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https://www.readbyqxmd.com/read/28625339/non-invasive-ventilation-in-emergency-departments-in-public-hospitals-in-catalonia-the-venur-cat-study
#1
J Jacob, J Zorrilla, E Gené, G Alonso, P Rimbau, F Casarramona, C Netto, P Sánchez, R Hernández, X Escalada, Ò Miró
OBJECTIVES: To know the implementation and characteristics of non-invasive ventilation (NIV) in the Emergency Departments (EDs) of public hospitals in Catalonia (Spain) and analyze possible differences based on the typology, degree of activity and the availability of an Intensive Care Unit (ICU) in the hospital. DESIGN: A non-interventional, descriptive study was carried out, using a structured questionnaire divided into 3sections: 1) professional experience and training; 2) devices used; and 3) clinical scenarios and the use of NIV...
June 15, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28601264/high-flow-nasal-cannula-versus-conventional-oxygen-therapy-in-emergency-department-patients-with-cardiogenic-pulmonary-edema-a%C3%A2-randomized-controlled-trial
#2
Onlak Makdee, Apichaya Monsomboon, Usapan Surabenjawong, Nattakarn Praphruetkit, Wansiri Chaisirin, Tipa Chakorn, Chairat Permpikul, Phakphoom Thiravit, Tanyaporn Nakornchai
STUDY OBJECTIVE: High-flow nasal cannula is a new method for delivering high-flow supplemental oxygen for victims of respiratory failure. This randomized controlled trial compares high-flow nasal cannula with conventional oxygen therapy in emergency department (ED) patients with cardiogenic pulmonary edema. METHODS: We conducted an open-label randomized controlled trial in the ED of Siriraj Hospital, Bangkok, Thailand. Patients aged 18 years or older with cardiogenic pulmonary edema were randomly assigned to receive either conventional oxygen therapy or high-flow nasal cannula...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28579487/intoxication-by-gamma-hydroxybutyrate-and-related-analogues-clinical-characteristics-and-comparison-between-pure-intoxication-and-that-combined-with-other-substances-of-abuse
#3
Òscar Miró, Miguel Galicia, Paul Dargan, Alison M Dines, Isabelle Giraudon, Fridtjof Heyerdahl, Knut E Hovda, Christopher Yates, David M Wood
OBJECTIVE: To study the profile of European gamma-hydroxybutyrate (GHB) and gammabutyrolactone (GBL) intoxication and analyse the differences in the clinical manifestations produced by intoxication by GHB/GBL alone and in combination with other substances of abuse. METHOD: We prospectively collected data on all the patients attended in the Emergency Departments (ED) of the centres participating in the Euro-DEN network over 12 months (October 2013 to September 2014) with a primary presenting complaint of drug intoxication (excluding ethanol alone) and registered the epidemiological and clinical data and outcomes...
June 1, 2017: Toxicology Letters
https://www.readbyqxmd.com/read/28572743/design-and-rationale-of-the-high-sensitivity-troponin-t-rules-out-acute-cardiac-insufficiency-trial
#4
Benton R Hunter, Sean P Collins, Gregory J Fermann, Phillip D Levy, Changyu Shen, Syed Imran Ayaz, Mette L Cole, Karen F Miller, Adam A Soliman, Peter S Pang
BACKGROUND: Acute heart failure (AHF) is a common presentation in the Emergency Department (ED), and most patients are admitted to the hospital. Identification of patients with AHF who have a low risk of adverse events and are suitable for discharge from the ED is difficult, and an objective tool would be useful. METHODS: The highly sensitive Troponin T Rules Out Acute Cardiac Insufficiency Trial (TACIT) will enroll ED patients being treated for AHF. Patients will undergo standard ED evaluation and treatment...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28544539/intensive-care-unit-admissions-and-ventilation-support-in-infants-with-bronchiolitis
#5
Ed Oakley, Vi Chong, Meredith Borland, Jocelyn Neutze, Natalie Phillips, David Krieser, Stuart Dalziel, Andrew Davidson, Susan Donath, Kim Jachno, Mike South, Amanda Fry, Franz E Babl
OBJECTIVES: To describe the rate of intensive care unit (ICU) admission, type of ventilation support provided and risk factors for ICU admission in infants with bronchiolitis. DESIGN: Retrospective review of hospital records and Australia and New Zealand Paediatric Intensive Care (ANZPIC) registry data for infants 2-12 months old admitted with bronchiolitis. SETTING: Seven Australian and New Zealand hospitals. These infants were prospectively identified through the comparative rehydration in bronchiolitis (CRIB) study between 2009 and 2011...
May 19, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28501384/acute-heart-failure-in-the-emergency-department-the-safe-simeu-epidemiological-study
#6
Andrea Fabbri, Giulio Marchesini, Giorgio Carbone, Roberto Cosentini, Annamaria Ferrari, Mauro Chiesa, Alessio Bertini, Federico Rea
BACKGROUND: Patients with acute heart failure (AHF) have high rates of attendance to emergency departments (EDs), with significant health care costs. OBJECTIVES: We aimed to describe the clinical characteristics of patients attending Italian EDs for AHF and their diagnostic and therapeutic work-up. METHODS: We carried out a retrospective analysis on 2683 cases observed in six Italian EDs for AHF (January 2011 to June 2012). RESULTS: The median age of patients was 84 years (interquartile range 12), with females accounting for 55...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28491475/referral-patterns-and-diagnostic-yield-of-lung-scintigraphy-in-the-diagnosis-of-acute-pulmonary-embolism
#7
Matthieu Pelletier-Galarneau, Erik Zannier, Lionel S Zuckier, Gregoire Le Gal
Introduction. The purpose of this study is to assess referral patterns and the yield of ventilation-perfusion (V/Q) scintigraphy in patients referred for acute pulmonary embolism (PE). Methods. We retrospectively reviewed the charts of all patients who underwent V/Q studies between April 1, 2008, and March 31, 2010. Patients were subdivided into 4 groups based on their referral source: emergency department (ED), hospital inpatient ward, outpatient thrombosis clinic, and all other outpatient sources. Results...
2017: Thrombosis
https://www.readbyqxmd.com/read/28486318/asking-a-better-question-development-and-evaluation-of-the-need-for-trauma-intervention-nfti-metric-as-a-novel-indicator-of-major-trauma
#8
Jacob W Roden-Foreman, Nakia R Rapier, Luanna Yelverton, Michael L Foreman
Many existing metrics, such as Injury Severity Score (ISS), cannot fully describe many trauma patients because of comorbidities. This study developed and evaluated the Need For Trauma Intervention (NFTI) metric as a novel indicator of major trauma. The NFTI metric was developed from an analysis of 2,396 trauma patients at a Level I trauma center. Six commonly recorded registry variables were found to be indicative of major trauma and comprised the NFTI criteria: receiving packed red blood cells within 4 hr; discharge from the emergency department (ED) to the operating room within 90 min; discharge from the ED to interventional radiology; discharge from the ED to the intensive care unit (ICU) with an ICU length of stay (LOS) of 3 or more days; mechanical ventilation outside of procedural anesthesia within 3 days; or death within 60 hr...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28485710/epidemiological-typing-of-multidrug-resistant-klebsiella-pneumoniae-which-causes-paediatric-ventilator-associated-pneumonia-in-egypt
#9
Eman R Mohamed, Sherine A Aly, Hamada M Halby, Shabaan H Ahmed, Amira M Zakaria, Osama M El-Asheer
PURPOSE: Multidrug-resistant Klebsiella pneumoniae is a common nosocomial pathogen that plays an important role in ventilator-associated pneumonia (VAP). This study aimed to define the clonal relatedness of K. pneumoniae strains isolated from paediatric VAP in addition to those isolated from environmental samples. METHODOLOGY: This study included 19 clinical and 4 environmental K. pneumoniae isolates recovered from the paediatric intensive care unit (PICU) in Assiut University Children's Hospital...
May 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28421973/-bitten-by-an-exotic-venomous-snake
#10
M A Dijkman, I de Vries, M van Dam, D W de Lange
BACKGROUND: Patients who have been bitten by an exotic venomous snake are at risk of severe morbidity and a fatal outcome following an incorrect risk-assessment. Treatment with an antivenom can be necessary and can turn out to be lifesaving. In the Netherlands there are only a few cases of bites from exotic venomous snakes each year. CASE DESCRIPTION: A 28-year-old man presented at the emergency department (ED) after having been bitten by a monocled cobra (Naja kaouthia)...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28410544/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-a-systematic-review-and-meta-analysis
#11
Elliot Long, Ed Oakley, Trevor Duke, Franz E Babl
BACKGROUND: The aim of fluid resuscitation is to increase stroke volume, yet this effect is observed in only 50% of patients. Prediction of fluid responsiveness may allow fluid resuscitation to be administered to those most likely to benefit. The aim of this study was to systematically review the test characteristics of respiratory variation in inferior vena cava (IVC) diameter as a predictor of fluid responsiveness in patients with acute circulatory failure. METHODS: Electronic searches combined with reference review of identified studies...
May 2017: Shock
https://www.readbyqxmd.com/read/28392369/compression-to-ventilation-ratio-and-incidence-of-rearrest-a-secondary-analysis-of-the-roc-ccc-trial
#12
David D Salcido, Robert H Schmicker, Jason E Buick, Sheldon Cheskes, Brian Grunau, Peter Kudenchuk, Brian Leroux, Stephanie Zellner, Dana Zive, Tom P Aufderheide, Allison C Koller, Heather Herren, Jack Nuttall, Matthew L Sundermann, James J Menegazzi
BACKGROUND: Previous work has demonstrated that when out-of-hospital cardiac arrest (OHCA) patients achieve return of spontaneous circulation (ROSC), but subsequently have another cardiac arrest prior to hospital arrival (rearrest), the probability of survival to hospital discharge is significantly decreased. Additionally, few modifiable factors for rearrest are known. We sought to examine the association between rearrest and compression-to-ventilation ratio during cardiopulmonary resuscitation (CPR) and to confirm the association between rearrest and outcomes...
April 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28379349/enterovirus-d68-infection-among-children-with-medically-attended-acute-respiratory-illness-cincinnati-ohio-july%C3%A2-october-2014
#13
Holly M Biggs, Monica McNeal, W Allan Nix, Carolyn Kercsmar, Aaron T Curns, Beverly Connelly, Marilyn Rice, Shur-Wern Wang Chern, Mila M Prill, Nancy Back, M Steven Oberste, Susan I Gerber, Mary A Staat
Background: Enterovirus D68 (EV-D68) caused a widespread outbreak of respiratory illness in the United States in 2014, predominantly affecting children. We describe EV-D68 rates, spectrum of illness and risk factors from prospective, population-based acute respiratory illness (ARI) surveillance at a large U.S. pediatric hospital. Methods: Children <13 years of age with ARI and residence in Hamilton County, Ohio were enrolled from the inpatient and emergency department (ED) settings at a children's hospital in Cincinnati, Ohio, from July 1-October 31, 2014...
April 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28342626/understanding-the-health-care-utilization-of-children-who-require-medical-technology-a-descriptive-study-of-children-who-require-tracheostomies
#14
Regena Spratling
Children who require medical technology have complex chronic illnesses. This medical technology, including ventilators, oximeters, tracheostomy tubes, and feeding tubes, allows children and their families to live at home; however, the management of the children's care by informal caregivers is complex with the need for intensive, specialized care. The purpose of this study was to examine the sociodemographic and clinical characteristics that affect health care utilization in a population of children who require medical technology...
April 2017: Applied Nursing Research: ANR
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
#15
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
#16
Sarah Cornish, Rochelle Wynne, Sharon Klim, Ann-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...
May 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
#17
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
#18
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
#19
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
#20
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
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