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Vital Sign Monitor

Ian C Gibbs, Oluwole Fadahunsi, Natoya Reid, Andrea M Bonnick
Malignant hyperthermia is a rare condition that occurs in susceptible patients exposed to triggering anesthetic agents. It is associated with a high mortality rate if not recognized immediately and treated appropriately. A 52-year-old man presented to our clinic 2 days after an assault for management of jaw pain. A minimally displaced right parasymphyseal fracture and moderately displaced left body fracture of the mandible were diagnosed. There were no known drug allergies. The patient reported no previous difficulty with anesthesia, as well as no known prior adverse reactions to anesthesia in any relatives...
July 19, 2018: Journal of Oral and Maxillofacial Surgery
Lexandra Schick, Brian Driver, Johanna C Moore, Erik Fagerstrom, James R Miner
OBJECTIVES: To determine if there is a difference in procedural amnesia and adverse respiratory events (ARE) between the target sedation levels of moderate (MS) and deep (DS) procedural sedation. METHODS: This was a prospective, randomized clinical trial of consenting adult patients planning to undergo deep procedural sedation with propofol between March 5th , 2015 and May 24th , 2017. Patients were randomized to a target sedation level of moderate or deep sedation using the American Society of Anesthesiologist's definitions...
August 11, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Hamish R Tomlinson, Marco A F Pimentel, Stephen Gerry, David A Clifton, Lionel Tarassenko, Peter J Watkinson
BACKGROUND: Data smoothing of vital signs has been reported in the anesthesia literature, suggesting that clinical staff are biased toward measurements of normal physiology. However, these findings may be partially explained by clinicians interpolating spurious values from noisy signals and by the undersampling of physiological changes by infrequent manual observations. We explored the phenomenon of data smoothing using a method robust to these effects in a large postoperative dataset including respiratory rate, heart rate, and oxygen saturation (SpO2)...
August 9, 2018: Anesthesia and Analgesia
Mallory Woiski, Suzan de Visser, Helena van Vugt, Anneke Dijkman, Nico Schuitemaker, Claudia van Meir, Johanna Middeldorp, Anjoke Huisjes, Ben W Mol, Jan Molkenboer, Desiree Moonen-Delarue, Martijn Oudijk, Leonie van Rheenen-Flach, Robert Rijnders, Paula Pernet, Martina Porath, Sander de Wit, Richard Grol, Hubertina Scheepers, Rosella Hermens
OBJECTIVE: To assess adherence to the national postpartum hemorrhage guideline and Managing Obstetric Emergencies and Trauma course instructions and its determinants in the Netherlands. METHODS: A prospective observational multicenter study in 16 Dutch hospitals analyzing data from medical records of 398 women at high risk for postpartum hemorrhage, of which 293 were supplemented with data from prospective video recordings. Adherence to guideline-based quality indicators for prevention, management, and organization of postpartum hemorrhage care was measured...
August 6, 2018: Obstetrics and Gynecology
Sue Carol Verrillo, Maria Cvach, Krysia Warren Hudson, Bradford D Winters
BACKGROUND: Episodic vital sign collection (eVSC), as single data points, gives an incomplete picture of adult patients' postoperative physiologic status. LOCAL PROBLEM: Late detection of patient deterioration resulted in poor patient outcomes on a postsurgical unit. METHODS: Baseline demographic and outcome data were collected through retrospective chart review of all patients admitted to the surgical unit for 12 weeks prior to this quality improvement project...
August 7, 2018: Journal of Nursing Care Quality
Christa Boer, Hugo R Touw, Stephan A Loer
PURPOSE OF REVIEW: This narrative review summarizes recent insights into the role of remote monitoring of vital signs in the postoperative period in surgical wards. RECENT FINDINGS: Despite recent improvements in the safety of anesthesia and surgical procedures, postoperative complication rates are still unacceptably high. This is partly attributable to the intermittent provision of personal care to patients by nurses and ward physicians. Continuous remote monitoring of vital functions in the early postoperative period may reduce these complication rates...
August 7, 2018: Current Opinion in Anaesthesiology
Rasmus Munch Olsen, Eske Kvanner Aasvang, Christian Sahlholt Meyhoff, Helge Bjarup Dissing Sorensen
BACKGROUND: The aim of this study was to develop a predictive algorithm detecting early signs of deterioration (ESODs) in the post anesthesia care unit (PACU), thus being able to intervene earlier in the future to avoid serious adverse events. The algorithm must utilize continuously collected cardiopulmonary vital signs and may serve as an alternative to current practice, in which an alarm is activated by single parameters. METHODS: The study was a single center, prospective cohort study including 178 patients admitted to the PACU after major surgical procedures...
August 1, 2018: Computers in Biology and Medicine
Marion E Rice, Romeo R Galang, Nicole M Roth, Sascha R Ellington, Cynthia A Moore, Miguel Valencia-Prado, Esther M Ellis, Aifili John Tufa, Livinson A Taulung, Julia M Alfred, Janice Pérez-Padilla, Camille A Delgado-López, Sherif R Zaki, Sarah Reagan-Steiner, Julu Bhatnagar, John F Nahabedian, Megan R Reynolds, Marshalyn Yeargin-Allsopp, Laura J Viens, Samantha M Olson, Abbey M Jones, Madelyn A Baez-Santiago, Philip Oppong-Twene, Kelley VanMaldeghem, Elizabeth L Simon, Jazmyn T Moore, Kara D Polen, Braeanna Hillman, Ruta Ropeti, Leishla Nieves-Ferrer, Mariam Marcano-Huertas, Carolee A Masao, Edlen J Anzures, Ransen L Hansen, Stephany I Pérez-Gonzalez, Carla P Espinet-Crespo, Mildred Luciano-Román, Carrie K Shapiro-Mendoza, Suzanne M Gilboa, Margaret A Honein
INTRODUCTION: Zika virus infection during pregnancy causes serious birth defects and might be associated with neurodevelopmental abnormalities in children. Early identification of and intervention for neurodevelopmental problems can improve cognitive, social, and behavioral functioning. METHODS: Pregnancies with laboratory evidence of confirmed or possible Zika virus infection and infants resulting from these pregnancies are included in the U.S. Zika Pregnancy and Infant Registry (USZPIR) and followed through active surveillance methods...
August 10, 2018: MMWR. Morbidity and Mortality Weekly Report
Tooba Sohail, Mykolas Pajaujis, Sarah E Crawford, Jian W Chan, Tom Eke
PURPOSE: To present a case series of patients who were unable to lie flat for cataract surgery. SETTING: University teaching hospital, district hospital, and private practice, Norwich, United Kingdom. DESIGN: Prospective case series. METHODS: All patients had phacoemulsification using face-to-face upright seated positioning. The patient sits upright or semi-recumbent, and the surgeon sits or stands, facing the patient...
August 2, 2018: Journal of Cataract and Refractive Surgery
Yi-Maun Subeq, Wai-Mau Choi, Cian-Huei Shih, Ru-Ping Lee
A hospital emergency department is unique among medical environments, with risks of medical errors often higher than in other medical units. Previous studies have confirmed that establishing comprehensive clinical practice guidelines in the emergency department reduces medical costs and improves patient safety and satisfaction. Furthermore, having these guidelines positively influences and significantly impacts the work of emergency care professionals. This article addresses the current assessment and treatment of common emergency care, including non-invasive temperature measurements, oxygenated monitoring during procedural sedation and analgesia, postural differences and vital signs monitoring, and difficulties in peripheral vein placement...
August 2018: Hu Li za Zhi the Journal of Nursing
Sarah Forster, Gemma Housley, Tricia M McKeever, Dominick E Shaw
OBJECTIVE: Early Warning Scores (EWSs) are used to monitor patients for signs of imminent deterioration. Although used in respiratory disease, EWSs have not been well studied in this population, despite the underlying cardiopulmonary pathophysiology often present. We examined the performance of two scoring systems in patients with respiratory disease. DESIGN: Retrospective cohort analysis of vital signs observations of all patients admitted to a respiratory unit over a 2-year period...
July 30, 2018: BMJ Open
Insa Korten, Elisabeth Kieninger, Sophie Yammine, Giulia Cangiano, Sylvia Nyilas, Pinelopi Anagnostopoulou, Florian Singer, Claudia E Kuehni, Nicolas Regamey, Urs Frey, Carmen Casaulta, Ben D Spycher, Philipp Latzin
BACKGROUND: Lung impairment in cystic fibrosis (CF) starts in infancy. However, tools to monitor early lung disease are limited. Respiratory rate (RR) as a key vital sign is easy to assess during sleep and is elevated during acute respiratory disease. Thus, elevated RR could indicate early lung impairment and potentially serve as a diagnostic tool in disease monitoring. METHODS: In a prospective cohort of infants with CF diagnosed by newborn screening and healthy controls RR was measured and respiratory symptoms reported weekly throughout infancy...
July 27, 2018: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Audrey Uong, Ariel Brandwein, Colin Crilly, Tamar York, Jahn Avarello, Sandeep Gangadharan
BACKGROUND: Status asthmaticus (SA) is a common reason for admission to the pediatric emergency department (ED). Assessing asthma severity efficiently in the ED can be challenging for clinicians. Adjunctive tools for the clinician have demonstrated inconsistent results. Studies have shown that pulsus paradoxus (PP) correlates with asthma severity. Pleth Variability Index (PVI) is a surrogate measure of PP. OBJECTIVE: We investigated whether PVI at triage correlates with disposition from the ED...
August 2018: Journal of Emergency Medicine
Nan Zhang, Hong Zhang, Zheng Ni, Shaohong Shang, Gang Chen, Liying Zhang, Xiang Li, Jingwei Zhu, Zheng Cao, Suxia Ma
OBJECTIVE: To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR). METHODS: Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Yaohui Wang, Chongyang Zhang, Wei Sun, Xiaodong Hu, Zhe Lyu, Weibin Liu
OBJECTIVE: To investigate the prehospital intervention based on emergency medical services (EMS) in patients with acute ischemic stroke (AIS) for door-to-needle time (DNT) with intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) impact. METHODS: 112 emergency patients receiving rt-PA intravenous thrombolysis admitted to the First Hospital of Qinhuangdao City based on EMS from June 2016 to December 2017 were enrolled. According to whether or not to receive prehospital interventions, patients were divided into prehospital intervention group (n = 42) and routine treatment group (n = 70)...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Duarte Dias, João Paulo Silva Cunha
Wearable Health Devices (WHDs) are increasingly helping people to better monitor their health status both at an activity/fitness level for self-health tracking and at a medical level providing more data to clinicians with a potential for earlier diagnostic and guidance of treatment. The technology revolution in the miniaturization of electronic devices is enabling to design more reliable and adaptable wearables, contributing for a world-wide change in the health monitoring approach. In this paper we review important aspects in the WHDs area, listing the state-of-the-art of wearable vital signs sensing technologies plus their system architectures and specifications...
July 25, 2018: Sensors
F Ivy Carroll, Thomas R Kosten, Jeffrey J Buda, Laurene Wang, Bradford B Walters
Background: Preclinical and clinical data suggest that a compound which binds potently to and inhibits the dopamine transporter, but with a slower onset and offset rate than cocaine and with less abuse potential and psychomotor stimulant activity, could be a useful adjunct in the treatment of cocaine dependence. Methods: We assessed the safety, tolerability, and pharmacokinetics (PK) of oral single doses (0.3, 1, 3, 6, 12, and 20 mg) of such an analog, RTI-336, in a randomized, double-blind, and placebo-controlled trial in healthy adult males...
2018: Frontiers in Pharmacology
Christian N Nouryan, Stephanie Morahan, Kathleen Pecinka, Meredith Akerman, Martin Lesser, Dale Chaikin, Stacy Castillo, Meng Zhang, Renee Pekmezaris
BACKGROUND: Home telemonitoring (HTM) is a promising approach to improve quality of life (QoL) and decrease hospital utilization. METHODS: This randomized-controlled study followed 89 community-dwelling Medicare outpatients with heart failure (HF) after discharge from home care for 6 months. Patients were randomized to HTM or comprehensive outpatient management (COM). HTM received weekly (video) televisits with daily vital sign monitoring. COM was contacted weekly by telephone...
July 23, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Chia-Wen Lu, Chih-Jen Chang, Yi-Ching Yang, Wen-Yuan Lin, Kuo-Chin Huang
OBJECTIVE: This study aimed to evaluate the effects of lorcaserin on body weight, cardiovascular risk factors, and safety in obese patients in Taiwan. METHODS: In this double-blind, randomised controlled trial, 171 obese adults were assigned to receive lorcaserin at a dose of 10mg, or placebo, twice a day for 24weeks. Diet and exercise counselling were given to all patients through the treatment period. Primary outcomes were proportion of patients achieving at least 5% and 10% reduction in body weight and mean change in body weight...
July 19, 2018: Obesity Research & Clinical Practice
J M Bao, J P Lin, X Yu, H Yu
Objective: To investigate the incidence and severity of embolicevents, and degree of postoperative inflammation when pneumoperitoneal pressures 15 mmHg and 12 mmHg were used during laparoscopic hepatectomy. Methods: A computer-generated 1∶1 randomization protocol was used to assign fifty patients to either the 15 mmHg(P15, n =25) or 12 mmHg(P12, n =25) group. Throughout the surgery, air embolisms were detected by transesophageal echocardiography (TEE) and graded based on their size. Vital signs, arterial blood gases (ABG), P(ET)CO(2) levels, blood loss, operative time and postoperative hospital stays were monitored...
July 10, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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