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Burn critical care

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https://www.readbyqxmd.com/read/29787959/high-voltage-electrical-injury-complicated-by-compartment-syndrome-and-acute-kidney-injury-with-successful-limb-salvage-a-case-report-and-review-of-the-literature
#1
Christopher Wei Guang Ho, Shi-Hui Yang, Chu Hui Wong, Si Jack Chong
INTRODUCTION: Although an uncommon form of admission to a burns centre, the deep, penetrating nature of noxious currents mean that electrical burns have the most catastrophic consequences of all burn injuries. Understanding the physics of electricity is crucial to explaining the mechanisms of tissue damage and organ failure in electrical injuries which necessitate special management above and beyond that of regular thermal burns. PRESENTATION OF CASE: We present a young man who suffered significant occupation-related electrical burns that was complicated by compartment syndrome, rhabdomyolysis and acute kidney injury...
May 16, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29786947/does-general-experience-affect-self-assessment
#2
Parisa Rezaiefar, Kelly Forse, Joseph K Burns, Sharon Johnston, Elizabeth Muggah, Claire Kendall, Douglas Archibald
BACKGROUND: The assessment of clinical competence is critical in medical education. Understanding the effect of general experience on a physician's self-assessment would help design more effective curricula and evaluations of procedural skills in postgraduate training and continuing professional development (CPD). In this observational study, we assessed the effect of general experience on the correlation between confidence and competence amongst experienced clinicians (ECs) and postgraduate trainees (PGTs) when learning an office-based procedure in pessary care...
May 22, 2018: Clinical Teacher
https://www.readbyqxmd.com/read/29783252/the-analytical-prognosis-of-the-susceptibility-to-aminoglycosides-and-doxycycline-inacinetobacter-baumanniiisoolated-from-burns-of-intensive-care-unit-patients
#3
Vasyl I Nahaichuk, Oleksandr A Nazarchuk, Neonila I Osadchuk, Dmytro V Dmytriiev, Halyna H Nazarchuk
OBJECTIVE: Introduction: Clinical strains of A.baumannii are becoming highly important in hospital-acquired infections, especially because of their association with low susceptibility to antibiotics, which requires in-depth study with a prognostic determination of the dynamics of antimicrobial efficacy of antibiotics. The aim was to investigate of prognostic models of aminoglycoside antibiotics effectiveness on the basis of the mathematical analysis of real susceptibility of A.baumannii clinical strains, isolated from patients in BICU...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29762869/the-organisation-of-critical-care-for-burn-patients-in-the-uk-epidemiology-and-comparison-of-mortality-prediction-models
#4
A P Toft-Petersen, P Ferrando-Vivas, D A Harrison, K Dunn, K M Rowan
In the UK, a network of specialist centres has been set up to provide critical care for burn patients. However, some burn patients are admitted to general intensive care units. Little is known about the casemix of these patients and how it compares with patients in specialist burn centres. It is not known whether burn-specific or generic risk prediction models perform better when applied to patients managed in intensive care units. We examined admissions for burns in the Case Mix Programme Database from April 2010 to March 2016...
May 15, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29760022/burnout-and-scope-of-practice-in-new-family-physicians
#5
Amanda K H Weidner, Robert L Phillips, Bo Fang, Lars E Peterson
PURPOSE: Family physicians report some of the highest levels of burnout, but no published work has considered whether burnout is correlated with the broad scope of care that family physicians may provide. We examined the associations between family physician scope of practice and self-reported burnout. METHODS: Secondary analysis of the 2016 National Family Medicine Graduate Survey respondents who provided outpatient continuity care (N = 1,617). We used bivariate analyses and logistic regression to compare self-report of burnout and measures of scope of practice including: inpatient medicine, obstetrics, pediatric ambulatory care, number of procedures and/or clinical content areas, and providing care outside the principal practice site...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29758059/divergent-humoral-responses-to-23-valent-pneumococcal-polysaccharide-vaccine-in-critically-ill-burn-and-neurosurgical-patients
#6
Scott W Mueller, Laura J Baumgartner, Rob MacLaren, Robert Neumann, Arek J Wiktor, Tyree H Kiser, Gordon Lindberg, Luis Cava, Douglas N Fish, Edward N Janoff
INTRODUCTION: Critically ill hospitalized patients are at increased risk of infection so we assessed the immunogenicity of 23-valent pneumococcal polysaccharide vaccine (PPSV23) administered within six days of injury. METHODS: This prospective observational study compared the immunogenicity of PPSV23 among critically ill burn and neurosurgical patients at a tertiary, academic medical center. Patients received PPSV23 vaccination within six days of ICU admission per standard of care...
2018: PloS One
https://www.readbyqxmd.com/read/29752016/perioperative-research-into-memory-prime-cognitive-impairment-following-a-severe-burn-injury-and-critical-care-admission-part-1
#7
Edward J R Watson, Klará Nenadlová, Olivia H Clancy, Mena Farag, Naz A Nordin, Agnes Nilsen, Ashley R T Mehmet, Ahmed Al-Hindawi, Sundhiya Mandalia, Lisa M Williams, Trudi L Edginton, Marcela P Vizcaychipi
INTRODUCTION: An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns. METHODS: A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate® electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks...
May 8, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29694931/urinary-potassium-excretion-and-its-association-with-acute-kidney-injury-in-the-intensive-care-unit
#8
Alasdair R Burns, Kwok M Ho
PURPOSE: Using urinary indices as a quick bedside test to assist management of oliguria and acute kidney injury (AKI) has long been sought. This study assessed whether urinary potassium excretion is related to simultaneously calculated creatinine clearance (CrCl) and can predict AKI in the critically ill. MATERIALS AND METHODS: In this prospective cohort study, the correlation between 2-h urinary potassium excretion and simultaneously calculated CrCl of 61 critically ill patients was assessed by Pearson's correlation coefficient, and their ability to predict AKI (≥stage 1 KDIGO) in the subsequent 7 days was assessed by area under the receiver-operating-characteristic (AUROC) curve...
April 16, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29690735/-lay-emphasis-on-circulatory-state-research-after-fluid-resuscitation-in-early-burns
#9
Q Zhang, Y Q Tang
In this article, we discuss future development of circulatory state research after fluid resuscitation in early burns from its history and difficulties confronted. We believe that the Chinese fluid resuscitation formula to predict initial volume of fluid infusion of extensive burn patients is still useful and effective, while we should attach more importance to advances in the research of burn pathophysiology, basic theory and clinical practices of Chinese fluid resuscitation formula, so as to provide strategy of fluid resuscitation in early burns for international burn world...
April 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29660009/critical-care-in-the-military-health-system-a-24-h-point-prevalence-study
#10
Raymond Fisher, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Background: Healthcare expenditures are a significant economic cost with critical care services constituting one of its largest components. The Military Health System (MHS) is the largest, global healthcare system of its kind. In this project, we sought to describe critical care services and the patients who receive them in the MHS. Methods: We surveyed 26 military treatment facilities (MTFs) representing 38 critical care services or intensive care units (ICUs)...
April 11, 2018: Military Medicine
https://www.readbyqxmd.com/read/29651952/special-traumatized-populations-burns-and-hypothermia
#11
Shruti Mehrotra, Amita Misir
It is important for physicians treating children to be aware of unique presentation that require expertise and knowledge. Two areas of importance when caring for traumatized children are Thermal Burn Injuries, and Hypothermia. Burns commonly result in morbidity in children; as such, the appropriate identification of the severity of the burn and appropriate management are integral to minimize the complications of burns during the acute phase. Attention to proper fluid management is paramount. Knowledge of types of solutions to use during Burn treatment is important...
April 11, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29628217/development-and-characterization-of-a-point-of-care-rate-based-transcutaneous-respiratory-status-monitor
#12
Xudong Ge, Prosper Adangwa, Ja Young Lim, Yordan Kostov, Leah Tolosa, Richard Pierson, Daniel Herr, Govind Rao
Blood gas measurements provide vital clinical information in critical care. The current "gold standard" for blood gas measurements involves obtaining blood samples, which can be painful and can lead to bleeding, thrombus formation, or infection. Mass transfer equilibrium-based transcutaneous blood gas monitors have been used since the 1970s, but they require heating the skin to ≥42 °C to speed up the transcutaneous gas diffusion. Thus, these devices have a potential risk for skin burns. Here we report a new generation of noninvasive device for respiratory status assessment...
April 5, 2018: Medical Engineering & Physics
https://www.readbyqxmd.com/read/29624408/patient-and-family-engagement-in-the-icu-untapped-opportunities-and-under-recognized-challenges
#13
Karen E A Burns, Cheryl Misak, Margaret Herridge, Maureen O Meade, Simon Oczkowski
The call for meaningful patient and family engagement in healthcare and research is gaining impetus. Healthcare institutions and research funding agencies increasingly encourage clinicians and researchers to work actively with patients and their families to advance clinical care and research. Engagement is increasingly mandated by healthcare organizations and is becoming a prerequisite for research funding. In this article, we review the rationale and the current state of patient and family engagement in patient care and research in the intensive care unit (ICU)...
April 6, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29615134/improving-outcomes-after-pediatric-cardiac-arrest-the-icu-resuscitation-project-study-protocol-for-a-randomized-controlled-trial
#14
Ron W Reeder, Alan Girling, Heather Wolfe, Richard Holubkov, Robert A Berg, Maryam Y Naim, Kathleen L Meert, Bradley Tilford, Joseph A Carcillo, Melinda Hamilton, Matthew Bochkoris, Mark Hall, Tensing Maa, Andrew R Yates, Anil Sapru, Robert Kelly, Myke Federman, J Michael Dean, Patrick S McQuillen, Deborah Franzon, Murray M Pollack, Ashley Siems, John Diddle, David L Wessel, Peter M Mourani, Carleen Zebuhr, Robert Bishop, Stuart Friess, Candice Burns, Shirley Viteri, David A Hehir, R Whitney Coleman, Tammara L Jenkins, Daniel A Notterman, Robert F Tamburro, Robert M Sutton
BACKGROUND: Quality of cardiopulmonary resuscitation (CPR) is associated with survival, but recommended guidelines are often not met, and less than half the children with an in-hospital arrest will survive to discharge. A single-center before-and-after study demonstrated that outcomes may be improved with a novel training program in which all pediatric intensive care unit staff are encouraged to participate in frequent CPR refresher training and regular, structured resuscitation debriefings focused on patient-centric physiology...
April 3, 2018: Trials
https://www.readbyqxmd.com/read/29609274/-practice-and-thinking-about-the-establishment-and-management-of-burn-intensive-care-unit
#15
X J Li
The treatment of critically burned patients has benefited from the development of knowledge and technologies that we got in critical care medicine of our country in the past ten years. The close-ended management model of general intensive care unit (ICU) and the idea of general ICU doctors who treat the monitoring of organ function and alternative therapy of organs as their primary tasks would affect the treatments for special critical patients hospitalized in general ICU, especially for those patients who were severely burned...
March 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29596686/hypertrophic-scar-severity-at-autograft-sites-is-associated-with-increased-pain-and-itch-after-major-thermal-burn-injury
#16
Matthew C Mauck, Jeffrey W Shupp, Felicia Williams, Marie Ashley Villard, Samuel W Jones, James Hwang, Jennifer Smith, Rachel Karlnoski, David J Smith, Bruce A Cairns, Samuel A McLean
Approximately three quarters of major thermal burn injury (MThBI) survivors suffer from hypertrophic scarring (HTS) and over half experience chronic pain or itch. In survivors of MThBI, HTS and chronic pain or itch are considered one of the greatest unmet challenges of postburn injury care and psychosocial reintegration. Although scarring, itch, and pain have been clinically associated, there are no prospective, multisite studies examining tissue autograft site pain or itch and scar outcomes. The authors collected a representative cohort (n = 56) of MThBI survivors who received autografting within 14 days of injury and evaluated graft-site pain or itch severity (0-10 Numeric Rating Scale) and HTS using a validated scar photograph assessment scale 6 months following MThBI...
December 4, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29596679/burn-injuries-in-patients-with-paralysis-a-national-perspective-on-injury-patterns-and-outcomes
#17
Christina E Stiles, Melissa M McLawhorn, Lauren B Nosanov, Jennifer L Paul, Jeffrey W Shupp
The affect of paralysis-related comorbidities on outcomes in burn-injured patients has not been explored. We hypothesize that comorbid paralysis is associated with increased morbidity in this population. All burned patients with prior diagnoses of paralysis were identified from the National Burn Repository (Version 8.0). One-to-one matching of nonparalyzed burn-injured patients was performed, and nonparametric analysis was used to compare the groups. We identified 432 paralyzed patients, who were predominantly male (70...
December 27, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29596291/interprofessional-simulations-promote-knowledge-retention-and-enhance-perceptions-of-teamwork-skills-in-a-surgical-trauma-burn-intensive-care-unit-setting
#18
Katie L George, Beth Quatrara
BACKGROUND: The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources...
May 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29563014/optimizing-mass-casualty-burns-intensive-care-organization-and-treatment-using-evidence-based-outcome-predictors
#19
Huang-Kai Kao, Charles Yuen Yung Loh, Hao-Wei Kou, Kuo-Chin Kao, Han-Chung Hu, Chia-Ming Chang, Chia-Hui Lee, Hsiang-Hao Hsu
BACKGROUND: Majority of current research focuses on pre-hospital care in mass casualty incidents (MCI) whereas this study is the first to examine multifactorial aspects of intensive care unit (ICU) resource management during a surge in massive burn injury (MBI) patients whilst identifying key outcome predictors that resulted in successful disaster managements. METHODS: Both critical care, surgical parameters and cost-effectiveness are investigated in patients admitted with severe burns resulting from the explosion...
March 18, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29554422/optimization-of-secondary-air-injection-in-a-wood-burning-cookstove-an-experimental-study
#20
Julien J Caubel, Vi H Rapp, Sharon S Chen, Ashok J Gadgil
Nearly 40% of the world's population regularly cooks on inefficient biomass stoves that emit harmful airborne pollutants, such as particulate matter (PM). Secondary air injection can significantly reduce PM mass emissions to mitigate the health and climate impacts associated with biomass cookstoves. However, secondary air injection can also increase the number of ultrafine particles emitted, which may be more harmful to health. This research investigates the effect of secondary air injection on the mass and size distribution of PM emitted during solid biomass combustion...
April 3, 2018: Environmental Science & Technology
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