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https://www.readbyqxmd.com/read/29149359/-preclinical-and-intrahospital-management-of-mass-casualties-and-terrorist-incidents
#1
REVIEW
A Franke, D Bieler, B Friemert, E Kollig, S Flohe
Due to the recent terrorist attacks in Paris, Brussels, Ansbach, Munich, Berlin and more recently Manchester and London, terrorism is realized as a present threat to our society and social life, as well as a challenge for the health care system. Without fueling anxiety, there is a need for sensitization to this subject and to familiarize all concerned with the special kind of terrorist attack-related injuries, the operational priorities and tactics and the individual basic principles of preclinical and hospital care...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29123904/comparison-of-registry-and-government-evaluation-data-to-ascertain-severe-trauma-cases-in-japan
#2
Shinji Nakahara, Tetsuya Sakamoto, Takashi Fujita, Tomohide Koyama, Yoichi Katayama, Seizan Tanabe, Yasuhiro Yamamoto
Aims: Accurate evaluation of health care quality requires high-quality data, and case ascertainment (confirming eligible cases and deaths) is a foundation for accurate data collection. This study examined the accuracy of case ascertainment from two Japanese data sources. Methods: Using hospital-level data, we investigated the concordance in ascertaining trauma cases between a nationwide trauma registry (the Japan Trauma Data Bank) and annual government evaluations of tertiary hospitals between April 2012 and March 2013...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29116544/antithrombotic-therapy-for-acs-in-elderly-patients
#3
REVIEW
Vincent Roule, Katrien Blanchart, Xavier Humbert, Damien Legallois, Adrien Lemaitre, Paul Milliez, Farzin Beygui, Joachim Alexandre
BACKGROUND: Patients over 75 account for more than one third of those presenting with myocardial infarction and more than 50% of intrahospital mortality. There are no specific guidelines for the management of acute coronary syndromes (ACS) in the elderly. SETTING: Although antithrombotic therapy seems to be effective and safe in such patients, it requires specific precautions and treatment adjustments because of the higher bleeding risk due to comorbidities such as renal function impairment and malnutrition...
November 7, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29062574/analysis-of-adverse-events-during-intrahospital-transportation-of-critically-ill-patients
#4
Francielli Mary Pereira Gimenez, Wesley Henrique Bueno de Camargo, Ana Clara Beraldo Gomes, Thaylla Sumyre Nihei, Monique Walicheki Maria Andrade, Maria Laura de A F Sé Valverde, Larissa D' Epiro de Souza Campos, Debora Carvalho Grion, Josiane Festti, Cintia Magalhães Carvalho Grion
PURPOSE: To describe adverse events occurring during intrahospital transportation of adult patients hospitalized in an Intensive Care Unit (ICU) and to evaluate the association with morbidity and mortality. METHOD: Prospective cohort study from July 2014 to July 2015. Data collection comprised clinical data, prognostic scores, length of stay, and outcome at hospital discharge. Data was collected on transport and adverse events. Adverse events were classified according to the World Health Organization following the degree of damage...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29018132/one-stop-management-of-acute-stroke-patients-minimizing-door-to-reperfusion-times
#5
Marios-Nikos Psychogios, Daniel Behme, Katharina Schregel, Ioannis Tsogkas, Ilko L Maier, Johanna Rosemarie Leyhe, Antonia Zapf, Julia Tran, Mathias Bähr, Jan Liman, Michael Knauth
BACKGROUND AND PURPOSE: Intrahospital time delays significantly affect the neurological outcome of stroke patients with large-vessel occlusion. This study was conducted to determine whether a one-stop management can reduce intrahospital times of patients with acute large-vessel occlusion. METHODS: In this observational study, we report the first 30 consecutive stroke patients imaged and treated in the same room. As part of our protocol, we transported patients with a National Institutes of Health Stroke Scale score of ≥10 directly to the angio suite, bypassing multidetector computed tomography (CT)...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28993606/external-validation-of-survival-predicting-models-for-acute-myocardial-infarction-with-extracorporeal-cardiopulmonary-resuscitation-in-a-chinese-single-center-cohort
#6
Lei Huang, Tong Li, Xiao-Min Hu, Ying-Wu Liu, Da-Wei Duan, Peng Wu, Xiao-di Wu, Yu-Heng Lang
BACKGROUND This study was designed as an external evaluation of potentially relevant models for acute myocardial infarction (AMI) with extracorporeal cardiopulmonary resuscitation (E-CPR). MATERIAL AND METHODS Twenty AMI adults that met criteria were retrospectively analyzed from January 2009 to January 2015. Six possible models - ENCOURAGE, SAVE, ECPR, GRACE, SHOCK, and a simplified risk chart - were identified by literature review and model scores calculated based on original data. Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment, commonly used in intensive care units, served as controls...
October 10, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28993049/prestroke-mobility-and-dementia-as-predictors-of-stroke-outcomes-in-patients-over-65%C3%A2-years-of-age-a-cohort-study-from-the-swedish-dementia-and-stroke-registries
#7
Sara Garcia-Ptacek, Beatriz Contreras Escamez, Eva Zupanic, Dorota Religa, Lena von Koch, Kristina Johnell, Mia von Euler, Ingemar Kåreholt, Maria Eriksdotter
OBJECTIVES: To explore the association between prestroke mobility dependency and dementia on functioning and mortality outcomes after stroke in patients>65 years of age. DESIGN: Longitudinal cohort study based on SveDem, the Swedish Dementia Registry and Riksstroke, the Swedish Stroke Registry. PARTICIPANTS: A total of 1689 patients with dementia >65 years of age registered in SveDem and suffering a first stroke between 2007 and 2014 were matched with 7973 controls without dementia with stroke...
October 6, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28953041/safety-hazards-during-intrahospital-transport-a-prospective-observational-study
#8
Lina M Bergman, Monica E Pettersson, Wendy P Chaboyer, Eric D Carlström, Mona L Ringdal
OBJECTIVE: To identify, classify, and describe safety hazards during the process of intrahospital transport of critically ill patients. DESIGN: A prospective observational study. Data from participant observations of the intrahospital transport process were collected over a period of 3 months. SETTING: The study was undertaken at two ICUs in one university hospital. PATIENTS: Critically ill patients transported within the hospital by critical care nurses, unlicensed nurses, and physicians...
August 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28905212/hub-and-spoke-stroke-network-in-the-veneto-region-a-retrospective-study-investigating-the-effectiveness-of-the-stroke-pathway-and-trends-over-time
#9
L Nardetto, B Giometto, G Moretto, D Mantoan, M Saia
After recognizing the pivotal role played by stroke unit (SU) admission in reducing mortality and dependency in stroke patients, the need to organize and monitor stroke networks has become an increasingly essential aspect of stroke care. We conducted a retrospective study of stroke patients admitted to hospitals in the Veneto region from 2007 to 2015 in order to evaluate the effectiveness of the stroke pathway and trends over time. Between 2007 and 2015, 61,062 stroke patients were discharged from Veneto hospitals: they were more frequently female, females were older than males, and had higher intrahospital mortality and a lower probability of undergoing systemic thrombolysis...
September 13, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28900664/-prehospital-care-for-stroke-patients
#10
REVIEW
C H Nolte, H J Audebert
The effectiveness of thrombolysis or mechanical recanalization for acute stroke is higher, the sooner these therapies are started. Therefore, acute stroke patients need to be evaluated by qualified staff for these therapies as soon as possible. Lay persons need to identify the typical symptoms of stroke as an emergency and act accordingly by calling the emergency medical system (EMS). The EMS team reassesses the symptoms and prompts cerebral imaging. Cerebral imaging is performed ideally in hospitals with a stroke unit where subsequent (stroke) treatments occur...
November 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28892306/effect-of-locally-tailored-labour-management-guidelines-on-intrahospital-stillbirths-and-birth-asphyxia-at-the-referral-hospital-of-zanzibar-a-quasi-experimental-pre-post-study-the-partoma-study
#11
N Maaløe, N Housseine, T Meguid, B B Nielsen, Akg Jensen, R S Khamis, A G Mohamed, M M Ali, S M Said, J van Roosmalen, I C Bygbjerg
OBJECTIVE: To evaluate effect of locally tailored labour management guidelines (PartoMa guidelines) on intrahospital stillbirths and birth asphyxia. DESIGN: Quasi-experimental pre-post study investigating the causal pathway through changes in clinical practice. SETTING: Tanzanian low-resource referral hospital, Mnazi Mmoja Hospital. POPULATION: Facility deliveries during baseline (1 October 2014 until 31 January 2015) and the 9th to 12th intervention month (1 October 2014 until 31 January 2015)...
September 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28869634/the-effects-of-an-early-intrahospital-rehabilitation-on-weight-bearing-during-lower-extremity-lengthening-with-ilizarov-method
#12
Grzegorz Konieczny, Piotr Morasiewicz, Natalia Kuciel
PURPOSE: Exerting axial pressure on the affected lower limb remains one of the most crucial elements of Ilizarov method. The objective was to determine the effects of an early intrahospital rehabilitation on weight bearing during lower extremity lengthening with Ilizarov method. METHODS: The study included 15 patients who underwent lower limb lengthening. The patients were tested on the third day after surgery using the pedobarographic platform. The tests were performed four times in the standing position: twice with the support of forearm crutches and twice without crutches...
2017: Acta of Bioengineering and Biomechanics
https://www.readbyqxmd.com/read/28839885/emergency-general-surgery-hot-clinics-reduce-admission-rates-and-duration-of-inpatient-stay
#13
Francesca Th'ng, Christos Skouras, Alice Paterson-Brown, Rajan Ravindran, Peter Lamb, Andrew de Beaux, Simon Paterson-Brown, Damian J Mole
OBJECTIVE: To determine the impact of a 'Hot Clinic' (HC) on emergency general surgery patient flow-through. DESIGN: Prospective service evaluation study. SETTING: HC is a four-bedded area coordinated by a specialist nurse. The HC consultant sees emergency patients referred from the emergency department, general practitioners or those in preceding 24 h considered suitable for interim discharge while awaiting investigations and HC reassessment...
January 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28831517/-terrorist-attack-trauma-an-individual-entity-of-polytrauma-a-10-year-update
#14
REVIEW
C Güsgen, A Franke, S Hentsch, E Kollig, R Schwab
The incidence of terrorist attacks is increasing worldwide, and they have also become a permanent threat in European cities. Due to its complexity, terrorist attack trauma places high demands on the strategy of surgical treatment. The combination of various mechanisms, explosions and gunshot injuries, with the characteristic pressure (blast) damage and a high proportion of penetrating trauma with simultaneous burns are characteristic features. Unlike in military conflicts, injuries to people of all ages and without ballistic body protection (body armor) are to be expected...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28807696/a-tailored-intervention-to-improving-the-quality-of-intrahospital-nursing-handover
#15
Jochen Bergs, Frank Lambrechts, Ines Mulleneers, Kim Lenaerts, Caroline Hauquier, Geert Proesmans, Sarah Creemers, Dominique Vandijck
INTRODUCTION: Nursing handover is a process central to the delivery of high-quality and safe care. We aimed to improve the quality of nursing handover from the emergency department to ward and intensive care unit (ICU). METHODS: A quasi-experimental non-equivalent control group pre-test - post-test design was applied. Handover quality was measured using the Handover Evaluation Scale (HES). A tailored intervention, inspired by appreciative inquiry, was designed to improve the implementation of an existing handover form and procedure...
August 11, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28719478/a-review-of-nonfatal-drowning-in-the-pediatric-age-group-a-10-year-experience-at-a-university-hospital-in-saudi-arabia
#16
Faisal O Al-Qurashi, Abdullah A Yousef, Abdullah Aljoudi, Saleh M Alzahrani, Nasser Y Al-Jawder, Abdulrahman K Al-Ahmar, Mosab S Al-Majed, Hussam M Abouollo
OBJECTIVE: The aim of this study was to evaluate the nonfatal drowning experience, risk factors, intrahospital assessment and postincidental outcomes for children admitted to King Fahd Hospital of the University, AlKhobar, Saudi Arabia, over a 10-year period. METHODS: Children up to the age of 14 years who were admitted with the diagnosis of nonfatal drowning from July 2005 to June 2015 were included. Data regarding demographics, timing, season and location of drowning, presence of an assigned lifeguard, duration of submersion and transport to hospital, cardiopulmonary resuscitation, initial Glasgow Coma Scale, temperature, pH, blood sugar level, total hospital stay, and discharge status were extrapolated, and their effects on the patient's outcome analyzed...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28694343/non-withdrawal-of-beta-blockers-in-acute-decompensated-chronic-and-de-novo-heart-failure-with-reduced-ejection-fraction-in-a-prospective-multicentre-study-of-patients-with-acute-heart-failure-in-the-middle-east
#17
Charbel Abi Khalil, Kadhim Sulaiman, Ziyad Mahfoud, Rajvir Singh, Nidal Asaad, Khalid F AlHabib, Alawi Alsheikh-Ali, Mohammed Al-Jarallah, Bassam Bulbanat, Wael AlMahmeed, Mustafa Ridha, Nooshin Bazargani, Haitham Amin, Ahmed Al-Motarreb, Husam Al Faleh, Abdelfatah Elasfar, Prashanth Panduranga, Jassim Al Suwaidi
OBJECTIVES: Beta blockers reduce mortality in heart failure (HF). However, it is not clear whether they should be temporarily withdrawn during acute HF. DESIGN: Analysis of prospectively collected data. SETTING: The Gulf aCute heArt failuRe rEgistry is a prospective multicentre study of patients hospitalised with acute HF in seven Middle Eastern countries. PARTICIPANTS: 5005 patients with acute HF. OUTCOME MEASURES: We studied the effect of beta blockers non-withdrawal on intrahospital, 3-month and 12-month mortality and rehospitalisation for HF in patients with acute decompensated chronic heart failure (ADCHF) and acute de novo heart failure (ADNHF) and a left ventricular ejection fraction (LVEF) <40%...
July 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28660768/comparison-of-peri-and-post-procedural-complications-in-patients-undergoing-revascularisation-of-coronary-artery-multivessel-disease-by-coronary-artery-bypass-grafting-or-protected-percutaneous-coronary-intervention-with-the-impella-2-5-device
#18
Tobias Becher, Stefan Baumann, Frederik Eder, Simon Perschka, Dirk Loßnitzer, Christian Fastner, Michael Behnes, Christina Doesch, Martin Borggrefe, Ibrahim Akin
BACKGROUND: While coronary artery bypass grafting remains the standard treatment of complex multivessel coronary artery disease, the advent of peripheral ventricular assist devices has enhanced the safety of percutaneous coronary intervention. We therefore evaluated the safety in terms of inhospital outcome comparing protected high-risk percutaneous coronary intervention with the Impella 2.5 device and coronary artery bypass grafting in patients with complex multivessel coronary artery disease...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28618404/prevalence-of-hyponatremia-and-its-associated-morbimortality-in-hospitalized-patients-receiving-parenteral-nutrition
#19
Emilia Gómez-Hoyos, Martín Cuesta, Nayade Del Prado-González, Pilar Matía, Natalia Pérez-Ferre, Daniel Antonio De Luis, Alfonso Calle-Pascual, Miguel Ángel Rubio, Isabelle Runkle-De la Vega
BACKGROUND: The objective of the study was to determine the prevalence of hyponatremia (HN) and its associated morbimortality in hospitalized patients receiving parenteral nutrition (PN). METHODS: A retrospective study including 222 patients receiving total PN (parenteral nutrition group [PNG]) over a 7-month period in a tertiary hospital and 176 matched to 179 control subjects without PN (control subjects group [CSG]). Demographic data, Charlson Comorbidity Index (CCI), date of HN detection-(serum sodium or SNa <135 mmol/L)-intrahospital mortality, and hospital length-of-stay (LOS) were registered...
2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/28589019/provider-initiated-delivery-late-preterm-birth-and-perinatal-mortality-a-secondary-analysis-of-the-who-multicountry-survey-on-maternal-and-newborn-health
#20
Naho Morisaki, Xun Zhang, Togoobaatar Ganchimeg, Joshua P Vogel, Joo Paulo Dias Souza, Jose G Cecatti, Maria Regina Torloni, Erika Ota, Rintaro Mori, Suneeta Mittal, Suzanne Tough, Siobhan Dolan, Michael S Kramer
INTRODUCTION: In high-income countries, a reduced clinical threshold for obstetric interventions such as labour induction (LI) and prelabour caesarean delivery (PLCD) has played a substantial role in increasing rates of late preterm births. However, the association between provider-initiated delivery and perinatal outcomes have not been studied in a multicountry setting including low-income and middle-income countries. METHODS: 286 hospitals in 29 countries participated in the WHO Multi-Country Survey on Maternal and Newborn Health and yielded 2 52 198 singleton births of at least 34 weeks in 2010-2011...
March 2017: BMJ Global Health
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