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https://www.readbyqxmd.com/read/29666129/preventing-emergency-department-ed-visits-and-hospitalisations-of-older-adults-with-cognitive-impairment-compared-with-the-general-senior-population-what-do-we-know-about-avoidable-incidents-results-from-a-scoping-review
#1
Mireille Gagnon-Roy, Benyahia Hami, Mélissa Généreux, Nathalie Veillette, Marie-Josée Sirois, Mary Egan, Véronique Provencher
OBJECTIVES: Older cognitively impaired adults present a higher risk of hospitalisation and mortality following a visit to the emergency department (ED). Better understanding of avoidable incidents is needed to prevent them and the associated ED presentations in community-dwelling adults. This study aimed to synthetise the actual knowledge concerning these incidents leading this population to ED presentation, as well as possible preventive measures to reduce them. DESIGN: A scoping review was performed according to the Arksey and O'Malley framework...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29559211/tracheotomy-in-the-intensive-care-unit-guidelines-from-a-french-expert-panel-the-french-intensive-care-society-and-the-french-society-of-anaesthesia-and-intensive-care-medicine
#2
Jean-Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L'Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard, François Ravat, Sébastien Vergez, Julien Amour, Max Guillot
Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29549171/inter-rater-and-intrarater-reliability-of-the-south-african-triage-scale-in-low-resource-settings-of-haiti-and-afghanistan
#3
Mohammed Dalwai, Katie Tayler-Smith, Michèle Twomey, Masood Nasim, Abdul Qayum Popal, Waliul Haq Haqdost, Olivia Gayraud, Sophia Cheréstal, Lee Wallis, Pola Valles
OBJECTIVE: The South African Triage Scale (SATS) has demonstrated good validity in the EDs of Médecins Sans Frontières (MSF)-supported sites in Afghanistan and Haiti; however, corresponding reliability in these settings has not yet been reported on. This study set out to assess the inter-rater and intrarater reliability of the SATS in four MSF-supported EDs in Afghanistan and Haiti (two trauma-only EDs and two mixed (including both medical and trauma cases) EDs). METHODS: Under classroom conditions between December 2013 and February 2014, ED nurses at each site assigned triage ratings to a set of context-specific vignettes (written case reports of ED patients)...
March 16, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29546588/tracheotomy-in-the-intensive-care-unit-guidelines-from-a-french-expert-panel
#4
REVIEW
Jean Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L'Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard, François Ravat, Sebastien Vergez, Julien Amour, Max Guillot
Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method...
March 15, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29511602/infectious-disease-risk-and-vaccination-in-northern-syria-after-5-years-of-civil-war-the-msf-experience
#5
Alan de Lima Pereira, Rosamund Southgate, Hikmet Ahmed, Penelope O'Connor, Vanessa Cramond, Annick Lenglet
Introduction: In 2015, following an influx of population into Kobanê in northern Syria, Médecins Sans Frontières (MSF) in collaboration with the Kobanê Health Administration (KHA) initiated primary healthcare activities. A vaccination coverage survey and vaccine-preventable disease (VPD) risk analysis were undertaken to clarify the VPD risk and vaccination needs. This was followed by a measles Supplementary Immunization Activity (SIA). We describe the methods and results used for this prioritisation activity around vaccination in Kobanê in 2015...
February 2, 2018: PLoS Currents
https://www.readbyqxmd.com/read/29387145/provision-of-emergency-obstetric-care-at-secondary-level-in-a-conflict-setting-in-a-rural-area-of-afghanistan-is-the-hospital-fulfilling-its-role
#6
Daphne Lagrou, Rony Zachariah, Karen Bissell, Catherine Van Overloop, Masood Nasim, Hamsaya Nikyar Wagma, Shafiqa Kakar, Séverine Caluwaerts, Eva De Plecker, Renzo Fricke, Rafael Van den Bergh
Background: Provision of Emergency Obstetric and Neonatal Care (EmONC) reduces maternal mortality and should include three components: Basic Emergency Obstetric and Neonatal Care (BEmONC) offered at primary care level, Comprehensive EmONC (CEmONC) at secondary level and a good referral system in-between. In a conflict-affected province of Afghanistan (Khost), we assessed the performance of an Médecins Sans Frontières (MSF) run CEmONC hospital without a primary care and referral system...
2018: Conflict and Health
https://www.readbyqxmd.com/read/29364979/navigating-the-risks-of-prevention-of-mother-to-child-transmission-pmtct-of-hiv-services-in-kibera-kenya-barriers-to-engaging-and-remaining-in-care
#7
Kerry A Thomson, Barbara Telfer, Patricia Opondo Awiti, Jane Munge, Mathew Ngunga, Anthony Reid
Within the first year of implementation, 43% of women who tested HIV positive at their first antenatal care visit were no longer retained and being followed in the free prevention of mother to child transmission (PMTCT) of HIV program offered by the Kenyan Ministry of Health and Médecins Sans Frontières in the informal settlement of Kibera, Nairobi. This study aimed to explore barriers to enrolling and remaining engaged in PMTCT services throughout the pregnancy and postpartum periods. Qualitative data from 31 focus group discussions and 35 in-depth interviews across six stakeholder groups that included women, men, and PMTCT service providers were analyzed...
2018: PloS One
https://www.readbyqxmd.com/read/29298314/improving-mapping-for-ebola-response-through-mobilising-a-local-community-with-self-owned-smartphones-tonkolili-district-sierra-leone-january-2015
#8
Laura M Nic Lochlainn, Ivan Gayton, Georgios Theocharopoulos, Robin Edwards, Kostas Danis, Ronald Kremer, Karline Kleijer, Sumaila M Tejan, Mohamed Sankoh, Augustin Jimissa, Jane Greig, Grazia Caleo
BACKGROUND: During the 2014-16 Ebola virus disease (EVD) outbreak, the Magburaka Ebola Management Centre (EMC) operated by Médecins Sans Frontières (MSF) in Tonkolili District, Sierra Leone, identified that available district maps lacked up-to-date village information to facilitate timely implementation of EVD control strategies. In January 2015, we undertook a survey in chiefdoms within the MSF EMC catchment area to collect mapping and village data. We explore the feasibility and cost to mobilise a local community for this survey, describe validation against existing mapping sources and use of the data to prioritise areas for interventions, and lessons learned...
2018: PloS One
https://www.readbyqxmd.com/read/29297408/nubia-s-mother-being-pregnant-in-the-time-of-experimental-vaccines-and-therapeutics-for-ebola
#9
Séverine Caluwaerts
During the 2014-2016 Ebola epidemic, Médecins Sans Frontières (MSF) treated Ebola-positive pregnant women in its Ebola Treatment Centers (ETCs). For pregnant women with confirmed Ebola virus disease, inclusion in clinical vaccine/drug/therapeutic trials was complicated. Despite their extremely high Ebola-related mortality in previous epidemics (89-93%) and a neonatal mortality of 100%, theoretical concerns about safety of vaccines and therapeutics in pregnancy were invoked, limiting pregnant women's access to an experimental live attenuated vaccine and brincidofovir, an experimental antiviral...
December 14, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29166354/smoothing-the-transition-points-in-canadian-medical-education
#10
Nick Busing, Jay Rosenfield, Kamal Rungta, Matt Raegele, Andrew Warren, Bruce Wright, Mark Walton, Ivy Oandasan, Anthony Sanfilippo, Anurag Saxena
In 2010 the Association of Faculties of Medicine of Canada, Collège des médecins du Québec, College of Family Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada launched The Future of Medical Education in Canada Postgraduate (FMEC PG) Project to examine postgraduate medical education (PGME) in Canada and make recommendations for improvement. One recommendation that emerged concerns the transitions learners experience across the undergraduate medical education-PGME-practice continuum...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28912964/is-the-south-african-triage-scale-valid-for-use-in-afghanistan-haiti-and-sierra-leone
#11
Mohammed Dalwai, Pola Valles, Michele Twomey, Yvonne Nzomukunda, Prince Jonjo, Manoj Sasikumar, Masood Nasim, Abdul Razaaq, Olivia Gayraud, Pierre Ronald Jecrois, Lee Wallis, Katie Tayler-Smith
OBJECTIVE: To assess the validity of the South African Triage Scale (SATS) in four Médecins Sans Frontières (MSF)-supported emergency departments (ED, two trauma-only sites, one mixed site (both medical and trauma cases) and one paediatric-only site) in Afghanistan, Haiti and Sierra Leone. METHODS: This was a retrospective cohort study conducted between June 2013 and June 2014. Validity was assessed by comparing patients' SATS ratings with their final ED outcome (ie, hospital admission, death or discharge)...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/28852784/-orthopedic-surgery-with-limited-resources-after-mass-disasters-and-during-armed-conflicts-first-international-guidelines-for-the-management-of-limb-injuries-and-the-experience-of-doctors-without-borders
#12
REVIEW
Inga Osmers
Disasters and armed conflicts are often the unfortunate basis for aid projects run by Doctors Without Borders/Médecins Sans Frontières (MSF). The nature of war and disasters means that surgery is an integral part of this medical emergency aid. In these situations, resources are usually limited. As a result, surgical work in these contexts differs significantly from the daily routine of a surgeon working in a highly resourced hospital. The principles of surgery do not change but surgeons must adapt their tactical approach to the changed context otherwise there is a high risk of failing to improve the health of patients and potentially jeopardizing their prospects for recovery...
October 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28837294/-emergency-medecine-myths-in-hospital-care
#13
Alain Maillard, Nicolas Beysard
Many of our medical procedures are conditioned by beliefs or experiences by our mentors, which we pass on to the younger, for example: gradually emptying a full bladder to avoid hypotension or haemorrhage, hydrating the alcoholic so that the blood alcohol level decreases faster, always obtaining an arterial blood gas instead of a venous one and not injecting iodinated intravenous contrast in patients allergic to shellfish.
August 9, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28835247/the-modified-south-african-triage-scale-system-for-mortality-prediction-in-resource-constrained-emergency-surgical-centers-a-retrospective-cohort-study
#14
Jacques Massaut, Pola Valles, Arnold Ghismonde, Claudinette Jn Jacques, Liseberth Pierre Louis, Abdulmutalib Zakir, Rafael Van den Bergh, Lunick Santiague, Rose Berly Massenat, Nathalie Edema
BACKGROUND: The South African Triage Scale (SATS) was developed to facilitate patient triage in emergency departments (EDs) and is used by Médecins Sans Frontières (MSF) in low-resource environments. The aim was to determine if SATS data, reason for admission, and patient age can be used to develop and validate a model predicting the in-hospital risk of death in emergency surgical centers and to compare the model's discriminative power with that of the four SATS categories alone. METHODS: We used data from a cohort hospitalized at the Nap Kenbe Surgical Hospital in Haiti from January 2013 to June 2015...
August 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28750691/the-use-of-interpreters-in-medical-triage-during-a-refugee-mass-gathering-incident-in-europe
#15
Lykourgos Christos Alexakis, Anastasia Papachristou, Chiara Baruzzi, Angeliki Konstantinou
Introduction During a refugees' mass-gathering incident in Kos Island, Greece, Médecins Sans Frontières (MSF; Brussels, Belgium) teams provided emergency medical care. A case report of the event focusing on difficulties encountered by the interpreters during triage and emergency response was prepared. METHODS: Data collected during the event were reviewed from the patient's register and qualitative interviews were obtained from the MSF interpreters involved in the response. In addition, a description of the event and a literature review were included...
December 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28716879/international-issues-teleneurology-in-humanitarian-crises-lessons-from-the-m%C3%A3-decins-sans-fronti%C3%A3-res-experience
#16
Altaf Saadi, Farrah J Mateen
Humanitarian emergencies defined by armed conflict, political strife, famine, or natural disaster can devastate populations rapidly. Neurologic disorders accompany these complex humanitarian emergencies but often go unheeded, exacerbated by a scarcity of neurologists. Teleneurology offers the promise of neurologic care remotely in the face of this inadequate local clinician supply. We describe our experiences as voluntary neurology teleconsultants with Médecins Sans Frontières in order to highlight both the promises and challenges of teleneurology in humanitarian contexts...
July 18, 2017: Neurology
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#17
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gérard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigué, Laure de Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28645279/diabetes-care-in-a-complex-humanitarian-emergency-setting-a-qualitative-evaluation
#18
Adrianna Murphy, Michel Biringanine, Bayard Roberts, Beverley Stringer, Pablo Perel, Kiran Jobanputra
BACKGROUND: Evidence is urgently needed from complex emergency settings to support efforts to respond to the increasing burden of diabetes mellitus (DM). We conducted a qualitative study of a new model of DM health care (Integrated Diabetic Clinic within an Outpatient Department [IDC-OPD]) implemented by Médecins Sans Frontières (MSF) in Mweso Hospital in eastern Democratic Republic of Congo (DRC). We aimed to explore patient and provider perspectives on the model in order to identify factors that may support or impede it...
June 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#19
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28628463/operational-research-during-the-ebola-emergency
#20
Gabriel Fitzpatrick, Tom Decroo, Bertrand Draguez, Rosa Crestani, Axelle Ronsse, Rafael Van den Bergh, Michel Van Herp
Operational research aims to identify interventions, strategies, or tools that can enhance the quality, effectiveness, or coverage of programs where the research is taking place. Médecins Sans Frontières admitted ≈5,200 patients with confirmed Ebola virus disease during the Ebola outbreak in West Africa and from the beginning nested operational research within its emergency response. This research covered critical areas, such as understanding how the virus spreads, clinical trials, community perceptions, challenges within Ebola treatment centers, and negative effects on non-Ebola healthcare...
July 2017: Emerging Infectious Diseases
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