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Resuscitation

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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/27920829/clinical-and-genetic-features-of-australian-families-with-long-qt-syndrome-a-registry-based-study
#2
Charlotte Burns, Jodie Ingles, Andrew M Davis, Vanessa Connell, Belinda Gray, Lauren Hunt, Julie McGaughran, Christopher Semsarian
BACKGROUND: Familial long QT syndrome (LQTS) is a primary arrhythmogenic disorder caused by mutations in ion channel genes. The phenotype ranges from asymptomatic individuals to sudden cardiac arrest and death. LQTS is a rare but significant health problem for which global data should exist. This study sought to provide the first clinical and genetic description of Australian families with LQTS. METHODS: We performed a cross-sectional study to evaluate clinical and genetic features of families with LQTS...
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27920046/resuscitation-of-infants-with-congenital-diaphragmatic-hernia
#3
Anthony O'Rourke-Potocki, Kamal Ali, Vadivelam Murthy, Anthony Milner, Anne Greenough
OBJECTIVE: To determine whether the respiratory response to resuscitation in infants with congenital diaphragmatic hernia (CDH) as measured by a respiratory function monitor differed between those who did and did not survive. DESIGN: Observational study. SETTING: Tertiary perinatal centre. PATIENTS: Thirty-eight infants born at 34 weeks of gestation or greater and diagnosed antenatally with a CDH. INTERVENTIONS: Expiratory tidal volume (VTe), peak inflation pressure (PIP) and end-tidal carbon dioxide level (ETCO2) were simultaneously recorded during resuscitation using a respiratory function monitor...
December 5, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27918869/paramedic-initiated-cms-sepsis-core-measure-bundle-prior-to-hospital-arrival-a-stepwise-approach
#4
Jason G Walchok, Ronald G Pirrallo, Douglas Furmanek, Martin Lutz, Colt Shope, Brandi Giles, Greta Gue, Aaron Dix
BACKGROUND: To improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) implemented core measures that outline the initial treatment of the septic patient. These measures include initial blood culture collection prior to antibiotics, adequate intravenous fluid resuscitation, and early administration of broad spectrum antibiotics. We sought to determine if Paramedics can initiate the CMS sepsis core measure bundle in the prehospital field reliably. METHODS: This is a retrospective, case series from a 3rd service EMS system model in Greenville, South Carolina between November 17, 2014 and February 20, 2016...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918852/anomaly-detection-outperforms-logistic-regression-in-predicting-outcomes-in-trauma-patients
#5
Zachary D W Dezman, Chen Gao, Shiming Yang, Peter Hu, Li Yao, Hsiao-Chi Li, Chein-I Chang, Colin Mackenzie
OBJECTIVE: Recent advancements in trauma resuscitation have shown a great benefit of early identification and control of hemorrhage, which is the most common cause of death in injured patients. We introduce a new analytical approach, anomaly detection (AD), as an alternative method to the traditional logistic regression (LR) method in predicting which injured patients receive transfusions, intensive care, and other interventions. METHODS: We abstracted routinely collected prehospital vital sign data from patient records (adult patients who survived more than 15 minutes after being directly admitted to a level 1 trauma center)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918851/influence-of-a-100-m-simulated-in-water-rescue-on-cardiopulmonary-parameters
#6
Ana Sousa, Ricardo J Fernandes, Núria Rodríguez, J Arturo Abraldes
OBJECTIVE: Cardiopulmonary resuscitation (CPR) after a drowning episode is performed under fatigue conditions. However, the characterization of CPR in this context is still unknown. Our purpose was to investigate the effect of a 100-m simulated in-water rescue on CPR and physiological parameters in trained certified lifeguards. METHODS: Thirty trained certified lifeguards (age 24.6 ± 3.8 yrs; height 178.2 ± 7.4 cm and weight 76.9 ± 10.6 kg) completed two protocols using an adult manikin: (i) 4-min CPR after 4-min baseline conditions (CPR), and (ii) 4-min CPR after a 100-m simulated in-water rescue in the sea (CPR Rescue), both with a compression-ventilation ratio of 30:2...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918847/left-ventricular-compressions-improve-hemodynamics-in-a-swine-model-of-out-of-hospital-cardiac-arrest
#7
Kenton L Anderson, Maria G Castaneda, Susan M Boudreau, Danny J Sharon, Vikhyat S Bebarta
INTRODUCTION: We hypothesized that chest compressions located directly over the left ventricle (LV) would improve hemodynamics, including coronary perfusion pressure (CPP), and return of spontaneous circulation (ROSC) in a swine model of cardiac arrest. METHODS: Transthoracic echocardiography (echo) was used to mark the location of the aortic root and the center of the left ventricle on animals (n = 26) which were randomized to receive chest compressions in one of the two locations...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918639/evaluation-of-an-outpatient-protocol-in-the-treatment-of-canine-parvoviral-enteritis
#8
Emilee C Venn, Karolina Preisner, Pedro L Boscan, David C Twedt, Lauren A Sullivan
OBJECTIVE: To compare 2 treatment protocols (standard in-hospital versus modified outpatient) in affecting the duration of treatment or survival of dogs with parvoviral enteritis. DESIGN: Prospective, randomized study. SETTING: University teaching hospital. ANIMALS: Client-owned dogs with naturally acquired parvovirus were randomized to receive either an inpatient (n = 20) or outpatient (n = 20) treatment protocol. INTERVENTIONS: Both groups received intravenous (IV) fluid resuscitation and correction of hypoglycemia at hospital admission...
December 5, 2016: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/27917433/deaths-among-elderly-patients-in-the-emergency-department-a-needs-assessment-for-end-of-life-care
#9
Rakhee Yash Pal, Win Sen Kuan, Yiwen Koh, Kuhan Venugopal, Irwani Ibrahim
INTRODUCTION: Elderly patients with serious chronic diseases often present to the emergency department (ED) in the last moments of their life, many with identifiable trajectories of dying: organ failure; advanced cancer; and chronic frailty. These patients and their families may benefit more from good end-of-life (EOL) care provision than the standard resuscitative approach. This study aimed to determine the incidence and nature of death among patients aged 65 years and above in an ED, and characterise their trajectories of dying...
December 5, 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27917213/efficacy-of-early-skin-to-skin-contact-on-the-rate-of-exclusive-breastfeeding-in-term-neonates-a-randomized-controlled-trial
#10
Amit Sharma
BACKGROUND: Despite multiple benefits of breast milk, the rates of exclusive breastfeeding in developing countries are low. OBJECTIVE: To evaluate the efficacy of early skin -to -skin contact (SSC) on the rate of exclusive breastfeeding (EBF) at 6 weeks of age among term neonates born by vaginal delivery. METHODS: Term neonates born by vaginal delivery and did not require any resuscitation were randomized at birth to SSC (n=100) and control (n=100) group...
September 2016: African Health Sciences
https://www.readbyqxmd.com/read/27917163/severely-heat-injured-survivors-of-e-coli-o157-h7-atcc-43888-display-variable-and-heterogeneous-stress-resistance-behavior
#11
Elisa Gayán, Sander K Govers, Chris W Michiels, Abram Aertsen
Although minimal food processing strategies aim to eliminate foodborne pathogens and spoilage microorganisms through a combination of mild preservation techniques, little is actually known on the resistance behavior of the small fraction of microorganisms surviving an inimical treatment. In this study, the conduct of severely heat stressed survivors of E. coli O157:H7 ATCC 43888, as an indicator for the low infectious dose foodborne enterohemorrhagic strains, was examined throughout their resuscitation and outgrowth...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27916478/development-and-external-validation-of-a-model-predicting-death-after-surgery-in-patients-with-a-ruptured-abdominal-aortic-aneurysm-the-dutch-aneurysm-score
#12
G C I von Meijenfeldt, S C van Beek, F Bastos Gonçalves, H J M Verhagen, C J Zeebregts, A C Vahl, W Wisselink, M J van der Laan, R Balm
OBJECTIVE: The decision whether or not to proceed with surgical intervention of a patient with a ruptured abdominal aortic aneurysm (rAAA) is very difficult in daily practice. The primary objective of the present study was to develop and to externally validate a new prediction model: the Dutch Aneurysm Score (DAS). METHODS: With a prospective cohort of 10 hospitals (n = 508) the DAS was developed using a multivariate logistic regression model. Two retrospective cohorts with rAAA patients from two hospitals (n = 373) were used for external validation...
December 1, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27916210/heart-type-fatty-acid-binding-protein-in-the-assessment-of-acute-pulmonary-embolism
#13
Hai-Yan Qian, Ji Huang, Yue-Jin Yang, Yan-Min Yang, Zhi-Zhong Li, Jing-Mei Zhang
OBJECTIVE: To explore the predictive value of heart-type fatty acid binding protein (H-FABP) in the stratification and prognosis of patients with acute pulmonary embolism (APE). METHODS: According to risk stratification, 69 patients with APE admitted into the emergency department within 24 hours after onset were divided into the following 3 groups: high-risk group, moderate-risk group and low-risk group. H-FABP- and cardiac troponin I (cTNI)-positive rates of all groups were analyzed and compared, and the correlation between major adverse events (death, endotracheal intubation and cardiopulmonary resuscitation) and the cardiac markers (heart rate, arterial partial pressure of oxygen, right ventricular dimension, pulmonary arterial pressure, etc...
December 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27915265/the-ethics-of-unilateral-implantable-cardioverter-defibrillators-and-cardiac-resynchronization-therapy-with-defibrillator-deactivation-patient-perspectives
#14
Margaret Daeschler, Ralph J Verdino, James N Kirkpatrick
AIMS: Decisions about deactivation of implantable cardioverter defibrillators (ICDs) are complicated. Unilateral do-not-resuscitate (DNR) orders (against patient/family wishes) have been ethically justified in cases of medical futility. Unilateral deactivation of ICDs may be seen as a logical extension of a unilateral DNR order. However, the ethical implications of unilateral ICD deactivation have not been explored. METHODS AND RESULTS: Sixty patients who had an ICD or cardiac resynchronization therapy with defibrillator (CRT-D) were interviewed at a quaternary medical centre outpatient electrophysiology practice...
December 2, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27915124/a-literature-review-examining-the-barriers-to-the-implementation-of-family-witnessed-resuscitation-in-the-emergency-department
#15
REVIEW
Catherine Johnson
BACKGROUND: Caring for people near death in the Emergency Department (ED) is challenging for professionals, duty bound to respond to the needs of the dying. Family witnessed resuscitation (FWR) is practiced internationally, allowing relatives to be present at the time of a patient's death, offering comfort to the dying and aiding the bereaved along a healthy grief trajectory. AIM: The literature review elicits barriers to the implementation of FWR in the ED, examining why practice is sporadic despite numerous professional bodies calling for implementation...
November 30, 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/27914759/fluid-management-in-patients-with-trauma-restrictive-versus-liberal-approach
#16
REVIEW
Lee Palmer
Massive hemorrhage remains a major cause of traumatic deaths. The ideal fluid resuscitative strategy is much debated. Research has provided inconsistent results regarding which fluid strategy is ideal; the optimum fluid type, timing, and volume remains elusive. Aggressive large-volume resuscitation has been the mainstay based on controlled hemorrhage animal models. For uncontrolled hemorrhagic shock, liberal fluid resuscitative strategies exacerbate the lethal triad, invoke resuscitative injury, and increase mortality while more restrictive fluid strategies tend to ameliorate trauma-induced coagulopathy and favor a greater chance of survival...
December 1, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27914232/resuscitation-attempts-and-duration-in-traumatic-out-of-hospital-cardiac-arrest
#17
Ben Beck, Janet E Bray, Peter Cameron, Lahn Straney, Emily Andrew, Stephen Bernard, Karen Smith
BACKGROUND: This study aimed to understand factors associated with paramedics' decision to attempt resuscitation in traumatic out-of-hospital cardiac arrest (OHCA) and to characterise resuscitation attempts ≤10min in patients who die at the scene. METHODS: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all cases of traumatic OHCA between July 2008 and June 2014. We excluded cases <16 years of age or with a mechanism of hanging or drowning...
November 30, 2016: Resuscitation
https://www.readbyqxmd.com/read/27913992/c-type-natriuretic-peptide-prevents-kidney-injury-and-attenuates-oxidative-and-inflammatory-responses-in-hemorrhagic-shock
#18
Gan Chen, Xiang Song, Yujing Yin, Sha Xia, Qingjun Liu, Guoxing You, Lian Zhao, Hong Zhou
Oxidative stress induced by hemorrhagic shock (HS) initiates a systemic inflammatory response, which leads to subsequent kidney injury. This study assessed the efficacy of c-type natriuretic peptide (CNP) in attenuating kidney injury in a rat model of hemorrhagic shock and resuscitation (HS/R). Sodium pentobarbital-anesthetized adult male Wistar rats underwent HS induced by the withdrawal of blood to a mean arterial pressure of 30-35 mmHg for 50 min. Then, the animals received CNP (25 μg/kg) or vehicle (saline) intravenously, followed byresuscitation with 1...
December 2, 2016: Amino Acids
https://www.readbyqxmd.com/read/27913842/alfonso-luis-herrera-and-the-beginnings-of-evolutionism-and-studies-in-the-origin-of-life-in-mexico
#19
Ismael Ledesma-Mateos, H James Cleaves
Alfonso Luis Herrera (1868-1942) was a Mexican biologist, and significant as the principal promoter of Darwinian thought in that country. However, Herrera's thinking went beyond the evolution of living beings, and extended to the question of the origin of life itself and the place of living phenomena in the larger context of the cosmos. Perhaps more significantly, though now largely forgotten, Herrera was among the first to embark on an experimental program to understand the origin of life, one which may be seen as foundational for later workers, most notably Sidney Fox and Alexander Oparin, and which has been resuscitated recently...
December 2016: Journal of Molecular Evolution
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#20
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
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