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https://www.readbyqxmd.com/read/29151053/protocol-of-the-sepsivit-study-a-prospective-observational-study-to-determine-whether-continuous-heart-rate-variability-measurement-during-the-first-48-hours-of-hospitalisation-provides-an-early-warning-for-deterioration-in-patients-presenting-with-infection
#1
Vincent M Quinten, Matijs van Meurs, Maurits H Renes, Jack J M Ligtenberg, Jan C Ter Maaten
INTRODUCTION: One in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an early warning for deterioration in patients presenting with suspected infection or sepsis to the emergency department (ED). METHODS AND ANALYSIS: The protocol of a prospective observational study in the ED...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#2
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29147858/community-interventions-to-increase-stroke-preparedness-and-acute-stroke-treatment-rates
#3
REVIEW
Kathleen M Kelly, Kathryn T Holt, Gina M Neshewat, Lesli E Skolarus
PURPOSE OF REVIEW: Acute stroke treatments reduce the risk of post-stroke disability. These treatments, tissue plasminogen activator (tPA) and intra-arterial treatment, are highly time-dependent; thus, one of the main barriers to treatment is pre-hospital delay. Stroke preparedness is defined as the ability to recognize stroke symptoms and the intent to activate emergency medical services (EMS). This review describes types of acute stroke treatment and preparedness interventions, including recent mass media interventions to increase acute stroke treatment rates, and adult and youth community interventions to increase stroke preparedness...
November 16, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29140185/thrombolysis-improving-door-to-needle-times-for-ischemic-stroke-treatment-a-narrative-review
#4
Noreen Kamal, Eric E Smith, Thomas Jeerakathil, Michael D Hill
Background The effectiveness of thrombolysis is highly time dependent. For this reason, short target times have been set to reduce time to treatment from hospital arrival, which is called door-to-needle time. Summary of review There has been considerable work done at single centers and across multiple hospitals to improve door-to-needle time. There have been reductions of 8 to 47 min when applying one or more improvement strategies at single centers, and there have been many multi-hospital initiatives. The delays to treatment have been attributed to both patient and hospital factors, and strategies to address these delays have been proven to reduce door-to-needle time...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29137903/implementation-of-alere-i-influenza-a-b-point-of-care-test-for-the-diagnosis-of-influenza-in-an-emergency-department
#5
E Trabattoni, V Le, B Pilmis, G Pean de Ponfilly, C Caisso, C Couzigou, B Vidal, A Mizrahi, O Ganansia, A Le Monnier, B Lina, J C Nguyen Van
STUDY OBJECTIVE: This study aimed to evaluate the impact of implementing rapid point-of-care testing (POCT) with the Alere i Influenza A & B in an emergency department (ED) during an influenza epidemic. METHODS: Direct nasal swabs were prospectively collected following the physical examination of patients aged >18years who presented to the ED of a tertiary hospital in France with influenza-like illness (ILI) symptoms (N=301) between February 1st and March 31st, 2016, which coincided with an influenza epidemic...
October 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137902/effects-of-opioid-medications-on-cognitive-skills-among-emergency-department-patients
#6
Catherine A Marco, Dennis Mann, Jordan Rasp, Michael Ballester, Oswald Perkins, Michael B Holbrook, Kyle Rako
INTRODUCTION: Treatment for pain and related conditions has been identified as the most common reason for Emergency Department (ED) visits. Concerns exist regarding the effects of opioid pain medications on cognition and patient ability to consent for procedures, hospital admission, or to refuse recommended medical interventions. This study was undertaken to identify cognitive skills before and after opioid pain medication in the ED setting. METHODS: This was a prospective study comparing performance on the Mini-Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) before and after administration of opioid pain medications...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29132499/use-of-medical-emergency-call-data-as-a-marker-of-quality-of-emergency-department-care-in-the-post-national-emergency-access-target-era
#7
Lorraine Westacott, Judy Graves, Mohsina Khatun, John Burke
Objectives Any new model of care should always be accompanied by rigorous monitoring to ensure that there are no negative consequences, especially any that impact upon patient safety. In 2013, 'THERMoSTAT' (Two- Hour Evaluation and Referral Model for Shorter Turnaround Times), an emergency department model of care developed by Royal Brisbane and Women's Hospital staff was launched to gain efficiencies and improve hospital National Emergency Access Target (NEAT) compliance. The aim of this study was to trial the use of medical emergency call data as a novel marker of the quality of care delivered by our emergency department...
November 14, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29126894/developments-in-pre-hospital-patient-transport-in-st-elevation-myocardial-infarction
#8
Maria Inês da Costa Silveira, Maria João Monteiro Sousa, Patrícia Fernandes Dias de Madureira Rodrigues, Bruno Miguel Fernandes Brochado, Raquel Bachen Guimarães Santos, Maria Ana Meixa Alves Burbach Trêpa, André Miguel Coimbra Luz, João Antonio Brum da Silveira, Aníbal António Braga de Albuquerque, Henrique José Cyrne de Castro Machado Carvalho, Severo Barreiro Torres
INTRODUCTION: ST-elevation myocardial infarction (STEMI) is a medical emergency that benefits from rapid access to specialized care. The objective of this study was to describe developments in patient transport via the pre-hospital emergency medical system (EMS) and its impact on clinical outcomes. METHODS: We retrospectively studied STEMI patients who underwent primary percutaneous coronary intervention between January 2008 and July 2015. Patients were divided according to type of admission...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29126602/the-potential-of-blended-learning-in-education-and-training-for-advanced-civilian-and-military-trauma-care
#9
Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark, Klas Karlgren
INTRODUCTION: In the field of advanced care of the complex trauma patient, there is an emerging need for focused education and training. However, several hospitals do not support further education and training in this field, and the challenge of releasing time for physicians and nurses is well-known. Educational strategies using blended learning, which combines traditional classroom methods with modern computer-assisted methods and media, have not yet been widely used. This study analysed the educational challenges and areas for improvement, according to senior physicians and nurses, and investigated the potential use of blended learning...
November 6, 2017: Injury
https://www.readbyqxmd.com/read/29125217/an-evaluation-of-the-impact-of-fifa-world-cup-on-soccer-emergency-department-injuries-among-montreal-adolescents
#10
Glenn Keays, Debbie Friedman, Marianne Beaudin, Isabelle Gagnon
AIM: The 'trickle-down effect', or how major sports events have a positive impact on sports participation, has been the subject of many studies, but none produced conclusive results. We took a different approach and rather than look at sports participation, we used injuries as a proxy and see if injuries increased, or remained the same, after the International Federation of Association Football World Cup. METHODS: Using a retrospective cohort design, we looked at the injuries suffered by males and females (13-16 years old) while playing team sports in Montreal, that occurred in May to July, from 1999 to 2014...
November 10, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29124454/evaluating-the-effectiveness-of-community-and-hospital-medical-record-integration-on-management-of-behavioral-health-in-the-emergency-department
#11
Stephanie Ngo, Mohammad Shahsahebi, Sean Schreiber, Fred Johnson, Mina Silberberg
This study evaluated the correlation of an emergency department embedded care coordinator with access to community and medical records in decreasing hospital and emergency department use in patients with behavioral health issues. This retrospective cohort study presents a 6-month pre-post analysis on patients seen by the care coordinator (n=524). Looking at all-cause healthcare utilization, care coordination was associated with a significant median decrease of one emergency department visit per patient (p < 0...
November 9, 2017: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/29123877/performance-review-of-regional-emergency-medical-service-pre-arrival-cardiopulmonary-resuscitation-with-or-without-dispatcher-instruction-a-population-based-observational-study
#12
Hidetada Fukushima, Yasuyuki Kawai, Hideki Asai, Tadahiko Seki, Kazunobu Norimoto, Yasuyuki Urisono, Kazuo Okuchi
Background: To investigate variations in emergency medical service (EMS) pre-arrival cardiopulmonary resuscitation (CPR), including both bystander CPR without dispatch assistance and dispatch-assisted CPR (DACPR). Methods: We carried out an observational study by implementing EMS pre-arrival CPR reports in three fire agencies. We included adult, non-traumatic, and non-EMS witnessed out-of-hospital cardiac arrests. This reporting system comprised the dispatch instruction process and bystander CPR quality based on evaluations by EMS crews who arrived on the scene...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123868/cardiocerebral-and-cardiopulmonary-resuscitation-2017-update
#13
REVIEW
Gordon A Ewy
Sudden cardiac arrest is a major public health problem in the industrialized nations of the world. Yet, in spite of recurrent updates of the guidelines for cardiopulmonary resuscitation and emergency cardiac care, many areas have suboptimal survival rates. Cardiocerebral resuscitation, a non-guidelines approach to therapy of primary cardiac arrest based on our animal research, was instituted in Tucson (AZ, USA) in 2002 and subsequently adopted in other areas of the USA. Survival rates of patients with primary cardiac arrest and a shockable rhythm significantly improved wherever it was adopted...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122112/prehospital-transfusion-for-gastrointestinal-bleeding
#14
Maile E Parker, Mohammad A Khasawneh, Cornelius A Thiels, Kathleen S Berns, James R Stubbs, Donald H Jenkins, Scott P Zietlow, Martin D Zielinski
OBJECTIVE: Gastrointestinal (GI) bleeding is a common medical emergency with significant morbidity and mortality. Many patients are coagulopathic, which may perpetuate bleeding. Remote damage control resuscitation, including early correction of coagulopathy and anemia, may benefit exsanguinating patients with GI bleeding. METHODS: We conducted a retrospective review of patients with acute GI bleeding who received packed red blood cells (pRBC) and/or plasma during transportation to our institution between 2010 and 2014...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29120913/effectiveness-of-specimen-collection-technology-in-the-reduction-of-collection-turnaround-time-and-mislabeled-specimens-in-emergency-medical-surgical-critical-care-and-maternal-child-health-departments
#15
April M Saathoff, Ryan MacDonald, Erundina Krenzischek
The objective of this study was to evaluate the impact of specimen collection technology implementation featuring computerized provider order entry, positive patient identification, bedside specimen label printing, and barcode scanning on the reduction of mislabeled specimens and collection turnaround times in the emergency, medical-surgical, critical care, and maternal child health departments at a community teaching hospital. A quantitative analysis of a nonrandomized, pre-post intervention study design evaluated the statistical significance of reduction of mislabeled specimen percentages and collection turnaround times affected by the implementation of specimen collection technology...
November 8, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/29118126/respiratory-syncytial-virus-rsv-targeting-the-g-protein-provides-a-new-approach-for-an-old-problem
#16
Ralph A Tripp, Ultan F Power, Peter J M Openshaw, Lawrence M Kauvar
Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infection (LRTI) annually affecting >2 million children in the US <5 years old. In the elderly (>65 years old), RSV results in ∼175,000 hospitalizations annually in the US with worldwide incidence ∼34 million. There is no approved RSV vaccine and treatments are limited. Recently, a Phase 3 trial in the elderly using a recombinant RSV F protein vaccine failed to meet its efficacy objectives, namely prevention of moderate-to-severe RSV-associated LRTI and reduced incidence of acute respiratory disease...
November 8, 2017: Journal of Virology
https://www.readbyqxmd.com/read/29116680/emergency-department-utilization-among-kidney-transplant-recipients-in-the-united-states
#17
Brendan P Lovasik, Rebecca Zhang, Jason M Hockenberry, Justin D Schrager, Stephen O Pastan, Andrew B Adams, Sumit Mohan, Christian P Larsen, Rachel E Patzer
Patients with End Stage Renal Disease (ESRD) use the emergency department (ED) at a 6-fold higher rate than U.S. adults. No national studies have described ED utilization rates among kidney transplant (KTx) recipients, and the factors associated with higher ED utilization. We examined a cohort of 132,725 adult KTx recipients in the United States Renal Data System (2005-2013). ED visits, hospitalization, and outpatient nephrology visits were obtained from Medicare claims databases. Nearly half (46.1%) of KTx recipients had at least one ED visit (1...
November 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29115759/ghanaian-nurses-knowledge-of-invasive-procedural-pain-and-its-effect-on-children-parents-and-nurses
#18
Oboshie Anim-Boamah, Lydia Aziato, Victoria May Adabayeri
AIM: To explore Ghanaian nurses' knowledge of invasive procedural pain in children who are in hospital and to identify the effect of unrelieved pain on children, parents and nurses. METHOD: An exploratory, descriptive and qualitative design was adopted. A purposive sampling technique was used and individual face-to-face, semi-structured interviews were conducted with 16 registered nurses from four children's units at a hospital in the Eastern Region of Ghana. Thematic and content analyses were performed...
September 11, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/29115370/-febrile-syndromes-in-the-traveler-returning-from-tropical-regions-admitted-in-a-monographic-unit
#19
N Moya Notario, M Hernández-Cabrera, C Carranza-Rodríguez, E Pisos-Álamo, N Jaén-Sánchez, J L Pérez-Arellano
OBJECTIVE: The aim was to analyse those syndromes with fever in travellers who return from tropical regions evaluated at our Department of Infectology and Tropical Medicine. Clarifying these conditions intends to reach earlier diagnoses and, perhaps, to avoid the emergence and spread of imported diseases, as well as to establish appropriate preventive measures. METHODS: An observational descriptive transversal study was performed, selecting those patients who returned from tropical regions with fever, amongst all travellers evaluated in our department between 1998 and 2013...
November 8, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29113010/comparison-of-four-methods-of-endotracheal-tube-passage-in-simulated-airways-there-is-room-for-improved-techniques
#20
Kirsten Kingma, Ross Hofmeyr, Irene Suilan Zeng, Christin Coomarasamy, Andrew Brainard
OBJECTIVE: Endotracheal intubation requires laryngoscopy followed by passage of the endotracheal tube (ETT). Tube passage can be difficult, but there is little evidence to support which adjunct for tube passage is most effective. METHODS: The four tube passage adjuncts tested were the naked ETT, stylet ETT, railroaded bougie and preloaded bougie. Participants completed pre- and post-test surveys identifying demographics, experience and method preference. After instruction, participants completed eight intubations on manikins with 'easy' and 'difficult' airways...
November 7, 2017: Emergency Medicine Australasia: EMA
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