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Emergency, pre-hospital

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https://www.readbyqxmd.com/read/28729905/an69st-membranes-adsorb-nafamostat-mesylate-and-affect-the-management-of-anticoagulant-therapy-a-retrospective-study
#1
Takahiro Hirayama, Nobuyuki Nosaka, Yasumasa Okawa, Soichiro Ushio, Yoshihisa Kitamura, Toshiaki Sendo, Toyomu Ugawa, Atsunori Nakao
BACKGROUND: In Japan, nafamostat mesylate (NM) is frequently used as an anticoagulant during continuous renal replacement therapy (CRRT). The dialyzer membrane AN69ST has been reported to adsorb NM and affect the management of anticoagulant therapy. However, the adsorbed amount has not yet been quantitatively assessed. Therefore, in this study, we evaluated the pre- and post-hemofilter prolongation of the activated clotting time (ACT) in patients with AN69ST and PS membranes. We also measured the adsorption of NM in three types of CRRT membranes using an experimental model...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28728804/pharmacy-technician-self-efficacies-insight-to-aid-future-education-staff-development-and-workforce-planning
#2
Shane P Desselle, Ryan Hoh, Erin R Holmes, Amanpreet Gill, Lemuel Zamora
BACKGROUND: The roles of pharmacy technicians are increasingly prominent given pharmacy's transition to patient-centered activities and evolving scopes of practice in many U.S. states and throughout the world. OBJECTIVES: The aims of this study were to assess U.S. pharmacy technicians' self-efficacies for and attitudes toward performing current and emerging roles in hospital and in community pharmacy and to identify factors related to pharmacy technician self-efficacies in these roles...
July 15, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28727183/a-randomised-controlled-trial-on-a-nurse-led-smartphone-based-self-management-programme-for-patients-with-poorly-controlled-type-2-diabetes-a-study-protocol
#3
Wenru Wang, Betsy Seah, Ying Jiang, Violeta Lopez, Cherry Tan, Suan Tee Lim, Hongliang Ren, Yin Hao Khoo
AIM: To develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes for patients with poorly controlled type 2 diabetes in Singapore. BACKGROUND: Over the past decades, Asia has emerged as the 'diabetes epicentre' in the world due to rapid economic development, urbanisation and nutrition transition. There is an urgent need to develop more effective care management strategies in response to this rising diabetes epidemic...
July 20, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28727180/why-was-a-local-anaesthetic-used-before-administering-intranasal-ketamine-for-paediatric-injuries
#4
Sabine Lemoine, Daniel Jost, Kilian Bertho, Jean Pierre Tourtier
We were very interested to read Scheier et al's brief report on the use of intranasal ketamine in their pediatric emergency department, specifically for pain and anxiety in children who had resisted venipuncture or intravenous placement (1). Intravenous access can be difficult for pre-hospital medical teams that are not specialised in paediatric care, namely when children complain of pain from, for example suspected fractures and burns. This article is protected by copyright. All rights reserved.
July 20, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28726526/integrated-care-coordination-by-an-interprofessional-team-reduces-emergency-department-visits-and-hospitalisations-at-an-academic-health-centre
#5
Anne H Gaglioti, Patrick Barlow, Kate DuChene Thoma, George R Bergus
People with chronic behavioural and physical health conditions have higher healthcare costs and mortality rates than patients with chronic physical conditions alone. As a result, there has been promotion of integrated care for this group. It is important to train primary care residents to practice in integrated models of care with interprofessional teams and to evaluate the effectiveness of integrated care models to promote high-quality care for this at-risk group. We implemented an integrated, interprofessional care management programme for adults with chronic mental and physical health needs as part of a curriculum for family medicine and family medicine psychiatry residents...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28721570/task-shifting-the-use-of-laypersons-for-acquisition-of-vital-signs-data-for-clinical-decision-making-in-the-emergency-room-following-traumatic-injury
#6
Bryce E Haac, Jared R Gallaher, Charles Mabedi, Andrew J Geyer, Anthony G Charles
IMPORTANCE: In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. OBJECTIVE: To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital signs in the initial evaluation of trauma patients. DESIGN: We conducted a quasi-experimental study of patients presenting with traumatic injury pre- and post-intervention...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28721327/two-catastrophes-in-one-patient-drug-reaction-with-eosinophilia-and-systemic-symptoms-and-toxic-shock-syndrome
#7
Moayed Ibrahim, Diana L Nunley
A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. She was treated with steroids and discharged after her condition improved. However, a month later, she returned to the ER, complaining of nausea, vomiting, diarrhea, dizziness, chills, and shortness of breath over the past two days...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28721026/a-community-virtual-ward-model-to-support-older-persons-with-complex-health-care-and-social-care-needs
#8
C Lewis, Z Moore, F Doyle, A Martin, D Patton, L E Nugent
BACKGROUND: Globally the older population is increasing rapidly. As a result there is an increase in frail older persons living within the community, with increased risks of a hospital admission and higher mortality and morbidity rates. Due to complexity of care, health care professionals face challenges in providing effective case management and avoiding unplanned admissions to hospital. A community virtual ward (CVW) model was developed to assist health care professionals to support older persons at home during periods of illness and/or functional decline...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28719229/experiences-using-pre-exposure-prophylaxis-for-safer-conception-among-hiv-serodiscordant-heterosexual-couples-in-the-united-states
#9
Angela R Bazzi, Ashley A Leech, Dea L Biancarelli, Meg Sullivan, Mari-Lynn Drainoni
Antiretroviral pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for HIV serodiscordant couples (HIV-infected male, uninfected female) seeking safer conception. However, most research on PrEP for safer conception has focused on couples in sub-Saharan Africa; little is known about the perspectives or experiences of heterosexual couples in the United States. We conducted qualitative interviews with six couples (six women and five of their male partners) receiving PrEP for conception services at an urban safety net hospital in the US Northeast...
July 18, 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28717904/a-description-of-deaths-following-emergency-abdominal-surgery
#10
Henrik Wolsted, Ann Merete Møller, Mai-Britt Tolstrup, Morten Vester-Andersen
OBJECTIVE: Emergency major abdominal surgery carries a high mortality rate. The aim of this present study was to characterize a population of deceased abdominal surgical patients, to examine how many died unexpectedly and how many were subject to treatment limitations. MATERIALS AND METHODS: We included adult emergency abdominal surgical patients who died within 30 days postoperatively. We collected data from January 1, 2013, to December 31, 2014, in a Danish tertiary care hospital (Herlev)...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28717775/impact-of-early-coronary-angiography-on-the-survival-to-discharge-after-out-of-hospital-cardiac-arrest
#11
Jikyoung Shin, Eunsil Ko, Won Chul Cha, Tae Rim Lee, Hee Yoon, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong, Jin-Ho Choi
OBJECTIVE: Acute myocardial infarction is a major cause of out-of-hospital cardiac arrest (OHCA). Coronary angiography (CAG) enables diagnostic confirmation of coronary artery disease and subsequent revascularization, which might improve the prognosis of OHCA survivors. Non-randomized data has shown a favorable impact of CAG on prognosis for this population. However, the optimal timing of CAG has been debated. METHODS: The clinical outcomes of 607 OHCA patients registered in CAPTURES (Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance), a nationwide multicenter registry performed in 27 hospitals, were analyzed...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28716784/protocol-for-a-prospective-observational-study-to-improve-prehospital-notification-of-injured-patients-presenting-to-trauma-centres-in-india
#12
Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald
INTRODUCTION: Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716643/reduced-risk-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-after-bariatric-surgery-a-self-controlled-case-series-study
#13
Tadahiro Goto, Yusuke Tsugawa, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
BACKGROUND: Obesity is common among individuals with chronic obstructive pulmonary disease (COPD) and associated with increased COPD morbidities. However, little is known about the impact of weight reduction on COPD-related outcomes in obese patients. METHODS: Using the population-based emergency department (ED) and inpatient sample in three U.S. states (California, Florida, and Nebraska), we performed a self-controlled case series study of 481 obese adults (aged 40-65 years) with COPD who underwent bariatric surgery...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28713660/a-cross-sectional-pharmacoepidemiological-study-of-the-utilization-pattern-of-pre-anesthetic-medications-in-major-surgical-procedures-in-a-tertiary-care-hospital
#14
Madhuri Kulkarni, Anant Patil
OBJECTIVE : A study of the utilization pattern of pre-anesthetic medications in major surgical procedures. MATERIAL AND METHODS : A cross-sectional, pharmacoepidemiological study was conducted among patients undergoing surgical procedures in routine or emergency conditions under general anesthesia. The utilization of pre-anesthetic medicines in all patients was reported. RESULTS: A total of 110 patients (mean age - 42.36 years; 57.27% males) were enrolled...
June 13, 2017: Curēus
https://www.readbyqxmd.com/read/28713042/implementation-of-the-universal-bls-termination-of-resuscitation-rule-in-a-rural-ems-system
#15
Matthew R Jordan, Michael F O'Keefe, David Weiss, C Wes Cubberley, Charles D MacLean, Daniel L Wolfson
BACKGROUND: Emergency Medical Services (EMS) are often the first medical providers to begin resuscitation of out-of-hospital cardiac arrest (OHCA) victims. The universal Basic Life Support Termination of Resuscitation (BLS-TOR) rule is a validated clinical prediction tool used to identify patients in which continued resuscitation efforts are futile. OBJECTIVE: The primary aim is to compare the rate of transport of OHCA cases before and after the implementation of a BLS-TOR protocol and to determine the compliance rate of EMS personnel with the new protocol in a largely volunteer, rural system...
July 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/28712527/clinical-presentation-to-the-emergency-department-predicts-subarachnoid-hemorrhage-associated-myocardial-injury
#16
Khalil M Yousef, Elizabeth Crago, Theodore F Lagattuta, Marilyn Hravnak
INTRODUCTION: Aneurysmal subarachnoid hemorrhage (aSAH) is frequently seen in emergency departments. Secondary injury, such as subarachnoid hemorrhage-associated myocardial injury (SAHMI), affects one third of survivors and contributes to poor outcomes. SAHMI is not attributed to ischemia from myocardial disease but can result in hypotension and arrhythmias. It is important that emergency nurses recognize which clinical presentation characteristics are predictive of SAHMI to initiate proper interventions...
July 13, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28709556/intussusception-among-children-less-than-2years-of-age-findings-from-pre-vaccine-introduction-surveillance-in-pakistan
#17
Mohammad Tahir Yousafzai, Rozina Thobani, Saqib Hamid Qazi, Nasir Saddal, Catherine Yen, Negar Aliabadi, Syed Asad Ali
BACKGROUND: Rotavirus vaccination introduction in routine immunization is under consideration in Pakistan. Data on the baseline epidemiology of intussusception will inform surveillance strategies for intussusception after rotavirus vaccine introduction in Pakistan. We describe the epidemiology of intussusception-associated hospitalizations among children <2years of age in Karachi, Pakistan. METHODS: We conducted a retrospective chart review for July 01, 2012 through June 30, 2015 at the National Institute of Child Health (NICH) and Aga Khan University Hospital (AKUH) Karachi...
July 11, 2017: Vaccine
https://www.readbyqxmd.com/read/28706428/appropriateness-of-the-study-of-iron-deficiency-anemia-prior-to-referral-for-small-bowel-evaluation-at-a-tertiary-center
#18
Jaime Pereira Rodrigues, Rolando Pinho, Joana Silva, Ana Ponte, Mafalda Sousa, João Carlos Silva, João Carvalho
AIM: To evaluate the adequacy of the study of iron deficiency anemia (IDA) in real life practice prior to referral to a gastroenterology department for small bowel evaluation. METHODS: All consecutive patients referred to a gastroenterology department for small bowel investigation due to iron deficiency anemia, between January 2013 and December 2015 were included. Both patients referred from general practitioners or directly from different hospital departments were selected...
June 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28705570/la-pose-de-voie-veineuse-p%C3%A3-diatrique-par-les-%C3%A3-quipes-de-smur-adultes
#19
REVIEW
Frédéric Lemoine, Hugues Lefort, Sabine Lemoine, Benoît Frattini, Daniel Jost
Paediatric perfusion during pre-hospital care is a major issue in the event of life-threatening emergencies. Access, often restricted, to backup specialising in paediatrics, implies the existence of practices on protocols for the adult mobile emergency and intensive care service (Smur) in partnership with paediatricians. Paediatric perfusion practices were assessed in these teams. The results show the presence of a paediatric protocol in the adult Smur teams is not very common. Nursing practices seem to be evolving towards the recommendations, thanks to technological advances such as the use of the intraosseous device...
July 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/28703047/assessment-of-people-who-have-been-tasered
#20
Matthew Peel
The use of Tasers® by the police is subject to intense scrutiny and controversy. With increasing numbers of police officers carrying Tasers, it is important that nurses in pre-hospital, emergency department and police custody settings understand how Tasers work, and the physiological effects. This article describes Tasers, their mechanisms and physiological effects, and explains how nurses should undertake assessment of people who have been subjected to Taser discharge.
July 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
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