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https://www.readbyqxmd.com/read/29124121/patients-comorbidities-reduce-the-clinical-value-of-emergency-colonoscopy-results-of-a-retrospective-cohort-study
#1
Cristiano Cremone, Anouk Esch, Charlotte Gagniere, Alessandro Fugazza, Faria Mesli, Michael Levy, Aurelien Amiot, Alexis Laurent, Yann LeBaleur, Francois Hemery, Nicolas De'Angelis, Francesco Brunetti, Iradj Sobhani
Background and study aims:  Urgent endoscopy is often used to diagnose and sometimes treat acute upper gastrointestinal syndromes (hemorrhage, toxic ingestion, and occlusion). However, its suitability concerning the management of lower gastrointestinal conditions in emergency circumstances is controversial. Patients and methods:  We studied the role of emergency colonoscopy in diagnosis and treatment of all consecutive patients presenting with acute lower gastrointestinal symptoms referred to our hospital on an emergency basis...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29123887/two-cases-of-life-threatening-arrhythmia-induced-by-risperidone-evaluation-of-risperidone-and-9-hydroxy-risperidone-concentrations
#2
Asami Ito, Tomoyuki Enokiya, Eiji Kawamoto, Yoshiaki Iwashita, Taichi Takeda, Kenji Ikemura, Masahiro Okuda, Hiroshi Imai
Cases: Case 1: A 20-year-old woman suffering a suspected overdose was transported to the hospital. She presented bradycardia with wide QRS waves and QT prolongation, followed by cardiac arrest. Extracorporeal cardiopulmonary resuscitation was implemented, improving circulation. Risperidone and 9OH-RIS levels were 9.6 ng/mL and 127.6 ng/mL, respectively. Case 2: A 54-year-old woman was hospitalized for femoral fracture and underwent surgery. Her electrocardiogram showed bradycardia and complete AV block...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29114009/2017-american-heart-association-focused-update-on-pediatric-basic-life-support-and-cardiopulmonary-resuscitation-quality-an-update-to-the-american-heart-association-guidelines-for-cardio-pulmonary-resuscitation-and-emergency-cardiovascular-care
#3
REVIEW
Dianne L Atkins, Allan R de Caen, Stuart Berger, Ricardo A Samson, Stephen M Schexnayder, Benny L Joyner, Blair L Bigham, Dana E Niles, Jonathan P Duff, Elizabeth A Hunt, Peter A Meaney
This focused update to the American Heart Association guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care follows the Pediatric Task Force of the International Liaison Committee on Resuscitation evidence review. It aligns with the International Liaison Committee on Resuscitation's continuous evidence review process, and updates are published when the International Liaison Committee on Resuscitation completes a literature review based on new science. This update provides the evidence review and treatment recommendation for chest compression-only CPR versus CPR using chest compressions with rescue breaths for children <18 years of age...
November 6, 2017: Circulation
https://www.readbyqxmd.com/read/29076967/the-call-and-the-challenge-of-pediatric-resuscitation-and-simulation-research-in-low-resource-settings
#4
Amy R L Rule, Meredith Tabangin, David Cheruiyot, Priscilla Mueri, Beena D Kamath-Rayne
The greatest burden of younger than 5 years mortality is in low- and middle-income nations where education resources are often few. The World Health Organization recommends scale-up of simulation in these settings, but it has been poorly studied. Although there has been an increase of contextualized resuscitation simulation programs designed for these settings, sustaining clinical outcomes and provider skill retention have remained research gaps. Our team designed a study to evaluate skill retention after an initial Helping Babies Breathe training at a rural Kenya referral hospital between randomized learner groups receiving supervised mock codes with debriefing versus just-in-time training with a peer...
October 25, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29017643/-chinese-consensus-on-cpr-and-american-guidelines-on-cpr
#5
Lixiang Wang, Qingyi Meng, Tao Yu
In the article, we compared "2016 national consensus on cardiopulmonary resuscitation in China" and "2015 American Heart Association guidelines on cardiopulmonary resuscitation and emergency cardiovascular care" with their definition, orientation, characterization, quantifying and thinking mode. Chinese consensus on cardiopulmonary resuscitation (CPR) emphasizes the concept of "survival cycle" and focuses on the victim, it defines the rate of survival in its broad sense, and the thinking mode of the document is typically oriental style...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28993843/in-hospital-mortality-after-acute-stemi-in-patients-undergoing-primary-pci
#6
M Ali, S A Lange, T Wittlinger, G Lehnert, A G Rigopoulos, M Noutsias
BACKGROUND: Acute myocardial infarction (AMI) is the main cause of global and in-hospital mortality in patients with cardiovascular diseases. We aimed to examine the association between the coronary artery involved and the in-hospital mortality in patients who underwent primary percutaneous coronary intervention (pPCI) after ST segment elevation myocardial infarction (STEMI). METHODS: The in-hospital mortality of STEMI patients who underwent pPCI was assessed at the Department of Cardiology, Harzklinik Goslar, Germany, which has no access to immediate mechanical circulatory support (MCS), between 2013 and 2017...
October 9, 2017: Herz
https://www.readbyqxmd.com/read/28993522/cardiopulmonary-resuscitation-on-television-are-we-miseducating-the-public
#7
Michael Colwill, Charlotte Somerville, Eric Lindberg, Caroline Williams, James Bryan, Ted Welman
BACKGROUND: Out-of-hospital cardiac arrest survival rates in the UK are poor, and non-medically trained individuals have been identified to perform substandard cardiopulmonary resuscitation (CPR). Millions watch televised medical dramas and, for many, these comprise their only education on CPR. This study aims to investigate the quality of CPR portrayed on these programmes and whether this has an effect on public knowledge. METHODS: Prospective observational study of 30 consecutive episodes of three popular medical dramas...
October 9, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28959774/reducing-dnacpr-complaints-to-zero-designing-and-implementing-a-treatment-escalation-plan-using-quality-improvement-methodology
#8
Elizabeth Shermon, Laura Munglani, Sarah Oram, Linda William, Julian Abel
INTRODUCTION: Do Not Attempt Resuscitation (DNAR)decisions have traditionally formed the basis of ceiling of care discussions. However, poor quality discussions can lead to high patient and relative dissatisfaction, generating hospital complaints. Treatment escalation plans (TEPs) aim to highlight the wider remit of treatment options with a focus on effective communication. We aimed to improve TEP discussions and documentation at Weston General Hospital by introducing a standardised form...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28955248/aicar-administration-attenuates-hemorrhagic-hyperglycemia-and-lowers-oxygen-debt-in-anesthetized-male-rabbits
#9
Yi Huang, Paul H Ratz, Amy S Miner, Victoria A Locke, Grace Chen, Yang Chen, Robert W Barbee
Background: Many strategies have been utilized to treat traumatic shock via improved oxygen delivery (DO2), while fewer have been used to in an attempt to reduce oxygen demand (VO2). The cellular energy sensor 5' adenosine monophosphate-activated protein kinase (AMPK) has the potential to modulate both whole-body DO2 and VO2. Therefore, we determined the effect of the AMPK activator AICAR (5-aminoimidazole-4-carboxamide 1-β-D-ribonucleoside) given acutely or chronically on key metabolites, hemodynamics, and oxygen consumption/delivery before and during hemorrhage in anesthetized male rabbits...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28948321/contralateral-pulmonary-hypertension-following-resuscitation-of-unilateral-ductal-origin-of-a-pulmonary-artery-a-multi-institutional-review
#10
Hitesh Agrawal, Christopher J Petit, Joaquim Miro, Carlos D Miranda, Damien Kenny, Henri Justino
In isolated unilateral ductal origin of a pulmonary artery (DOPA), intervention to establish reperfusion of the affected lung without direct re-anastomosis may lead to pulmonary hypertension (PH) in the contralateral lung. Multicenter retrospective review of patients with unilateral DOPA, who underwent palliation with a ductal stent (DS) or Blalock-Taussig (BT) shunt with subsequent development of PH in the contralateral lung, was conducted. Ten patients (4 females; median weight 3.2 kg, range 2.1-5.2) who underwent DS or BT shunt and developed contralateral PH were identified...
September 25, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28941721/experience-with-integrating-pharmacist-documenters-on-cardiac-arrest-teams-to-improve-quality
#11
Mojdeh S Heavner, Ginger E Rouse, Steven M Lemieux, Kent A Owusu, David Pritchard, Marina Yazdi, Lorraine A Lee
OBJECTIVES: To determine if adding a clinical pharmacist to the cardiac arrest team in a documenter role improves completeness of documentation and quality of advanced cardiovascular life support (ACLS). SETTING: A 1541-bed, tertiary care, academic medical center with an integrated clinical pharmacy practice model. PRACTICE DESCRIPTION: In 2012, we identified documentation of resuscitation activities during cardiac arrest events and compliance with published ACLS guidelines as opportunities for systematic quality improvement at our tertiary care academic medical center...
September 20, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28927190/outcomes-differ-by-first-documented-rhythm-after-witnessed-out-of-hospital-cardiac-arrest-in-children-an-observational-study-with-prospective-nationwide-population-based-cohort-database-in-japan
#12
Masahiko Hara, Kenichi Hayashi, Tetsuhisa Kitamura
Aims: To evaluate and compare outcomes and impacts of delay of time to cardiopulmonary resuscitation (CPR) by type of first documented rhythm in paediatric patients with out-of-hospital cardiac arrest (OHCA). Methods and results: We enrolled 3968 paediatric (aged <18 years) OHCA patients whose events were witnessed between 2005 and 2012 from a prospective nationwide population-based cohort database in Japan. We assessed and compared their neurologically favourable 1-month survival according to first documented rhythm: pulseless ventricular tachycardia/ventricular fibrillation (pVT/VF), pulseless electrical activity (PEA), or asystole...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28926566/guidelines-for-the-management-of-a-brain-death-donor-in-the-rhesus-macaque-a-translational-transplant-model
#13
Tiffany J Zens, Juan S Danobeitia, Peter J Chlebeck, Laura J Zitur, Scott Odorico, Kevin Brunner, Jennifer Coonen, Saverio Capuano, Anthony M D'Alessandro, Kristina Matkowskyj, Weixiong Zhong, Jose Torrealba, Luis Fernandez
INTRODUCTION: The development of a translatable brain death animal model has significant potential to advance not only transplant research, but also the understanding of the pathophysiologic changes that occur in brain death and severe traumatic brain injury. The aim of this paper is to describe a rhesus macaque model of brain death designed to simulate the average time and medical management described in the human literature. METHODS: Following approval by the Institutional Animal Care and Use Committee, a brain death model was developed...
2017: PloS One
https://www.readbyqxmd.com/read/28914622/ce-assessing-patients-during-septic-shock-resuscitation
#14
Elizabeth Bridges
: In 2015, the Surviving Sepsis Campaign six-hour bundle was updated. The revised version now recommends documenting the reassessment of volume status and tissue perfusion after initial fluid resuscitation through a repeated focused examination. This article addresses the practice and interpretation of two components of this examination in adults: capillary refill time and skin mottling score. It further discusses how to best integrate these noninvasive parameters into the care of patients undergoing resuscitation for septic shock...
October 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28885062/out-of-hospital-cardiac-arrest-always-coronary-angiography
#15
Andrea Rognoni, Chiara Cavallino, Marco Giovanni Mennuni, Lucia Barbieri, Roberta Rosso, Francesco Rametta, Federico Nardi, Alessandro Lupi, Angelo Sante Bongo
Out-of-hospital cardiac arrest (OHCA) remains one of the principle challenges in the setting of critical care medicine and emergency cardiology. Areas covered: Long-term survival rates even after successful resuscitation are variable but increasing in the recent years; due to the improvement of base and advanced cardiac life support techniques an increasing number of resuscitated patients are admitted to the hospital. Recent data suggested that patients surviving to hospital discharge after OHCA presented long-term outcome similar to patients with ST-elevation myocardial infarction...
November 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28882750/grey-areas-new-zealand-ambulance-personnel-s-experiences-of-challenging-resuscitation-decision-making
#16
Natalie Elizabeth Anderson, Merryn Gott, Julia Slark
INTRODUCTION: When faced with a patient in cardiac arrest, ambulance personnel must rapidly make complex decisions with limited information. Much of the research examining decisions to commence, continue, withhold or terminate resuscitation has used retrospective audits of registry data and clinical documentation. This study offers a provider-perspective which characterises uncertainty and highlights clinical, cognitive, emotional and physical demands associated with decision-making in the cardiac arrest context...
September 4, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28878814/thoracic-trauma-severity-contributes-to-differences-in-intensive-care-therapy-and-mortality-of-severely-injured-patients-analysis-based-on-the-traumaregister-dgu%C3%A2
#17
Jörg Bayer, Rolf Lefering, Sylvia Reinhardt, Jan Kühle, Jörn Zwingmann, Norbert P Südkamp, Thorsten Hammer
BACKGROUND: Thoracic trauma is a relevant source of comorbidity throughout multiply-injured patient care. We aim to determine a measurable influence of chest trauma's severity on early resuscitation, intensive care therapy, and mortality in severely injured patients. METHODS: Patients documented between 2002 and 2012 in the TraumaRegister DGU®, aged ≥ 16 years, injury severity score (ISS) ≥ 16 are analyzed. Isolated brain injury and severe head injury led to exclusion...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28864448/discussion-and-documentation-of-future-care-a-before-and-after-study-examining-the-impact-of-an-alternative-approach-to-recording-treatment-decisions-on-advance-care-planning-in-an-acute-hospital
#18
Alexandra C Malyon, Julia R Forman, Jonathan P Fuld, Zoë Fritz
OBJECTIVE: To determine whether discussion and documentation of decisions about future care was improved following the introduction of a new approach to recording treatment decisions: the Universal Form of Treatment Options (UFTO). METHODS: Retrospective review of the medical records of patients who died within 90 days of admission to oncology or respiratory medicine wards over two 3-month periods, preimplementation and postimplementation of the UFTO. A sample size of 70 per group was required to provide 80% power to observe a change from 15% to 35% in discussion or documentation of advance care planning (ACP), using a two-sided test at the 5% significance level...
September 1, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28859764/no-347-obstetric-management-at-borderline-viability
#19
Noor Niyar N Ladhani, Radha S Chari, Michael S Dunn, Griffith Jones, Prakesh Shah, Jon F R Barrett
OBJECTIVE: The primary objective of this guideline was to develop consensus statements to guide clinical practice and recommendations for obstetric management of a pregnancy at borderline viability, currently defined as prior to 25+6 weeks. INTENDED USERS: Clinicians involved in the obstetric management of women whose fetus is at the borderline of viability. TARGET POPULATION: Women presenting for possible birth at borderline viability. EVIDENCE: This document presents a summary of the literature and a general consensus on the management of pregnancies at borderline viability, including maternal transfer and consultation, administration of antenatal corticosteroids and magnesium sulfate, fetal heart rate monitoring, and considerations in mode of delivery...
September 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28831235/benign-heart-murmurs-as-a-predictor-for-complications-following-total-joint-arthroplasty
#20
James M Friedman, Ricardo Couso, Michael Kitchens, Venus Vakhshori, Cody D Hillin, Chia H Wu, Joshua Steere, Jaimo Ahn, Eric Hume
BACKGROUND: There is scant literature examining the predictive role of heart murmurs in the absence of suspected structural heart disease on complications of non-cardiac surgery. We hypothesize the detection of heart murmurs in the absence of structural heart disease will help identify patients at risk for complications following total joint arthroplasty (TJA) surgery. METHOD: This was a prospective cohort of patients undergoing TJA over a twenty-month period. The study was performed at a single academic institution with four subspecialty surgeons...
December 2017: Journal of Orthopaedics
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