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Emergency medicine AND critical care

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https://www.readbyqxmd.com/read/28086760/education-of-pediatric-subspecialty-fellows-in-transport-medicine-a-national-survey
#1
Geoffrey E Mickells, Denise M Goodman, Ranna A Rozenfeld
BACKGROUND: The transport of critically ill patients to children's hospitals is essential to current practice. The AAP Section on Transport Medicine has raised concerns about future leadership in the field as trainees receive less exposure to transport medicine. This study identifies the priorities of pediatric subspecialty fellows, fellowship directors and nursing directors in transport medicine education. METHODS: Internet based surveys were distributed to fellows, fellowship directors and nursing directors of transport teams affiliated with ACGME-approved fellowships in Neonatal-Perinatal Medicine (NPM), Pediatric Critical Care Medicine (PCCM), and Pediatric Emergency Medicine (PEM)...
January 13, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28065392/mapping-the-process-of-emergency-care-at-a-teaching-hospital-in-ghana
#2
Emily Aaronson, Elizabeth Mort, Samara Soghoian
Emergency Department (ED) overcrowding has become a global concern as the number of countries with formalized emergency care systems has expanded, and the burden of trauma and non-communicable diseases in low and middle-income countries increased. In light of this, the international Emergency Medicine literature has outlined the need for operational projects in low and middle income countries which focus on the process of care. Despite this, there is limited published literature describing these types of projects...
January 3, 2017: Healthcare
https://www.readbyqxmd.com/read/28065331/antimicrobial-stewardship-in-kansas-results-from-a-statewide-survey
#3
Carrie Poteete, Joseph M Scaletta
BACKGROUND: The availability of effective antibiotics is considered one of the most important developments in medicine. However, many organisms that were once susceptible to common antibiotics are becoming resistant. Antimicrobial stewardship programs (ASPs) are considered to be vital for combating the emergence of resistance. To understand current antimicrobial stewardship practices in Kansas, the authors designed a 36-question survey. Results of this survey will be used to develop a coordinated, public health strategy for improving current practices...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28056457/personalised-medicine-a-new-approach-to-improving-health-in-indigenous-australian-populations
#4
Kym M Rae, Steve Grimson, Kirsty G Pringle
Personalised medicine is a newly emerging field with much to offer to all populations in improved clinical treatment options. Since the 1970s, clinicians and researchers have all been working towards improving the health of Indigenous Australians. However, there has been little research on the impact of genetics on Indigenous health, how genetic and environmental factors interact to contribute to poor health in Indigenous people, and how genetic factors specific to Indigenous people affect their responses to particular treatments...
January 6, 2017: Public Health Genomics
https://www.readbyqxmd.com/read/28050654/misalignments-of-purpose-and-power-in-an-early-canadian-interprofessional-education-initiative
#5
Sarah Whyte, Elise Paradis, Carrie Cartmill, Ayelet Kuper, Heather Boon, Corinne Hart, Saleem Razack, Mandy Pipher, Cynthia R Whitehead
Interprofessional education (IPE) has been widely incorporated into health professional curricula and accreditation standards despite an arguably thin base of evidence regarding its clinical effects, theoretical underpinnings, and social implications. To better understand how and why IPE first took root, but failed to grow, this study examines one of the earliest documented IPE initiatives, which took place at the University of British Columbia between 1960 and 1975. We examined a subset of 110 texts (academic literature, grey literature, and unpublished records) from a larger study that uses Critical Discourse Analysis to trace the emergence of IPE in Canada...
January 3, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28047234/tu-fg-bra-03-systems-engineering-and-treatment-planning-process-control-in-radiation-medicine
#6
A Kapur
Optimizing Radiation Therapy Process The radiotherapy (RT) process has evolved over the years with innovations in CT and MR simulations, treatment planning, and treatment delivery. Image-Guided Radiotherapy (IGRT) has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body Radiotherapy (SBRT) and Stereotactic Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the simulation/plan/treatment even if the number of treatments per day remains the same...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28039294/process-mapping-evaluation-of-medication-reconciliation-in-academic-teaching-hospitals-a-critical-step-in-quality-improvement
#7
Anne Holbrook, James M Bowen, Harsit Patel, Chris O'Brien, John J You, Roshan Tahavori, Jeff Doleweerd, Tim Berezny, Dan Perri, Carmine Nieuwstraten, Sue Troyan, Ameen Patel
BACKGROUND: Medication reconciliation (MedRec) has been a mandated or recommended activity in Canada, the USA and the UK for nearly 10 years. Accreditation bodies in North America will soon require MedRec for every admission, transfer and discharge of every patient. Studies of MedRec have revealed unintentional discrepancies in prescriptions but no clear evidence that clinically important outcomes are improved, leading to widely variable practices. Our objective was to apply process mapping methodology to MedRec to clarify current processes and resource usage, identify potential efficiencies and gaps in care, and make recommendations for improvement in the light of current literature evidence of effectiveness...
December 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/28032432/perception-of-prognosis-of-cancer-patients-by-non-oncologists
#8
Hadar Goldvaser, Yonatan Milman, Tal Dujovni, Anat Stern, Muhamad Mahamid, Ekaterina Hanovich, Amir Zivony, Tzippy Shochat, Rinat Yerushalmi, Anat Gafter-Gvili, Baruch Brenner, Daniel Shepshelovich
BACKGROUND: Data are lacking regarding the perception of cancer patients' prognosis by physicians who are not oncologists. METHODS: This was a multicenter survey of seven university-affiliated hospitals, assessing physicians' perception of the median survival of patients with seven advanced malignancies. The study cohort included physicians from all 73 internal medicine, surgery, emergency medicine and critical care departments in the participating hospitals. Family practitioners were contacted through email...
December 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/27998322/international-federation-for-emergency-medicine-consensus-statement-sonography-in-hypotension-and-cardiac-arrest-shoc-an-international-consensus-on-the-use-of-point-of-care-ultrasound-for-undifferentiated-hypotension-and-during-cardiac-arrest
#9
Paul Atkinson, Justin Bowra, James Milne, David Lewis, Mike Lambert, Bob Jarman, Vicki E Noble, Hein Lamprecht, Tim Harris, Jim Connolly
: Introduction The International Federation for Emergency Medicine (IFEM) Ultrasound Special Interest Group (USIG) was tasked with development of a hierarchical consensus approach to the use of point of care ultrasound (PoCUS) in patients with hypotension and cardiac arrest. METHODS: The IFEM USIG invited 24 recognized international leaders in PoCUS from emergency medicine and critical care to form an expert panel to develop the sonography in hypotension and cardiac arrest (SHoC) protocol...
December 21, 2016: CJEM
https://www.readbyqxmd.com/read/27997480/health-care-provider-knowledge-and-attitudes-regarding-reporting-diseases-and-events-to-public-health-authorities-in-tennessee
#10
Mary-Margaret A Fill, Rendi Murphree, April C Pettit
CONTEXT: In the United States, state laws require health care providers to report specific diseases and events to public health authorities, a fundamental facet of disease surveillance. However, reporting by providers is often inconsistent, infrequent, and delayed. OBJECTIVE: To examine knowledge, attitudes, and practices regarding provider disease reporting and to understand current barriers to provider disease reporting. DESIGN: A cross-sectional study was conducted via an anonymous, standardized electronic survey...
December 16, 2016: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/27993937/validity-of-the-manchester-triage-system-in-patients-with-sepsis-presenting-at-the-ed-a-first-assessment
#11
Ingo Gräff, Bernd Goldschmidt, Procula Glien, Ramona C Dolscheid-Pommerich, Rolf Fimmers, Daniel Grigutsch
BACKGROUND: The Manchester Triage System (MTS) does not have a specific presentational flow chart for sepsis. The goal of this investigation was to determine adequacy of acuity assignment for patients with sepsis presenting at the ED and triaged using the MTS. MATERIALS AND METHODS: This retrospective analysis included patients >16 presenting to an ED in Bonn, Germany, on the first 12 days of each month between June 2012 and March 2014. Patients were classified into one of three septic groups, or no sepsis...
December 19, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27977530/a-survey-assessment-of-perceived-importance-and-methods-of-maintenance-of-critical-procedural-skills-in-pediatric-emergency-medicine
#12
Matthew R Mittiga, Michael R FitzGerald, Benjamin T Kerrey
OBJECTIVE: The aim of this study was to delineate pediatric emergency medicine provider opinions regarding the importance of, and to ascertain existing processes by which practitioners maintain, the following critical procedural skills: oral endotracheal intubation, intraosseous line placement, pharmacologic and electrical cardioversion, tube thoracostomy, and defibrillation. METHODS: A customized survey was administered to all members of the Listserv for the American Academy of Pediatrics Section on Emergency Medicine...
December 12, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27977013/acupuncture-in-the-neonatal-intensive-care-unit-using-ancient-medicine-to-help-today-s-babies-a-review
#13
K L Chen, I Quah-Smith, G M Schmölzer, R Niemtzow, J L Oei
Acupuncture has been used for thousands of years in Eastern medicine for a variety of conditions and illnesses, including pain. Neonatal intensive care, on the other hand, is a relatively new branch of medicine that has emerged as the pivotal influence in increasing survival of critically ill newborn infants only within the last 50 years. Unfortunately, pain is an inevitable part of treatment in a neonatal intensive care unit (NICU). The control and prevention of pain remains a major issue for clinicians despite recognition and understanding of the myriad of short- and long-term problems that are associated with both pain and its treatment within the NICU environment...
December 15, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27965560/ketamine-50-years-of-modulating-the-mind
#14
REVIEW
Linda Li, Phillip E Vlisides
Ketamine was introduced into clinical practice in the 1960s and continues to be both clinically useful and scientifically fascinating. With considerably diverse molecular targets and neurophysiological properties, ketamine's effects on the central nervous system remain incompletely understood. Investigators have leveraged the unique characteristics of ketamine to explore the invariant, fundamental mechanisms of anesthetic action. Emerging evidence indicates that ketamine-mediated anesthesia may occur via disruption of corticocortical information transfer in a frontal-to-parietal ("top down") distribution...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27959298/acute-liver-failure
#15
Ami Grek, Lisa Arasi
Acute liver failure, also known as fulminant hepatic failure, is a rare life-threatening disease that has a high mortality rate and affects many organ systems. Causes of acute liver failure vary-it can be attributed to drugs, viruses, and other uncommon sources. Complications of liver failure can include encephalopathy, cerebral edema, sepsis, renal failure, gastrointestinal bleeding, and respiratory failure. Fortunately, with advances in critical care medicine and emergent liver transplant, mortality rates have decreased in the past decade...
October 2016: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/27942002/the-impact-of-adding-a-physician-assistant-to-a-critical-care-outreach-team
#16
Hayley B Gershengorn, Yunchao Xu, Carri W Chan, Mor Armony, Michelle N Gong
RATIONALE: Hospitals are increasingly using critical care outreach teams (CCOTs) to respond to patients deteriorating outside intensive care units (ICUs). CCOT staffing is variable across hospitals and optimal team composition is unknown. OBJECTIVES: To assess whether adding a critical care medicine trained physician assistant (CCM-PA) to a critical care outreach team (CCOT) impacts clinical and process outcomes. METHODS: We performed a retrospective study of two cohorts-one with a CCM-PA added to the CCOT (intervention hospital) and one with no staffing change (control hospital)-at two facilities in the same system...
2016: PloS One
https://www.readbyqxmd.com/read/27938570/-advances-in-diagnosis-and-treatment-of-acute-kidney-injury-in-patients-with-liver-cirrhosis
#17
J Chen, S H Gao
Since the 21st century, nephrology and emergency and critical care medicine have proposed the concept of acute kidney injury (AKI), and its core lies in early diagnosis and early treatment to improve prognosis. The concept of AKI has also been used in the diagnosis and treatment of kidney injury in patients with liver cirrhosis. AKI is one of the common complications in patients with decompensated liver cirrhosis, and AKI has unique features in patients with liver cirrhosis. AKI greatly affects the prognosis of patients with liver cirrhosis and increases hospitalization rate and medical burden...
October 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27932271/deactivation-of-left-ventricular-assist-devices-differing-perspectives-of-cardiology-and-hospice-palliative-medicine-clinicians
#18
Colleen K McIlvennan, Sara E Wordingham, Larry A Allen, Daniel D Matlock, Jacqueline Jones, Shannon M Dunlay, Keith M Swetz
BACKGROUND: Beliefs around deactivation of a left ventricular assist device (LVAD) vary substantially between clinicians, institutions, and patients. Therefore, we sought to understand perspectives regarding LVAD deactivation among cardiology and hospice/palliative medicine (HPM) clinicians. METHODS AND RESULTS: We administered a 41-item survey via electronic mail to members of 3 cardiology and 1 HPM professional societies. A convergent parallel mixed methods design was used...
December 5, 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27923680/the-100-most-cited-manuscripts-in-emergency-abdominal-surgery-a-bibliometric-analysis
#19
Thomas Ellul, Nicholas Bullock, Tarig Abdelrahman, Arfon G M T Powell, Jolene Witherspoon, Wyn G Lewis
BACKGROUND: The number of citations a scientific article receives provides a good indication of its impact within any given field. This bibliometric analysis aimed to identify the 100 most cited articles in Emergency Abdominal Surgery (EAS), to highlight key areas of interest and identify those that have most significantly shaped contemporary clinical practice in this newly evolving surgical specialty. This is of increasing relevance as concerns grow regarding the variable and suboptimal outcomes in Emergency General Surgery...
January 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/27914760/update-clinical-use-of-plasma-lactate
#20
REVIEW
Íde Gillespie, Patricia G Rosenstein, Dez Hughes
Lactate is an essential, versatile metabolic fuel in cellular bioenergetics. In human emergency and critical care, lactate is used as a biomarker and therapeutic endpoint and evidence is growing in veterinary medicine supporting its clinical utility. Lactate production is a protective response providing ongoing cellular energy during tissue hypoperfusion or hypoxia and mitigating acidosis. Hence, hyperlactatemia is closely associated with disease severity but it is an epiphenomenon as the body attempts to protect itself...
November 30, 2016: Veterinary Clinics of North America. Small Animal Practice
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