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ABCDE approach

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https://www.readbyqxmd.com/read/28625562/do-trauma-courses-change-practice-a-qualitative-review-of-20-courses-in-east-central-and-southern-africa
#1
Rele Ologunde, Grace Le, Jim Turner, Hemant Pandit, Noel Peter, David Maurer, Sam Hodgson, Joseph Larvin, Chris Lavy
BACKGROUND: Trauma courses have been shown to improve clinical knowledge and patient outcomes. However, little is known about the individual drivers of change in practice amongst course participants in their home clinic environment. METHODS: Front-line healthcare workers participated in a two-day Primary Trauma Care (PTC) course. Immediately after the course participants completed an evaluation survey on intended change in the management of trauma patients. Six months after the course, participants completed a survey on actual changes that had occurred...
June 13, 2017: Injury
https://www.readbyqxmd.com/read/28609331/evaluation-and-impact-of-the-advanced-pediatric-life-support-course-in-the-care-of-pediatric-emergencies-in-spain
#2
Javier Benito, Carlos Luaces-Cubells, Santiago Mintegi, Ignacio Manrique Martínez, Mercedes De la Torre Espí, Concepción Miguez Navarro, Paula Vazquez López, Carmen Campos Calleja, Francesc Ferres Serrat, María Teresa Alonso Salas, Javier González Del Rey
INTRODUCTION: The Advanced Pediatric Life Support (APLS) course was introduced in the training of professionals who care for pediatric emergencies in Spain in 2005. OBJECTIVE: To analyze the impact of the APLS course in the current clinical practice in Spanish PEDs. METHODS: The directors of APLS courses were asked about information regarding the courses given to date, especially on the results of the satisfaction survey completed by students at the end of the course...
June 12, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28521019/a-whole-system-approach-to-improving-mortality-associated-with-acute-kidney-injury
#3
Thangavelu Chandrasekar, Asheesh Sharma, Lucinda Tennent, Christopher Wong, Peter Chamberlain, Kottarathil A Abraham
BACKGROUND: Acute kidney injury (AKI) is in the main managed by non-nephrologists, many who feel challenged by or lack awareness of the complexity that the renal element adds to their patients' care. National reports have raised major concerns about the quality of care and have predicted that mortality reductions of 30% are achievable with good medical practice. AIM: This quality improvement project evaluated whether a whole system approach could improve outcomes for patients with AKI...
May 18, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28469050/the-abcde-primary-assessment-in-the-emergency-department-in-medically-ill-patients-an-observational-pilot-study
#4
T J Olgers, R S Dijkstra, A M Drost-de Klerck, J C Ter Maaten
BACKGROUND: Competency in the Airway Breathing Circulation Disability Exposure (ABCDE) approach is required for working in the emergency department. There is limited knowledge on how often and how completely the ABCDE approach is applied to medical patients. The objectives of this study were to assess the frequency with which the ABCDE approach was used in potentially unstable patients and to determine factors influencing the choice of whether or not to use the ABCDE approach. METHODS: This observational pilot study included 270 medical patients admitted to the emergency department and it was observed if and how completely the ABCDE approach was performed...
April 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28403469/opportunities-missed-a-cross-sectional-survey-of-the-provision-of-smoking-cessation-care-to-pregnant-women-by-australian-general-practitioners-and-obstetricians
#5
Yael Bar Zeev, Billie Bonevski, Laura Twyman, Kerrianne Watt, Lou Atkins, Kerrin Palazzi, Christopher Oldmeadow, Gillian S Gould
Introduction: Similar to other high-income countries, smoking rates in pregnancy can be high in specific vulnerable groups in Australia. Several clinical guidelines exist, including the 5A's (Ask, Advice, Assess, Assist, and Arrange), ABCD (Ask, Brief advice, Cessation, and Discuss), and AAR (Ask, Advice, and Refer). There is lack of data on provision of smoking cessation care (SCC) of Australian General Practitioners (GPs) and Obstetricians. Methods: A cross-sectional survey explored the provision of SCC, barriers and enablers using the Theoretical Domains Framework, and the associations between them...
May 1, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28375331/evaluation-of-the-influence-of-arbitrary-masks-on-the-output-field-of-optical-systems-using-abcd-matrices
#6
Malchiel Haskel, Adrian Stern
We propose a method to express the complex field amplitude (CFA) at the output of any optical system with arbitrary masks. The method provides a general equation for any first-order optical system with given parameters and arbitrary masks. The method is based on the ABCD matrices of the system components, ignoring the masks. The obtained output CFA is formulated in a way that helps recognize the influence of each mask on the output CFA by projecting its influence on the output with the aid of ABCD matrices...
April 1, 2017: Journal of the Optical Society of America. A, Optics, Image Science, and Vision
https://www.readbyqxmd.com/read/28365735/annosys-implementation-of-a-generic-annotation-system-for-schema-based-data-using-the-example-of-biodiversity-collection-data
#7
L Suhrbier, W-H Kusber, O Tschöpe, A Güntsch, W G Berendsohn
Biological research collections holding billions of specimens world-wide provide the most important baseline information for systematic biodiversity research. Increasingly, specimen data records become available in virtual herbaria and data portals. The traditional (physical) annotation procedure fails here, so that an important pathway of research documentation and data quality control is broken. In order to create an online annotation system, we analysed, modeled and adapted traditional specimen annotation workflows...
January 1, 2017: Database: the Journal of Biological Databases and Curation
https://www.readbyqxmd.com/read/28357866/enantioselective-construction-of-the-abcde-pentacyclic-core-of-the-strychnos-alkaloids
#8
Adam D Gammack Yamagata, Darren J Dixon
An efficient enantioselective 12-step synthesis of the ABCDE pentacyclic core of the Strychnos alkaloids is described. A key feature of this approach is an organocatalyzed enantioselective desymmetrization to generate the morphan core in high ee and dr. After palladium-catalyzed installation of the indole moiety, a subsequent 5-exo-trig dearomatizing atom transfer radical cyclization was developed to construct the C-ring. Following a series of functional group interconversions, the pentacyclic amine core was obtained with all the relevant architecture including five stereocenters pertaining to the Strychnos alkaloids...
April 7, 2017: Organic Letters
https://www.readbyqxmd.com/read/28335823/the-forge-ahead-clinical-readiness-consultation-tool-a-validated-tool-to-assess-clinical-readiness-for-chronic-disease-care-mobilization-in-canada-s-first-nations
#9
Mariam Naqshbandi Hayward, Selam Mequanint, Jann Paquette-Warren, Ross Bailie, Alexandra Chirila, Roland Dyck, Michael Green, Anthony Hanley, Jordan Tompkins, Stewart Harris
BACKGROUND: Given the astounding rates of diabetes and related complications, and the barriers to providing care present in Indigenous communities in Canada, intervention strategies that take into account contextual factors such as readiness to mobilize are needed to maximize improvements and increase the likelihood of success and sustainment. As part of the national FORGE AHEAD Program, we sought to develop, test and validate a clinical readiness consultation tool aimed at assessing the readiness of clinical teams working on-reserve in First Nations communities to participate in quality improvement (QI) to enhance diabetes care in Canada...
March 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28314417/an-algorithmic-approach-to-triaging-facial-trauma-on-the-sidelines
#10
REVIEW
Kristi Colbenson
On-the-field evaluation of facial trauma requires a focused initial assessment of the patient's airway and breathing with a knowledge of the critical associated injuries. The initial triage in facial trauma involves assessing and protecting the athlete's airway, breathing, and cervical spine. The algorithm then requires a repeat evaluation for subtle causes of airway obstruction and aspiration risks. Final steps include control of hemorrhage, recognition of neurologic and ophthalmologic disability, and complete exposure of the athlete to examine for other associated injury...
April 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28258215/peroxisomal-atp-binding-cassette-transporters-form-mainly-tetramers
#11
Flore Geillon, Catherine Gondcaille, Quentin Raas, Alexandre M M Dias, Delphine Pecqueur, Caroline Truntzer, Géraldine Lucchi, Patrick Ducoroy, Pierre Falson, Stéphane Savary, Doriane Trompier
ABCD1 and its homolog ABCD2 are peroxisomal ATP-binding cassette (ABC) half-transporters of fatty acyl-CoAs with both distinct and overlapping substrate specificities. Although it is established that ABC half-transporters have at least to dimerize to generate a functional unit, functional equivalents of tetramers (i.e. dimers of full-length transporters) have also been reported. However, oligomerization of peroxisomal ABCD transporters is incompletely understood but is of potential significance because more complex oligomerization might lead to differences in substrate specificity...
April 28, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28209049/5-point-checklist-for-skin-cancer-detection-in-primary-care
#12
Elvira Moscarella, Aimilios Lallas, Caterina Longo, Roberto Alfano, Giuseppe Argenziano
BACKGROUND: Skin cancer screening interventions often relay on the involvement of general practitioners (GPs). Many interventions up to now have been directed to training approaches focusing on the clinical features of skin malignancies to increase GPs skill in skin cancer recognition. METHODS: Based on the available current knowledge about skin cancer epidemiology and risk factors, we built up a 5-point checklist to help GPs in triaging patients to be referred to a dermatologist...
February 16, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28197216/introducing-the-comprehensive-unit-based-safety-program-for-mechanically-ventilated-patients-in-saudi-arabian-intensive-care-units
#13
Raymond M Khan, Maha Aljuaid, Hanan Aqeel, Mohammed M Aboudeif, Shaimaa Elatwey, Rajeh Shehab, Yasser Mandourah, Khalid Maghrabi, Hassan Hawa, Imran Khalid, Ismael Qushmaq, Asad Latif, Bickey Chang, Sean M Berenholtz, Sultan Tayar, Khloud Al-Harbi, Amin Yousef, Anas A Amr, Yaseen M Arabi
Over the past decade, there have been major improvements to the care of mechanically ventilated patients (MVPs). Earlier initiatives used the concept of ventilator care bundles (sets of interventions), with a primary focus on reducing ventilator-associated pneumonia. However, recent evidence has led to a more comprehensive approach: The ABCDE bundle (Awakening and Breathing trial Coordination, Delirium management and Early mobilization). The approach of the Comprehensive Unit-based Safety Program (CUSP) was developed by patient safety researchers at the Johns Hopkins Hospital and is supported by the Agency for Healthcare Research and Quality to improve local safety cultures and to learn from defects by utilizing a validated structured framework...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28179250/impact-of-pharmacist-management-of-pain-agitation-and-delirium-in-the-intensive-care-unit-through-participation-in-multidisciplinary-bundle-rounds
#14
Patricia Louzon, Heath Jennings, Mahmood Ali, Marijo Kraisinger
PURPOSE: A two-phase program to increase pharmacist involvement in management of pain, agitation and delirium (PAD) at a large community teaching hospital is described. SUMMARY: Florida Orlando Hospital implemented a two-phase initiative to decrease intensive care unit (ICU) length of stay (LOS), ventilator use, sedative use, and hospital expenditures while advancing pharmacists' scope of practice. Phase 1 of the initiative involved a pilot project to evaluate pharmacist management of sedative therapy for mechanically ventilated patients...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27694354/the-abcds-of-managing-morbidly-obese-patients-in-intensive-care-units
#15
Luis A Berrios
More than one-third of the US adult population and 17% of the youth are now obese, and obesity is associated with more than $147 billion a year in health care costs. Critical care nurses should understand the physiological differences and practice guidelines for patients with a body mass index greater than 30. The ABCD approach encompasses key clinical concepts in the management of critically ill obese and morbidly obese patients, including management of airways and breathing, minimizing nurses' back and other injuries, increasing awareness of bias, circulation problems, risks of decubitus ulcers and other skin breakdown, differences in drug calculations and metabolism, limitations in diagnostic equipment and imaging, diet and nutritional recommendations, and concerns with durable medical equipment...
October 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27666096/assessment-and-management-of-the-septic-patient-part-1
#16
REVIEW
Jody Vaughan, Andy Parry
Sepsis has gained increasing publicity in recent years, and is now a strong focus of clinical education and training following the launch of the 'Surviving Sepsis' campaign. The assessment and management of a septic patient are far from simple and requires a systematic approach in both identifying and managing the condition. This two-part series explores the assessment and management of a septic patient, with this article emphasising the need to identify the signs and symptoms of sepsis at the early stages if positive patient outcomes are to be realised...
September 22, 2016: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/27615348/recognition-and-management-of-seizures-in-children-in-emergency-departments
#17
REVIEW
Edward Caplan, Indranil Dey, Andrea Scammell, Katy Burnage, Siba Prosad Paul
Seizure is defined as 'a sudden surge of electrical activity in the brain, which usually affects how a person appears or acts for a short time'. Children who have experienced seizures commonly present to emergency departments (EDs), and detailed history taking will usually help differentiate between epileptic and non-epileptic events. ED nurses are often the first health professionals to manage children with seizures, and this is best done by following the ABCDE approach. Treatment involves termination of seizures with anticonvulsants, and children may need other symptomatic management...
September 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27598775/low-enteric-colonization-with-multidrug-resistant-pathogens-in-soldiers-returning-from-deployments-experience-from-the-years-2007-2015
#18
Hagen Frickmann, Dorothea Wiemer, Claudia Frey, Ralf Matthias Hagen, Rebecca Hinz, Andreas Podbielski, Thomas Köller, Philipp Warnke
This assessment describes the enteric colonization of German soldiers 8-12 weeks after returning from mostly but not exclusively subtropical or tropical deployment sites with third-generation cephalosporin-resistant Enterobacteriaceae, vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA). Between 2007 and 2015, 828 stool samples from returning soldiers were enriched in nonselective broth and incubated on selective agars for Enterobacteriaceae expressing extended-spectrum beta-lactamases (ESBL), VRE and MRSA...
2016: PloS One
https://www.readbyqxmd.com/read/27597147/total-lineshape-analysis-of-high-resolution-nmr-spectra-powered-by-simulated-annealing
#19
D A Cheshkov, D O Sinitsyn, K F Sheberstov, V A Chertkov
The novel algorithm for a total lineshape analysis of high-resolution NMR spectra has been developed. A global optimization by simulated annealing has been applied that has allowed to overcome the main trouble of common approaches which had frequently returned solutions for local minima rather than for global ones. The algorithm has been verified for the four-spin test systems ABCD, and has been successfully used for analysis of experimental NMR spectra of proline. The approach has allowed to avoid a sophisticated manual setup of initial parameters and to conduct the analysis of complicated high-resolution NMR spectra nearly automatically...
August 23, 2016: Journal of Magnetic Resonance
https://www.readbyqxmd.com/read/27403225/multiparametric-approach-enhances-detection-of-patients-with-cerebral-tias-at-risk-of-stroke-a-prospective-pilot-case-series
#20
Foad Abd-Allah, Tarek Zoheir Tawfik, Reham Mohammed Shamloul, Montasser M Hegazy, Assem Hashad, Ayman Ismail Kamel, Dina Farees, Nevin M Shalaby
BACKGROUND: Patients with transient ischemic attack (TIA) are generally clinically unstable, with fear of developing a handicapping stroke. Identification of those at highest and lowest risk of stroke in the first days and weeks after a TIA would allow appropriate use of worthy secondary prevention strategies. OBJECTIVE: Incorporation of a clinical scoring system, neurovascular imaging, and magnetic resonance-diffusion-weighted imaging (MR-DWI) to help predicting risk of developing an ischemic stroke following a TIA...
June 2016: Journal of Vascular and Interventional Neurology
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