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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/29244793/effects-of-epinephrine-on-hemodynamic-changes-during-cardiopulmonary-resuscitation-in-a-neonatal-piglet-model
#2
Michael Wagner, Po-Yin Cheung, Elliott S Li, Tze-Fun Lee, Min Lu, Megan O'Reilly, Monika Olischar, Georg M Schmölzer
BACKGROUND: Asphyxia is the most common reason for newborns to fail to make a successful fetal to neonatal transition. There is currently a lack of data evaluating hemodynamic effects of epinephrine during neonatal cardiopulmonary resuscitation. METHODS: Twenty-four newborn piglets were exposed to asphyxia. Thereafter, positive pressure ventilation was commenced for 30 s, followed by chest compressions (CC). Piglets were randomized into three experimental groups: 3:1 compression:ventilation ratio; CC during sustained inflation (SI) at a rate of 90 CC per minute, or CC during SI at a rate of 120 CC per minute...
December 15, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29244522/pulmonary-vasodilator-therapy-in-shock-associated-cardiac-arrest
#3
Ryan W Morgan, Robert M Sutton, Michael Karlsson, Andrew J Lautz, Constantine D Mavroudis, William P Landis, Yuxi Lin, Sejin Jeong, Nancy Craig, Vinay M Nadkarni, Todd J Kilbaugh, Robert A Berg
RATIONALE: Many in-hospital cardiac arrests are precipitated by hypotension, often associated with systemic inflammation. These patients are less likely to be successfully resuscitated and novel approaches to their treatment are needed. OBJECTIVES: To determine if the addition of inhaled nitric oxide (iNO) to hemodynamic-directed cardiopulmonary resuscitation (HD-CPR) would improve short-term survival from cardiac arrest associated with shock and systemic inflammation...
December 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29244108/optimal-doses-of-rifampicin-in-the-standard-drug-regimen-to-shorten-tuberculosis-treatment-duration-and-reduce-relapse-by-eradicating-persistent-bacteria
#4
Yingjun Liu, Henry Pertinez, Fatima Ortega-Muro, Laura Alameda-Martin, Thomas Harrison, Geraint Davies, Anthony Coates, Yanmin Hu
Objectives: Although high-dose rifampicin holds promise for improving tuberculosis disease control by eradication of persistent bacteria, the optimal dose of rifampicin that kills persistent bacteria and shortens the treatment duration is unknown. Methods: The Cornell mouse model was used to test the efficacy of rifampicin at elevated doses combined with isoniazid and pyrazinamide to kill actively growing and persistent bacilli and to measure relapse rate. Persistent bacteria were evaluated using Mycobacterium tuberculosis culture supernatant containing resuscitation-promoting factors...
December 12, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29242573/extremely-premature-birth-informed-written-consent-and-the-greek-ideal-of-sophrosyne
#5
Joseph W Kaempf, Kevin Dirksen
Most extremely premature infants die in the intensive care unit or suffer significant neurologic impairment. Many therapies result in unhealthy consequences, and the emotional and financial turmoil for families warrant reappraisal of our motives. Shared decision-making and informed consent in preference-sensitive conditions imply the family: (a) understands the medical problem, (b) grasps the risks and benefits of each therapy, (c) has the opportunity to ask questions and reflect upon options, (d) knows their values and preferences are understood, and (e) accepts or declines therapies without judgment or penalty...
December 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29242058/endovascular-cooling-versus-standard-femoral-catheters-and-intravascular-complications-a-propensity-matched-cohort-study
#6
Olivier Andremont, Damien du Cheyron, Nicolas Terzi, Cedric Daubin, Amélie Seguin, Xavier Valette, Flore-Anne Lecoq, Jean-Jacques Parienti, Bertrand Sauneuf
BACKGROUND: Targeted temperature management (TTM) contributes to improved neurological outcome in adults who have been successfully resuscitated after cardiac arrest with shockable rhythm. Endovascular cooling catheters are widely used to induce and maintain targeted temperature in the ICU. The aim of the study was to compare the risk of complications with cooling catheters and standard central venous catheters. MATERIALS AND METHODS: In this prospective single-centre cohort study, we included all patients admitted to an intensive care unit for successfully resuscitated cardiac arrest that required endovascular TTM (Coolgard®, Zoll™ Medical corporation, MA, USA), between August 2012 and November 2014, inclusive...
December 11, 2017: Resuscitation
https://www.readbyqxmd.com/read/29242057/quality-of-audio-assisted-versus-video-assisted-dispatcher-instructed-bystander-cardiopulmonary-resuscitation-a-systematic-review-and-meta-analysis
#7
Yu-You Lin, Ming-Ju Hsieh, Jen-Tang Sun, Yi-Chung Chang, Matthew Huei-Ming Ma, Wen-Chu Chiang
AIM: This study aimed to conduct a systematic review and meta-analysis comparing the effect of video-assistance and audio-assistance on quality of dispatcher-instructed cardiopulmonary resuscitation (DI-CPR) for bystanders. METHODS: Five databases were searched, including PubMed, Cochrane library, Embase, Scopus and NIH clinical trial, to find randomized control trials published before June 2017. Qualitative analysis and meta-analysis were undertaken to examine the difference between the quality of video-instructed and audio-instructed dispatcher-instructed bystander CPR...
December 11, 2017: Resuscitation
https://www.readbyqxmd.com/read/29241913/the-comparison-of-umbilical-cord-arterial-blood-lactate-and-ph-values-for-predicting-short-term-neonatal-outcomes
#8
Ruta Einikyte, Vilija Snieckuviene, Diana Ramasauskaite, Jurate Panaviene, Virginija Paliulyte, Gina Opolskiene, Edita Kazenaite
OBJECTIVE: Current clinical practice of assessing neonatal condition is based on evaluation of umbilical cord arterial blood pH value rather than lactate. However, evidence shows that lactate is direct and more predictive measurement than pH or at least of equal importance. This study is to assess and compare umbilical cord arterial lactate and pH values for predicting short-term neonatal outcomes. MATERIALS AND METHODS: A retrospective cohort study was conducted at the tertiary level hospital, were arterial umbilical cord blood sampling was collected according to the standard procedures...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29241907/a-systematic-review-of-massive-transfusion-protocol-in-obstetrics
#9
REVIEW
Hiroaki Tanaka, Shigetaka Matsunaga, Tomoyuki Yamashita, Toshiyuki Okutomi, Atsushi Sakurai, Akihiko Sekizawa, Junichi Hasegawa, Katsuo Terui, Yasutaka Miyake, Jun Murotsuki, Tomoaki Ikeda
Post-partum obstetric haemorrhage is a leading cause of mortality among Japanese women, generally treated with haemostatic measures followed by supplementary transfusion. Commonly used in the setting of severe trauma, massive transfusion protocols (MTPs), preparations of red blood cell concentrate (RBC) and fresh frozen plasma (FFP) with additional supplements, have proved effective in decreasing patient mortality following major obstetric bleeding events. Although promising, the optimal configuration of RBC and FFP utilized for obstetric bleeding needs to be verified...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29241628/-care-of-the-newborn-with-perinatal-asphyxia-candidate-for-therapeutic-hypothermia-during-the-first-six-hours-of-life-in-spain
#10
Juan Arnaez, Alfredo Garcia-Alix, Sara Calvo, Simón Lubián-López
INTRODUCTION: The process of care and assistance from birth to the starting of therapeutic hypothermia (TH) is crucial in order to improve its effectiveness and prevent the worsening of hypoxic-ischaemic injury. METHODS: A national cross-sectional study carried out in 2015 by use of a questionnaire sent to all level iii units on the care of the newborn≥35 weeks gestation within the first hours of life after a perinatal asphyxia event. According to clinical practice guidelines, the quality of care was compared between the hospitals that carried out or did not carry out TH, and according to the level of care...
December 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29241515/barriers-to-family-presence-during-resuscitation-and-strategies-for-improving-nurses-invitation-to-families
#11
Kelly A Powers
No abstract text is available yet for this article.
December 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29241388/hypercalcemia-induced-pancreatitis-in-pregnancy-following-calcium-carbonate-ingestion
#12
May S Trezevant, John C Winton, Ashley K Holmes
BACKGROUND: Calcium carbonate is often used to relieve Gastroesophageal Reflux Disease (GERD) in pregnant patients. This report describes a potentially serious complication. CASE: A pregnant female presented at 34 weeks gestation with abdominal pain, nausea, and vomiting. Home medications included an unquantifiable amount of calcium carbonate 500 mg due to constant consumption for GERD. Laboratory findings included elevated calcium, amylase, lipase, and triglyceride level...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29241382/causes-of-mortality-in-icu-acquired-weakness
#13
Linda van Wagenberg, Esther Witteveen, Luuk Wieske, Janneke Horn
BACKGROUND: Intensive care unit-acquired weakness (ICU-AW) is a common complication of critical illness and is associated with increased mortality, longer mechanical ventilation and longer hospital stay. Little is known about the causes of mortality in patients with ICU-AW. In this study, we aimed to give an overview of the causes of death in a population diagnosed with ICU-AW during hospital admission. METHODS: Data from a prospective cohort study in the mixed medical-surgical ICU of the Academic Medical Center in Amsterdam were used...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29239980/derivation-and-internal-validation-of-a-mortality-prediction-tool-for-initial-survivors-of-pediatric-in-hospital-cardiac-arrest
#14
Mathias J Holmberg, Ari Moskowitz, Tia T Raymond, Robert A Berg, Vinay M Nadkarni, Alexis A Topjian, Anne V Grossestreuer, Michael W Donnino, Lars W Andersen
OBJECTIVES: To develop a clinical prediction score for predicting mortality in children following return of spontaneous circulation after in-hospital cardiac arrest. DESIGN: Observational study using prospectively collected data. SETTING: This was an analysis using data from the Get With The Guidelines-Resuscitation registry between January 2000 and December 2015. PATIENTS: Pediatric patients (< 18 yr old) who achieved return of spontaneous circulation...
December 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29239953/the-impact-of-prehospital-tranexamic-acid-on-blood-coagulation-in-trauma-patients
#15
Philipp Stein, Jan-Dirk Studt, Roland Albrecht, Stefan Müller, Dieter von Ow, Simon Fischer, Burkhardt Seifert, Sergio Mariotti, Donat R Spahn, Oliver M Theusinger
BACKGROUND: There is limited data on prehospital administration of tranexamic acid (TXA) in civilian trauma. The aim of this study was to evaluate changes in coagulation after severe trauma from on-scene to the hospital after TXA application in comparison to a previous study without TXA. METHODS: The study protocol was registered at ClinicalTrials.gov (NCT02354885). A prospective, multicenter, observational study investigating coagulation status in 70 trauma patients receiving TXA (1 g intravenously) on-scene versus a control group of 38 patients previously published without TXA...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29239852/management-specificities-for-abdominal-pelvic-and-vascular-penetrating-trauma
#16
E Hornez, F Béranger, T Monchal, Y Baudouin, G Boddaert, H De Lesquen, S Bourgouin, Y Goudard, B Malgras, G Pauleau, V Reslinger, N Mocellin, C Natale, L Meyrat, J-P Avaro, P Balandraud, S Gaujoux, S Bonnet
Management of patients with penetrating trauma of the abdomen, pelvis and their surrounding compartments as well as vascular injuries depends on the patient's hemodynamic status. Multiple associated lesions are the rule. Their severity is directly correlated with initial bleeding, the risk of secondary sepsis, and lastly to sequelae. In patients who are hemodynamically unstable, the goal of management is to rapidly obtain hemostasis. This mandates initial laparotomy for abdominal wounds, extra-peritoneal packing (EPP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) in the emergency room for pelvic wounds, insertion of temporary vascular shunts (TVS) for proximal limb injuries, ligation for distal vascular injuries, and control of exteriorized extremity bleeding with a tourniquet, compressive or hemostatic dressings for bleeding at the junction or borderline between two compartments, as appropriate...
November 24, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29239577/mechanical-compression-devices-for-cardiac-arrest-report-of-three-cases
#17
Marjut Varpula, Piia Simonen, Jouni Nurmi, Jukka Lehtonen, Ilkka Tierala
Mechanical compression devices enable transportation of patients with cardiac arrest to the catheterization laboratory. Coronary angiography and coronary interventions can be performed while the patients are being resuscitated with these devices. In this report, we describe three cases in whom resuscitation with mechanical compression devices and rapid transportation to the catheterization laboratory resulted in favorable cardiac and neurological outcome.
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29238847/which-pre-hospital-triage-parameters-indicate-a-need-for-immediate-evaluation-and-treatment-of-severely-injured-patients-in-the-resuscitation-area
#18
K O Jensen, R Heyard, D Schmitt, L Mica, C Ossendorf, H P Simmen, G A Wanner, C M L Werner, L Held, K Sprengel
PURPOSE: To find ways to reduce the rate of over-triage without drastically increasing the rate of under-triage, we applied a current guideline and identified relevant pre-hospital triage predictors that indicate the need for immediate evaluation and treatment of severely injured patients in the resuscitation area. METHODS: Data for adult trauma patients admitted to our level-1 trauma centre in a one year period were collected. Outpatients were excluded. Correct triage for trauma team activation was identified for patients with an ISS or NISS ≥ 16 or the need for ICU treatment due to trauma sequelae...
December 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29237674/tension-pneumothorax-and-diffuse-subcutaneous-emphysema-as-a-complication-of-cardiopulmonary-resuscitation
#19
Ahmad Sharayah, Dileep Unnikrishnan, Prem Shanker Shukla, Douglas Livornese
No abstract text is available yet for this article.
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29237658/emergency-salpingectomy-for-ruptured-ectopic-pregnancy-in-patient-with-melnick-needles-syndrome-a-rare-otopalatodigital-syndrome
#20
Mark Zachary Johnson, Cormac Francis Mullins, Declan Keane, Ingrid Browne
Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35 kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal/epidural anaesthesia...
December 13, 2017: BMJ Case Reports
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