strategies (PLS), comprising of low tidal volume (6mL/kg), control of oxygen and plateau pressures, and administration of positive end expiratory pressure (PEEP) has been shown to reduces the risks associated with MV but there is little evidence exists about nurses' knowledge or application of PLS. Our aim was to explore nurses knowledge and application of PLS in Australian EDs. METHODS: Descriptive, exploratory design utilising an online questionnaire...
March 3, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28259481/lung-protective-ventilation-initiated-in-the-emergency-department-lov-ed-a%C3%A2-quasi-experimental-before-after-trial
#3
Brian M Fuller, Ian T Ferguson, Nicholas M Mohr, Anne M Drewry, Christopher Palmer, Brian T Wessman, Enyo Ablordeppey, Jacob Keeperman, Robert J Stephens, Cristopher C Briscoe, Angelina A Kolomiets, Richard S Hotchkiss, Marin H Kollef
STUDY OBJECTIVE: We evaluated the efficacy of an emergency department (ED)-based lung-protective mechanical ventilation protocol for the prevention of pulmonary complications. METHODS: This was a quasi-experimental, before-after study that consisted of a preintervention period, a run-in period of approximately 6 months, and a prospective intervention period. The intervention was a multifaceted ED-based mechanical ventilator protocol targeting lung-protective tidal volume, appropriate setting of positive end-expiratory pressure, rapid oxygen weaning, and head-of-bed elevation...
March 1, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28246137/heart-failure-in-patients-presenting-with-dyspnoea-to-the-emergency-department-in-the-asia-pacific-region-an-observational-study
#4
Gerben Keijzers, Anne-Maree Kelly, Louise Cullen, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
OBJECTIVES: To describe demographic features, assessment, management and outcomes of patients who were diagnosed with heart failure after presenting to an emergency department (ED) with a principal symptom of dyspnoea. DESIGN: Planned substudy of the prospective, descriptive cohort study: Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM). SETTING: 46 EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia collected data over 3 72-hour periods in May, August and October 2014...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28160237/management-of-patients-presenting-with-haemoptysis-to-a-tertiary-care-italian-emergency-department-the-florence-haemoptysis-score-flhasc
#5
Simone Vanni, Simone Bianchi, Sofia Bigiarini, Claudia Casula, Marco Brogi, Stefano Orsi, Manlio Acquafresca, Lorenzo Corbetta, Stefano Grifoni
We analysed the clinical features and diagnostic workup of patients presenting with haemoptysis to an Italian teaching hospital to derive an easy-to-use clinical score to guide risk stratification and initial management in the emergency department (ED). We retrospectively reviewed clinical records of consecutive patients with haemoptysis over 1 year. A pre-specified set of variables, including demographic data, vital signs, type of expectorate (pure blood vs. blood-streaked sputum), comorbidities, and diagnostic tests and treatments was originally registered...
February 3, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28149030/sympathetic-crashing-acute-pulmonary-edema
#6
REVIEW
Naman Agrawal, Akshay Kumar, Praveen Aggarwal, Nayer Jamshed
Sympathetic crashing acute pulmonary edema (SCAPE) is the extreme end of the spectrum of acute pulmonary edema. It is important to understand this disease as it is relatively common in the emergency department (ED) and has better outcomes when managed appropriately. The patients have an abrupt redistribution of fluid in the lungs, and when treated promptly and effectively, these patients will rapidly recover. Noninvasive ventilation and intravenous nitrates are the mainstay of treatment which should be started within minutes of the patient's arrival to the ED...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28125855/predictors-and-outcomes-of-acute-pancreatitis-in-critically-ill-patients-presenting-to-the-emergency-department-of-a-tertiary-referral-centre-in-australia
#7
Krishnaswamy Sundararajan, Tom Schoeman, Lara Hughes, Suzanne Edwards, Benjamin Reddi
OBJECTIVE: To provide a current review of the clinical characteristics, predictors and outcomes in critically ill patients presenting to the ED with acute pancreatitis and subsequently admitted to an intensive care unit (ICU) of a tertiary referral centre in Australia. METHODS: A retrospective single-centre study of adult patients admitted with pancreatitis. Severe acute pancreatitis defined by Bedside Index of Severity in Acute Pancreatitis (BISAP) score ≥2. RESULTS: Eighty-seven patients fulfilled criteria for inclusion during the study period, representing 0...
January 26, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28110989/emergency-department-airway-management-of%C3%A2-severe-angioedema-a-video-review-of-45%C3%A2-intubations
#8
Brian E Driver, John W McGill
STUDY OBJECTIVE: Angioedema is an uncommon but important cause of airway obstruction. Emergency airway management of angioedema is difficult. We seek to describe the course and outcomes of emergency airway management for severe angioedema in our institution. METHODS: We performed a retrospective, observational study of all intubations for angioedema performed in an urban academic emergency department (ED) between November 2007 and June 2015. We performed a structured review of video recordings of each intubation...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28108054/acute-respiratory-compromise-in-the-emergency-department-a-description-and-analysis-of-3571-events-from-the-get-with-the-guidelines-resuscitation%C3%A2-registry
#9
Carl Mathias Karlsson, Michael W Donnino, Hans Kirkegaard, Michael N Cocchi, Maureen Chase, Lars W Andersen
BACKGROUND: Respiratory events requiring the use of assisted ventilation are relatively common in the emergency department (ED), and can be associated with substantial morbidity and mortality. OBJECTIVE: The aim of this study was to describe and elucidate patient and event characteristics associated with mortality and progression to cardiac arrest in ED patients with acute respiratory compromise. METHODS: Data were obtained from the multicenter Get With the Guidelines-Resuscitation® registry...
January 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28094484/a-simplified-screening-tool-to-identify-seriously-ill-patients-in-the-emergency-department-for-referral-to-a-palliative-care-team
#10
Paolo Cotogni, Anna DE Luca, Andrea Evangelista, Claudia Filippini, Renata Gili, Antonio Scarmozzino, Giovannino Ciccone, Luca Brazzi
BACKGROUND: The aims of this study were to evaluate the feasibility of an Emergency Department (ED)-initiated screening to identify seriously ill patients in need of palliative care (PC) and to develop a simplified screening tool (SST). METHODS: Eligible patients with known diagnosis of chronic heart, lung, liver, and kidney failures, progressive neurological diseases or advanced cancer, awaiting to be hospitalized after an ED-visit, were assessed with the screening tool from the Italian Society Anaesthesia Analgesia Resuscitation Intensive Care (SIAARTI)...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28093429/paediatric-ed-bipap-continuous-quality-improvement-programme-with-patient-analysis-2005-2013
#11
Thomas Abramo, Abby Williams, Samaiya Mushtaq, Mark Meredith, Rawle Sepaule, Kristen Crossman, Cheryl Burney Jones, Suzanne Godbold, Zhuopei Hu, Todd Nick
OBJECTIVE: In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28089059/management-of-hospitalized-asthmatic-children-before-transport
#12
Brande Mazzeo, Rami Bzeih, Robert Schultz, Melissa Tavolieri, Alicia Fraser, Sabrina M Heidemann
Asthmatic children are at risk for respiratory failure and should be appropriately treated before transport. The objectives were to find out if the Pediatric Advanced Life Support guidelines for asthma treatment were followed in the emergency department (ED); to determine if additional treatment during transport or within the first 2 hours of admission was needed; and to compare the management of intubated asthmatics by the ED, transport team, and the intensive care unit (ICU) physician. The records for children diagnosed with acute asthma over 7 years who were transported by the intensive care transport team were reviewed...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28072893/a-pediatric-application-of-the-strac-regional-hospital-trauma-registry-database-pediatric-trauma-deaths-in-south-central-texas-during-2004-2013
#13
Michelle Buehner, Jay Aden, Mathew Borgman, Preston Love, Brandi Wright, Mary Edwards
The purpose of this study was to define the demographics of pediatric traumatic injuries and to understand the predictive value of injury type, prehospital, and emergency department (ED) data regarding the mortality of pediatric trauma patients (<14 years of age) in South Central Texas. We report a retrospective review of pediatric trauma patients presenting to Trauma Service Area P in South Central Texas during 2004-2013. The primary outcome was mortality; secondary outcomes were ventilator days, hospital days, and intensive care unit stay...
January 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28013095/decreased-high-density-lipoprotein-cholesterol-level-is-an-early-prognostic-marker-for-organ-dysfunction-and-death-in-patients-with-suspected-sepsis
#14
Mihai Cirstea, Keith R Walley, James A Russell, Liam R Brunham, Kelly R Genga, John H Boyd
PURPOSE: We sought to determine whether an early high-density lipoprotein cholesterol (HDL-C) measurement at emergency department (ED) admission is prognostic of multiorgan dysfunction syndrome (MODS) and death in a suspected sepsis cohort. MATERIALS AND METHODS: Two hundred patients with clinically suspected sepsis were recruited at admission to our tertiary care hospital's ED. Lipids were measured at the time of first ED blood draw. Clinical data were collected via chart review...
April 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27976497/prospective-and-explicit-clinical-validation-of-the-ottawa-heart-failure-risk-scale-with-and-without-use-of-quantitative-nt-probnp
#15
Ian G Stiell, Jeffrey J Perry, Catherine M Clement, Robert J Brison, Brian H Rowe, Shawn D Aaron, Andrew D McRae, Bjug Borgundvaag, Lisa A Calder, Alan J Forster, George A Wells
OBJECTIVES: We previously developed the Ottawa Heart Failure Risk Scale (OHFRS) to assist with disposition decisions for acute heart failure patients in the emergency department (ED). We sought to prospectively evaluate the accuracy, acceptability, and potential impact of OHFRS. METHODS: This prospective observational cohort study was conducted at six tertiary hospital EDs. Patients with acute heart failure were evaluated by ED physicians for the 10 OHFRS criteria and then followed for 30 days...
March 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27903001/right-in-front-of-our-eyes-evolution-of-streptococcal-toxic-shock-syndrome-with-ischemic-optic-neuropathy
#16
Salaheldin M Elhamamsy, Mazen O Al-Qadi, Taro Minami, Marguerite Neill
INTRODUCTION: Toxic shock syndrome occurs from dysregulation of host inflammatory responses. Toxin- producing strains of Group A streptococcus cause TSS. Ischemic optic neuropathy rarely complicates septic shock. We present a rare case of streptococcal pharyngitis complicated by septic arthritis and TSS with reversible blindness due to non-arteritic ischemic optic neuropathy. CASE: A 28-year-old man drove to our ED with exudative pharyngitis. A rapid streptococcal test was positive...
December 1, 2016: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/27876327/endotracheal-intubation-with-the-king-laryngeal-tube%C3%A2-in-situ-using-video-laryngoscopy-and-a-bougie-a-retrospective-case-series-and-cadaveric-crossover-study
#17
Kenneth W Dodd, Rebecca L Kornas, Matthew E Prekker, Lauren R Klein, Robert F Reardon, Brian E Driver
BACKGROUND: Removal of a functioning King laryngeal tube (LT) prior to establishing a definitive airway increases the risk of a "can't intubate, can't oxygenate" scenario. We previously described a technique utilizing video laryngoscopy (VL) and a bougie to intubate around a well-seated King LT with the balloons deflated; if necessary, the balloons can be rapidly re-inflated and ventilation resumed. OBJECTIVE: Our objective is to provide preliminary validation of this technique...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27850578/940-the-impact-of-an-ed-ventilator-protocol-on-adherence-to-lung-protective-ventilation-in-ards
#18
Brian Fuller, Ian Ferguson, Christopher Palmer, Anne Drewry, Brian Wessman, Enyo Ablordeppey, Nicholas Mohr, Marin Kollef
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27769308/the-modified-save-score-predicting-survival-using-urgent-veno-arterial-extracorporeal-membrane-oxygenation-within-24%C3%A2-hours-of-arrival-at-the-emergency-department
#19
Wei-Cheng Chen, Kuo-Yang Huang, Chih-Wei Yao, Cing-Feng Wu, Shinn-Jye Liang, Chia-Hsiang Li, Chih-Yeh Tu, Hung-Jen Chen
BACKGROUND: Although many risk models have been tested in patients who undergo extracorporeal membrane oxygenation, few have been assessed for patients who received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support in the emergency department (ED). This study aimed to successfully predict outcomes of patients with cardiac or noncardiac failure who received VA-ECMO in the ED within 24 hours of arrival at the ED. METHOD: This retrospective, observational cohort study included 154 patients, who were classified as cardiac (n = 127) and noncardiac (n = 27) patients and received VA-ECMO within 24 hours after arrival at the China Medical University Hospital ED in Taiwan between January 2009 and September 2014...
October 22, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27742520/impact-of-delayed-admission-to-intensive-care-units-on-patients-with-acute-respiratory-failure
#20
Chih-Chia Hsieh, Ching-Chi Lee, Hsiang-Chin Hsu, Hsin-I Shih, Chien-Hsin Lu, Chih-Hao Lin
BACKGROUND/PURPOSE: To determine the impact of delayed admission to the intensive care unit (ICU) on the clinical outcomes of patients with acute respiratory failure (ARF) in the emergency department (ED). METHODS: This retrospective cohort study included non-traumatic adult patients with ARF and mechanical ventilation support in the ED of a tertiary university hospital in Taiwan from January 1, 2013, to August 31, 2013. Clinical data were extracted from chart records...
January 2017: American Journal of Emergency Medicine
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