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https://www.readbyqxmd.com/read/28438479/family-presence-during-resuscitation-fpdr-observational-case-studies-of-emergency-personnel-in-victoria-australia
#1
Joanne E Porter, Nareeda Miller, Anita Giannis, Nicole Coombs
INTRODUCTION: Family Presence During Resuscitation (FPDR), although not a new concept, remains inconsistently implemented by emergency personnel. Many larger metropolitan emergency departments (ED) have instigated a care coordinator role, however these personnel are often from a non-nursing background and have therefore limited knowledge about the clinical aspects of the resuscitation. In rural emergency departments there are simply not enough staff to allocate an independent role. A separate care coordinator role, who is assigned to care for the family and not take part in the resuscitation has been well documented as essential to the successful implementation of FPDR...
April 21, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28433804/crocin-attenuates-hemorrhagic-shock-induced-oxidative-stress-and-organ-injuries-in-rats
#2
Long Yang, Xiujuan Dong
We aimed to evaluate the effect of natural antioxidant crocin in alleviating hemorrhagic shock (HS)-induced organ damages. HS rats were treated with crocin during resuscitation. Mortality at 12h and 24h post resuscitation was documented. HS and resuscitation induced organ injuries, as characterized by elevated wet/dry ratio, quantitative assessment ratio, blood urea nitrogen, creatinine, aspartate aminotransferase and alanine aminotransferase, whereas rats received crocin treatment demonstrated improvements in all the above characteristics...
April 13, 2017: Environmental Toxicology and Pharmacology
https://www.readbyqxmd.com/read/28433454/a-randomized-comparison-of-three-chest-compression-techniques-and-associated-hemodynamic-effect-during-infant-cpr-a-randomized-manikin-study
#3
Jacek Smereka, Lukasz Szarpak, Antonio Rodríguez-Núñez, Jerzy R Ladny, Steve Leung, Kurt Ruetzler
INTRODUCTION: Pediatric cardiac arrest is an uncommon but critical life-threatening event requiring effective cardiopulmonary resuscitation. High-quality cardio-pulmonary resuscitation (CPR) is essential, but is poorly performed, even by highly skilled healthcare providers. The recently described two-thumb chest compression technique (nTTT) consists of the two thumbs directed at the angle of 90° to the chest while having the fingers fist-clenched. This technique might facilitate adequate chest-compression depth, chest-compression rate and rate of full chest-pressure relief...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28422404/the-use-of-resuscitation-plans-at-a-tertiary-australian-hospital-room-for-improvement
#4
Roger J Smith, John D Santamaria, Jennifer A Holmes, Espedito E Faraone, Patricia N Hurune, David A Reid
OBJECTIVES: To evaluate the introduction of a document for recording the resuscitation plans of patients at a tertiary hospital. The 'Acute Resuscitation Plan' (ARP) was introduced in September 2014, superseding the 'Not for Cardiopulmonary Resuscitation (CPR)' form. Unlike the Not for CPR form, the ARP was relevant to patients with and without resuscitation limits. DESIGN: Retrospective audit of the records of all admissions to the hospital from January-June 2014 (Not for CPR period) and January-June 2015 (ARP period)...
April 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28421842/the-management-of-ventricular-dysrhythmia-in-aconite-poisoning
#5
REVIEW
James M Coulson, Thomas M Caparrotta, John P Thompson
INTRODUCTION: Aconite poisoning is relatively rare but is frequently complicated by ventricular dysrhythmias, which may be fatal. Molecular basis of aconite alkaloid ventricular arrhythmogenicity: Aconite exerts its toxic effects due to the presence of an admixture of alkaloids present in all parts of the plant. The major target of these aconite alkaloids is the fast voltage-gates sodium channel, where they cause persistent activation. This blockade of the channel in the activated state promotes automaticity within the ventricular myocardium and the generation of ventricular arrhythmias...
June 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28413896/congenital-malformations-palliative-care-and-postnatal-redirection-to-more-intensive-treatment-a-review-at-a-swiss-tertiary-center
#6
Ulrich Pfeifer, Deborah Gubler, Eva Bergstraesser, Dirk Bassler
PURPOSE: The so-called lethal malformations pose ethical challenges. Most affected fetuses die before or at birth. Live-born neonates commonly receive palliative care. If the postnatal course is better than expected, redirection towards more treatment may occur. We aimed to analyze this in a Swiss patient cohort. MATERIALS AND METHODS: Over 6 years, fetal malformation was suspected in 1113 cases. We identified patients prenatally assigned to palliative care, assessed pre- and postnatal diagnoses, and outcomes...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28401688/goals-of-patient-care-system-change-with-video-based-education-increases-rates-of-advance-cardiopulmonary-resuscitation-decision-making-and-discussions-in-hospitalised-rehabilitation-patients
#7
Claire Johnson, Jeffrey Chong, Anne Wilkinson, Barbara Hayes, Sonia Tait, Nicholas Waldron
BACKGROUND: Advance CPR discussions and decision-making are not routine clinical practice in the hospital setting. Frail older patients may be at risk of non-beneficial CPR. AIM: To assess the utility and safety of two interventions to increase CPR decision-making, documentation and communication for hospitalised older patients. METHODS: A pre-post study tested two interventions: i) standard ward-based education forums with CPR content; and ii) a combined, two-pronged strategy with 'Goals of Patient Care' (GoPC) system change and structured video-based workshop; against usual practice (ie no formal training)...
April 12, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28401138/prevalence-of-symptoms-at-the-end-of-life-in-an-acute-care-hospital-a-retrospective-cohort-study
#8
Daniel Kobewka, Paul Ronksley, Dan McIsaac, Sunita Mulpuru, Alan Forster
BACKGROUND: There is currently debate over the benefits and harms of physician-assisted death. One of the factors influencing this debate is concern about symptoms in the days before death. The objective of this study was to describe the frequency of symptoms before death and determine patient characteristics associated with these symptoms. METHODS: We reviewed the medical record of every patient who died at a multisite academic teaching hospital over a 3-month period...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28399031/the-advance-care-planning-readiness-scale-development-and-validation-of-a-measure-of-willingness-to-discuss-and-acceptance-of-end-of-life-care-in-gynecologic-cancer-patients
#9
Alaina J Brown, Megan Johnson Shen, Diana Urbauer, Jolyn Taylor, Patricia A Parker, Cindy Carmack, Lauren Prescott, Carly Rosemore, Elizabeth Kolawole, Charlotte Sun, Lois Ramondetta, Diane C Bodurka
OBJECTIVE: The objective of this article was to develop and validate a scale that assesses the readiness of gynecologic oncology patients to engage in advance care planning. METHODS: The Advance Care Planning Readiness Scale (ACPRS) was validated across 3 independent samples of gynecologic oncology patients. In step I, patients underwent cognitive interviewing to determine if the scale items were comprehensible and applicable to patients. Based on this, modifications to the scale (addition, removal, and merger of items) were completed...
May 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28396614/can-takotsubo-cardiomyopathy-be-diagnosed-by-autopsy-report-of-a-presumed-case-presenting-as-cardiac-rupture
#10
Andrew Mitchell, François Marquis
BACKGROUND: Takostsubo (stress) cardiomyopathy (TC) is a clinical syndrome featuring transient left ventricular dysfunction and wall-motion abnormalities, usually following emotional or physical stress. The diagnosis of TC depends on fulfillment of multiple clinical criteria. Although the pathogenesis has not been firmly established, myocardial cathecholamine toxicity is thought to represent a primary mechanism. The vast majority of patients with TC survive. However, a rare cause of death in TC is myocardial rupture...
2017: BMC Clinical Pathology
https://www.readbyqxmd.com/read/28388951/implementing-the-emergency-triage-assessment-and-treatment-plus-admission-care-etat-clinical-practice-guidelines-to-improve-quality-of-hospital-care-in-rwandan-district-hospitals-healthcare-workers-perspectives-on-relevance-and-challenges
#11
Celestin Hategeka, Leah Mwai, Lisine Tuyisenge
BACKGROUND: An emergency triage, assessment and treatment plus admission care (ETAT+) intervention was implemented in Rwandan district hospitals to improve hospital care for severely ill infants and children. Many interventions are rarely implemented with perfect fidelity under real-world conditions. Thus, evaluations of the real-world experiences of implementing ETAT+ are important in terms of identifying potential barriers to successful implementation. This study explored the perspectives of Rwandan healthcare workers (HCWs) on the relevance of ETAT+ and documented potential barriers to its successful implementation...
April 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28383471/clinical-practice-guideline-adherence-during-operation-inherent-resolve
#12
Timothy P Plackett, Darren C Cherry, Gerald Delk, Steven Satterly, Jared Theler, Derek McVay, Jacqueline Moore, Stacy A Shackelford
BACKGROUND: The Joint Trauma System (JTS) Clinical Practice Guidelines (CPGs) contributed to the decrease in battlefield morality over the past 15 years. However, it is unknown to what degree the guidelines are being followed in current military operations. METHODS: A retrospective review was performed of all patients treated at three separate US Army Role II facilities during the first ten months of Operation Inherent Resolve in Iraq. Charts were reviewed for patient demographics, clinical care, and outcomes...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28379717/accounting-for-patient-preferences-regarding-life-sustaining-treatment-in-evaluations-of-medical-effectiveness-and-quality
#13
Allan J Walkey, Amber E Barnato, Renda Soylemez Wiener, Brahmajee K Nallamothu
The importance of understanding patient preferences for life-sustaining treatment is well-described for individual clinical decisions; however, its role in evaluations of healthcare outcomes and quality has received little attention. Decisions to limit life-sustaining therapies are strongly associated with high risks of death in ways that are unaccounted for by routine measures of illness severity. Yet, this essential information is generally unavailable to researchers, with the potential for spurious inferences...
April 5, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28372500/clinical-significance-of-bioimpedance-spectroscopy-in-critically-ill-patients
#14
Shang-Feng Yang, Ching-Min Tseng, I-Fan Liu, Shin-Hung Tsai, Wein-Shung Kuo, Tien-Ping Tsao
BACKGROUND: Early fluid resuscitation is a key aspect in the successful management of critically ill patients, but the optimal goal for volume control after the acute stage of critical illness remains unclear. This study aimed to evaluate the prognostic value of bioimpedance spectrometry for fluid management in critically ill patients. METHODS: In this prospective observational study, patients who consented to participate were screened within the first 24 hours of admission to a medical intensive care unit (ICU) from February 4, 2015, to January 31, 2016...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28371864/a-multicentre-study-of-patients-with-timothy-syndrome
#15
Mark A Walsh, Christian Turner, Katherine W Timothy, Neil Seller, Dominic L Hares, Andrew F James, Jules C Hancox, Orhan Uzun, Dean Boyce, Alan G Stuart, Paul Brennan, Caroline Sarton, Karen McGuire, Ruth A Newbury-Ecob, Karen Mcleod
Aims: Timothy syndrome (TS) is an extremely rare multisystem disorder characterized by marked QT prolongation, syndactyly, seizures, behavioural abnormalities, immunodeficiency, and hypoglycaemia. The aim of this study was to categorize the phenotypes and examine the outcomes of patients with TS. Methods and results: All patients diagnosed with TS in the United Kingdom over a 24-year period were reviewed. Fifteen centres in the British Congenital Arrhythmia Group network were contacted to partake in the study...
March 24, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28359288/termination-of-prehospital-resuscitative-efforts-a-study-of-documentation-on-ethical-considerations-at-the-scene
#16
Søren Mikkelsen, Caroline Schaffalitzky de Muckadell, Lars Grassmé Binderup, Hans Morten Lossius, Palle Toft, Annmarie Touborg Lassen
BACKGROUND: Discussions on ethical aspects of life-and-death decisions within the hospital are often made in plenary. The prehospital physician, however, may be faced with ethical dilemmas in life-and-death decisions when time-critical decisions to initiate or refrain from resuscitative efforts need to be taken without the possibility to discuss matters with colleagues. Little is known whether these considerations regarding ethical issues in crucial life-and-death decisions are documented prehospitally...
March 31, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28352468/introduction-of-a-microsoft-excel-based-unified-electronic-weekend-handover-document-in-acute-and-general-medicine-in-a-dgh-aims-outcomes-and-challenges
#17
Pablo Kostelec, Pietro Emanuele Garbelli, Pietro Emanuele Garbelli
On-call weekends in medicine can be a busy and stressful time for junior doctors, as they are responsible for a larger pool of patients, most of whom they would have never met. Clinical handover to the weekend team is extremely important and any communication errors may have a profound impact on patient care, potentially even resulting in avoidable harm or death. Several senior clinical bodies have issued guidelines on best practice in written and verbal handover. These include: standardisation, use of pro forma documents prompting doctors to document vital information (such as ceiling of care/resuscitation status) and prioritisation according to clinical urgency...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28336349/decisional-capacity-for-advanced-care-directives-in-parkinson-s-disease-with-cognitive-concerns
#18
Muneer Abu Snineh, Richard Camicioli, Janis M Miyasaki
INTRODUCTION: Physician Orders for Life Sustaining Therapies (POLST) or Goals of Care (GOC) are legal documents to guide intensity of interventions (ICU, resuscitation, hospitalization or comfort care) completed by healthcare professionals following counseling of patients or their designated medical decision makers. Capacity (understanding, appreciation, reasoning and expressing a choice) to consent to POLST or GOC has not been determined among Parkinson's disease (PD) patients. We sought to assess GOC PD decisional capacity for those with cognitive complaints but not dementia...
March 8, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28324968/improving-cardiopulmonary-resuscitation-cpr-outcomes-using-model-based-optimization
#19
Dieter Bender, Ali Jalali, C Nataraj
Cardiopulmonary Resuscitation (CPR) outcomes are far from optimal as practiced today, and prior work has documented that among probable reasons is the fact that the procedure remains to be fully understood. In an attempt to gain a broader understanding of the CPR physiology and the elemental principles underlying the CPR outcomes, this study proposes a novel approach. The analysis is carried out in three major steps. First, an appropriate cardiovascular system model was adopted and simulated using real CPR data as the input...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28306590/the-use-of-dipyrone-in-the-icu-is-associated-with-acute-kidney-injury-a-retrospective-cohort-analysis
#20
Thomas Stueber, Laura Buessecker, Andreas Leffler, Hans-Jörg Gillmann
BACKGROUND: Use of dipyrone (metamizole) in perioperative and ICU pain therapy remains controversial due to a lack of solid evidence weighing dipyrone benefit against its potential life-threatening complications. Although dipyrone has known analgesic and antipyretic properties, its mechanisms of actions are incompletely understood. Although dipyrone effects on renal vasodilator prostaglandin synthesis are documented, little is known about its potential renal side effects, especially in the critical care environment...
March 16, 2017: European Journal of Anaesthesiology
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