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https://www.readbyqxmd.com/read/28411936/is-there-a-doctor-onboard-medical-emergencies-at-40-000-feet
#1
REVIEW
Howard J Donner
It is estimated 2.75 billion people travel aboard commercial airlines every year and 44,000 in-flight medical emergencies occur worldwide each year. Wilderness medicine requires a commonsense and improvisational approach to medical issues. A sudden call for assistance in the austere and unfamiliar surroundings of an airliner cabin may present the responding medical professional with a "wilderness medicine" experience. From resource management to equipment, this article sheds light on the unique conditions, challenges, and constraints of the flight environment...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28400686/convergence-of-minds-for-better-patient-outcome-in-intensive-care-unit-infections
#2
Chand Wattal, Yash Javeri, Neeraj Goel, Debashish Dhar, Sonal Saxena, Sarman Singh, Jaswinder Kaur Oberoi, B K Rao, Purva Mathur, Vikas Manchanda, Vivek Nangia, Arti Kapil, Ashok Rattan, Supradip Ghosh, Omender Singh, Vinod Singh, Iqbal Kaur, Sanghamitra Datta, Sharmila Sen Gupta
BACKGROUND: There is emergence of resistance to the last-line antibiotics such as carbapenems in Intensive Care Units (ICUs), leaving little effective therapeutic options. Since there are no more newer antibiotics in the armamentarium in the near future, it has become imperative that we harness the interdisciplinary knowledge for the best clinical outcome of the patient. AIMS: The aim of the conference was to utilize the synergies between the clinical microbiologists and critical care specialists for better patient care and clinical outcome...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28395095/comparison-of-inflight-first-aid-performed-by-cabin-crew-members-and-medical-volunteers
#3
Jung Ha Kim, Smi Choi-Kwon, Young Hwan Park
Background: Since the number of air travellers, including the elderly and passengers with an underlying disease, is increasing every year, the number of inflight emergency patients is expected to increase as well. We attempted to identify the incidence and types of reported inflight medical incidents and analyse the first aid performed by cabin crew members or medical volunteers in flights by an Asian airline. We also investigated the cases of inflight deaths and aircraft diversions. Methods: We reviewed the cabin reports and medical records submitted by cabin crew members and inflight medical volunteers from 2009 to 2013...
March 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28385926/critical-care-air-transport-team-severe-traumatic-brain-injury-short-term-outcomes-during-flight-for-operation-iraqi-freedom-operation-enduring-freedom
#4
L Renee Boyd, J Borawski, J Lairet, A T Limkakeng
INTRODUCTION: Our understanding of the expertise and equipment required to air transport injured soldiers with severe traumatic brain injuries (TBIs) continue to evolve. METHODS: We conducted a retrospective chart review of characteristics, interventions required and short-term outcomes of patients with severe TBI managed by the US Air Force Critical Care Air Transport Teams (CCATTs) deployed in support of Operation Iraqi Freedom and Operation Enduring Freedom between 1 June 2007 and 31 August 2010...
April 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28383307/the-thrombolytic-effect-of-diagnostic-ultrasound-induced-microbubble-cavitation-in-acute-carotid-thromboembolism
#5
Thomas R Porter, Feng Xie, John Lof, Jeffry Powers, Francois Vignon, William Shi, Matthew White
BACKGROUND: Acute ischemic stroke is often due to thromboembolism forming over ruptured atherosclerotic plaque in the carotid artery (CA). The presence of intraluminal CA thrombus is associated with a high risk of thromboembolic cerebral ischemic events. The cavitation induced by diagnostic ultrasound high mechanical index (MI) impulses applied locally during a commercially available intravenous microbubble infusion has dissolved intravascular thrombi, especially when using longer pulse durations...
April 5, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28378108/risk-factors-for-neurological-deficits-after-surgical-treatment-of-brain-arteriovenous-malformations-supplied-by-deep-perforating-arteries
#6
Yuming Jiao, Fuxin Lin, Jun Wu, Hao Li, Xin Chen, Zhicen Li, Ji Ma, Yong Cao, Shuo Wang, Jizong Zhao
The treatment of brain arteriovenous malformations supplied by deep perforating arteries (PA) (P-BAVM) remains challenging. The aims of this study were to determine the outcomes after surgical treatment in patients with P-BAVMs and to identify the risk factors associated with postoperative neurological deficits. We retrospectively reviewed the medical charts and imaging records of 228 consecutive patients with BAVMs who underwent microsurgical resection of their BAVMs at Beijing Tiantan Hospital between September 2012 and March 2016...
April 4, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28351153/gas-chromatography-mass-spectrometry-metabolomics-of-urine-and-serum-from-nonhuman-primates-exposed-to-ionizing-radiation-impacts-on-the-tricarboxylic-acid-cycle-and-protein-metabolism
#7
Evan L Pannkuk, Evagelia C Laiakis, Simon Authier, Karen Wong, Albert J Fornace
Ionizing radiation (IR) directly damages cells and tissues or indirectly through reactive free radicals that may lead to longer term adverse sequelae such as cancers, persistent inflammation, or possible death. Potential exposures include nuclear reactor accidents, improper disposal of equipment containing radioactive materials or medical errors, and terrorist attacks. Metabolomics (comprehensive analysis of compounds <1 kDa) by mass spectrometry (MS) has been proposed as a tool for high-throughput biodosimetry and rapid assessment of exposed dose and triage needed...
March 29, 2017: Journal of Proteome Research
https://www.readbyqxmd.com/read/28348895/in-flight-hypoxemia-in-a-tracheostomy-dependent-infant
#8
Jason Quevreaux, Christopher Cropsey
Millions of passengers board commercial flights every year. Healthcare providers are often called upon to treat other passengers during in-flight emergencies. The case presented involves an anesthesia resident treating a tracheostomy-dependent infant who developed hypoxemia on a domestic flight. The patient had an underlying congenital muscular disorder and was mechanically ventilated while at altitude. Although pressurized, cabin barometric pressure while at altitude is less than at sea level. Due to this environment patients with underlying pulmonary or cardiac pathology might not be able to tolerate commercial flight...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28342095/-advances-in-diagnostic-microbiology-opportunities-and-limitations
#9
F P Maurer, M Hentschke, H Rohde
In the light of ever increasing problems related to the emergence of multidrug-resistant bacteria, rapid microbiological diagnostics are of growing importance. Timely pathogen detection and availability of susceptibility data are essential for optimal treatment, but are even more crucial for de-escalation of broad spectrum empiric therapies. Medical microbiology is, thus, an integral part of antimicrobial stewardship programs. Traditional microbiological techniques for species identification and susceptibility testing rely on bacterial growth and are, thus, characterized by inherent slowness...
March 24, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28336018/air-medical-transport-residency-program-for-flight-nurses-and%C3%A2-paramedics
#10
Jeff Phillips, Chad Kuhlman, Chris Evanson
No abstract text is available yet for this article.
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28336017/weather-webcam-system-for-the-safety-of-helicopter-emergency-medical-services-in-miyazaki-japan
#11
Katsuhiro Kanemaru, Robert Katzer, Syu Hanato, Koji Nakamura, Hiroshi Matsuoka, Hidenobu Ochiai
OBJECTIVE: In Japan, the helicopter emergency medical services (HEMS) system was initiated in 2001 and introduced to Miyazaki Prefecture in 2012. Mountainous areas occupy 88% of Miyazaki's land area, and HEMS flights can be subject to the effects of weather. Therefore, ensuring safety in changing weather conditions is a necessity for HEMS. METHODS: The weather webcam system (WWS) was established to observe the meteorological conditions in 29 locations. Assessments of the probability of a flight based on conventional data including a weather chart provided by the Japan Meteorological Agency and meteorological reports provided by the Miyazaki Airport were compared with the assessment based on the combination of the information obtained from the WWS and the conventional data...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28336016/review-of-issues-and-challenges-of-practicing-emergency-medicine-above-30-000-feet-altitude-2-anonymized-cases
#12
Kam Lun Hon, Karen Ka Yan Leung
We present 2 anonymized cases to identify issues and challenges associated with long-haul in-flight medical emergencies. The first case involved a middle-aged man with a history of carditis on a systemic steroid who developed vomiting and rigor. Four physicians, including a pediatric intensivist, responded to the emergency call. In the second case, a pediatric trainee who was the only onboard medical personnel was summoned for help when a middle-aged man developed acute shortness of breath while traveling on a commercial flight...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28336015/ten-years-of-en-route-critical-care-training
#13
Mathieu Boutonnet, Pierre Pasquier, Laurent Raynaud, Laurent Vitiello, Jérôme Bancarel, Sébastien Coste, Guillaume Pelée de Saint Maurice, Sylvain Ausset
OBJECTIVE: The French Military Health Service (FMHS) has developed a training program for medical evacuation (MEDEVAC) of critical care patients on fixed wing aircraft. METHODS: We conducted a 10-year retrospective analysis (2006-2015) of the data from the FMHS Academy. The number of trainees was listed according to the different courses and medical specialties. The number of MEDEVACs recorded during the period was described. RESULTS: Since 2006, the FMHS has developed training courses designed for MEDEVAC of critical care patients...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28328023/identification-of-microorganisms-in-biofluids-of-individuals-with-periodontitis-and-chronic-kidney-disease-using-matrix-assisted-laser-desorption-ionization-time-of-flight-mass-spectrometry
#14
Levy Anderson César Alves, Rafael Celestino Souza, Taciana Mara Couto da Silva, Andreia Watanabe, Meriellen Dias, Maria Anita Mendes, Ana Lídia Ciamponi
RATIONALE: Chronic kidney disease (CKD) and periodontitis (PD) are important health issues. There is a large variety of microorganisms related to the pathogenesis of periodontitis, and optimising the time and the cost of laboratory assays to detect these organisms is highly valuable in the medical field. METHODS: Bacteria were isolated from saliva and oral biofilm of 30 adolescents and young adults with definite medical and dental diagnosis of CKD and PD, respectively, and proteins were extracted for microorganism identification by means of the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS) technique...
May 30, 2016: Rapid Communications in Mass Spectrometry: RCM
https://www.readbyqxmd.com/read/28324770/a-non-fatal-intoxication-and-seven-deaths-involving-the-dissociative-drug-3-meo-pcp
#15
Anna Johansson, Daniel Lindstedt, Markus Roman, Gunilla Thelander, Elisabet I Nielsen, Ulrica Lennborn, Håkan Sandler, Sten Rubertsson, Johan Ahlner, Robert Kronstrand, Fredrik C Kugelberg
INTRODUCTION: 3-methoxyphencyclidine (3-MeO-PCP) appeared on the illicit drug market in 2011 and is an analogue of phencyclidine, which exhibits anesthetic, analgesic and hallucinogenic properties. In this paper, we report data from a non-fatal intoxication and seven deaths involving 3-MeO-PCP in Sweden during the period March 2014 until June 2016. CASE DESCRIPTIONS: The non-fatal intoxication case, a 19-year-old male with drug problems and a medical history of depression, was found awake but tachycardic, hypertensive, tachypnoeic and catatonic at home...
March 7, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28314568/health-workers-and-the-weaponisation-of-health-care-in-syria-a-preliminary-inquiry-for-the-lancet-american-university-of-beirut-commission-on-syria
#16
Fouad M Fouad, Annie Sparrow, Ahmad Tarakji, Mohamad Alameddine, Fadi El-Jardali, Adam P Coutts, Nour El Arnaout, Lama Bou Karroum, Mohammed Jawad, Sophie Roborgh, Aula Abbara, Fadi Alhalabi, Ibrahim AlMasri, Samer Jabbour
The conflict in Syria presents new and unprecedented challenges that undermine the principles and practice of medical neutrality in armed conflict. With direct and repeated targeting of health workers, health facilities, and ambulances, Syria has become the most dangerous place on earth for health-care providers. The weaponisation of health care-a strategy of using people's need for health care as a weapon against them by violently depriving them of it-has translated into hundreds of health workers killed, hundreds more incarcerated or tortured, and hundreds of health facilities deliberately and systematically attacked...
March 14, 2017: Lancet
https://www.readbyqxmd.com/read/28291468/navy-en-route-care-a-3-year-review-of-428-navy-air-evacuations
#17
Benjamin Walrath, Alejandra Mora, Victoria Ganem, Stephen Harper, Elliot Ross, Chetan Kharod, Gerard Demers, Vikhyat S Bebarta
BACKGROUND: Navy medical personnel have been recording en route care (ERC) missions through Search and Rescue (SAR) reports since the 1970's. Our objective was to report clinical ERC cases treated by Navy operational assets from January 2012 to January 2015. METHODS: The Search and Rescue Model Manager office collects SAR reports for all patient transports involving Navy personnel and equipment. From these reports, descriptive statistics to include total number of patients transported, percentages of Advanced Life Support versus Basic Life Support transports, time of transport, and type of ERC provider for the transport were collected...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291467/a-retrospective-cohort-analysis-of-battle-injury-versus-disease-non-battle-injury-two-validating-flight-surgeons-experience
#18
William P Butler, Lawrence W Steinkraus, Brittany L Fouts, Jennifer L Serres
Today, military combat medical care is the best it has ever been. Regulated U.S. Air Force aeromedical evacuation (AE) is one important reason. The Theater Validating Flight Surgeon (TVFS) validates that a patient is ready for flight. Two TVFSs' experiences, successively deployed in 2007, are the focus of this study. A unique operational worksheet used to manage the AE queue was used for approximately 5 months. A descriptive analysis of the worksheet's 1,389 patients found the majority male (94%), median age 30 years, and mostly Army enlisted soldiers (63%)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28270757/effectiveness-of-a-novel-qigong-meditative-movement-practice-for-impaired-health-in-flight-attendants-exposed-to-second-hand-cigarette-smoke
#19
Peter Payne, Steven Fiering, James C Leiter, David T Zava, Mardi A Crane-Godreau
This single-arm non-randomized pilot study explores an intervention to improve the health of flight attendants (FA) exposed to second-hand cigarette smoke prior to the smoking ban on commercial airlines. This group exhibits an unusual pattern of long-term pulmonary dysfunction. We report on Phase I of a two-phase clinical trial; the second Phase will be a randomized controlled trial testing digital delivery of the intervention. Subjects were recruited in the Northeastern US; testing and intervention were administered in 4 major cities...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28265817/risk-factors-and-outcome-of-levofloxacin-resistant-elizabethkingia-meningoseptica-bacteraemia-in-adult-patients-in-taiwan
#20
Y-C Huang, Y-W Huang, Y-T Lin, F-D Wang, Y-J Chan, T-C Yang
Elizabethkingia meningoseptica is an emerging nosocomial pathogen associated with high mortality and inherently resistant to many antimicrobial agents. Levofloxacin has been considered as a therapeutic agent based on in vitro susceptibility. We aim to investigate the risk factors and outcomes for levofloxacin-resistant E. meningoseptica bacteraemia. Adult patients with E. meningoseptica bacteraemia were identified retrospectively in a medical centre in Taiwan from January 2011 to July 2015. These strains were identified by the Vitek2 automated system or matrix-assisted laser desorption-ionization time-of-flight mass spectrometry...
March 7, 2017: European Journal of Clinical Microbiology & Infectious Diseases
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