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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/28634651/focus-issue-european-journal-of-trauma-and-emergency-surgery-on-volume-resuscitation-and-coagulation-focus-on-volume-resuscitation-and-coagulation-to-improve-outcomes-in-acute-trauma-haemorrhage
#2
EDITORIAL
M Maegele, T Lustenberger
No abstract text is available yet for this article.
June 20, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28634504/the-reemergence-of-eeg-reactivity-after-cardiac-arrest
#3
Joseph Zachariah, Alejandro A Rabinstein
Electroencephalogram (EEG) reactivity has been increasingly utilized in prognostication after cardiac arrest. Recent studies have demonstrated a false-positive rate of 0% in predicting poor outcome with a nonreactive EEG. The reemergence of reactivity after an initial nonreactive EEG has been noted in cases of drug intoxication, rewarming after hypothermia, and after discontinuing sedation. This is the first case describing the reemergence of EEG reactivity without the confounding factors listed above. We describe a case of resuscitated cardiac arrest with initial EEG demonstrating a lack of reactivity...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28633805/somatic-support-following-cardiac-arrest-for-90%C3%A2-days-leading-to-a-healthy-baby-boy-a-case-report
#4
Sarah Holliday, Barbara Magnuson-Woodward
Due to a lack of published case reports regarding the somatic support of brain dead pregnant patients, each one adds to the limited knowledge that directs care for this patient population. A young woman experienced a cardiac arrest and was subsequently determined to be approximately 20 weeks pregnant following cardio pulmonary resuscitation. Soon after, she was diagnosed as brain dead, but her family chose to keep her supported in hopes of the delivery of a healthy child. She was transferred to our facility, where she was supported after being diagnosed as brain dead for a total of 90 days and delivered a healthy baby boy at almost 32 weeks gestational age...
June 17, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28633761/the-opinion-of-health-professionals-regarding-the-presence-of-relatives-during-cardiopulmonary-resucitation
#5
J M Asencio-Gutiérrez, I Reguera-Burgos
BACKGROUND: The latest recommendations from the American Heart Association and the European Resuscitation Council invite allowance for the presence of relatives (PR) during cardiopulmonary resuscitation (CPR) as an extra measure of family care. OBJECTIVE: To discover the opinion of health professionals on the PR during CPR. METHOD: Cross-sectional observational study through an online survey in Spain, based on a non-probability sample (n=315)...
June 17, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28633090/pulmonary-and-cardiac-pathology-in-sudden-unexpected-death-in-epilepsy-sudep
#6
REVIEW
Fábio A Nascimento, Zian H Tseng, Cristian Palmiere, Joseph J Maleszewski, Takayuki Shiomi, Aileen McCrillis, Orrin Devinsky
OBJECTIVE: To review studies on structural pulmonary and cardiac changes in SUDEP cases as well as studies showing pulmonary or cardiac structural changes in living epilepsy patients. METHODS: We conducted electronic literature searches using the PubMed database for articles published in English, regardless of publication year, that included data on cardiac and/or pulmonary structural abnormalities in SUDEP cases or in living epilepsy patients during the postictal period...
June 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28632583/incremental-balloon-deflation-following-complete-resuscitative-endovascular-balloon-occlusion-of-the-aorta-results-in-steep-inflection-of-flow-and-rapid-reperfusion-in-a-large-animal-model-of-hemorrhagic-shock
#7
Anders J Davidson, Rachel M Russo, Sarah-Ashley E Ferencz, Jeremy W Cannon, Todd E Rasmussen, Lucas P Neff, M Austin Johnson, Timothy K Williams
INTRODUCTION: To avoid potential cardiovascular collapse after resuscitative endovascular balloon occlusion of the aorta (REBOA), current guidelines recommend methodically deflating the balloon for 5 minutes to gradually reperfuse distal tissue beds. However, anecdotal evidence suggests that this approach may still result in unpredictable aortic flow rates and hemodynamic instability. We sought to characterize aortic flow dynamics following REBOA as the balloon is deflated in accordance with current practice guidelines...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28632582/the-effect-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-partial-aortic-occlusion-and-aggressive-blood-transfusion-on-traumatic-brain-injury-in-a-swine-multiple-injuries-model
#8
M Austin Johnson, Timothy K Williams, Sarah-Ashley E Ferencz, Anders J Davidson, Rachel M Russo, William T O'Brien, Joseph M Galante, J Kevin Grayson, Lucas P Neff
BACKGROUND: Despite clinical reports of poor outcomes, the degree to which resuscitative endovascular balloon occlusion of the aorta (REBOA) exacerbates traumatic brain injury (TBI) is not known. We hypothesized that combined effects of increased proximal mean arterial pressure (pMAP), carotid blood flow (Qcarotid), and intracranial pressure (ICP) from REBOA would lead to TBI progression compared with partial aortic occlusion (PAO) or no intervention. METHODS: Twenty-one swine underwent a standardized TBI via computer Controlled cortical impact followed by 25% total blood volume rapid hemorrhage...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#9
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
BACKGROUND: Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS: This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28631394/helping-babies-breathe-implementation-in-zanzibar-tanzania
#10
Gina Marie Wilson, Ame Masemo Ame, Maimuna Mohamed Khatib, Elizabeth K Rende, Ann Michelle Hartman, Jane Blood-Siegfried
AIM: To assess the efficacy and feasibility of implementing Helping Babies Breathe, a neonatal resuscitation programme for resource-limited environments. BACKGROUND: This quality improvement project focused on training midwives on Helping Babies Breathe to address high rates of neonatal mortality secondary to birth asphyxia. METHODS: The convenience sample was 33 midwives in Zanzibar, Tanzania. The train-the-trainer strategy with repeated measures design was used to assess knowledge and skills at 3 time points...
June 19, 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28630852/adult-traumatic-inferior-hip-dislocation-rare-case-ended-with-open-reduction
#11
Salam Ismael, J Vora, P Thomas
INTRODUCTION: An inferior hip dislocation also called luxatio erecta femoris is a rare type of hip dislocation that is not widely reported in literature. Only 12 cases are reported in British literature. CASE REPORT: This article reports a 17-year-old male involved in a road traffic accident, sustaining inferior hip dislocation. Following resuscitation, computed tomography confirmed the clinical diagnoses. Several attempts to perform a closed reduction of the hip under sedation and general anesthesia failed to reduce the dislocation...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630388/spontaneous-liver-rupture-associated-with-anticoagulant-therapy-a-case-report
#12
Marco Clementi, Sara Colozzi, Stefano Guadagni, Beatrice Pessia, Federico Sista, Mario Schietroma, Andrea Della Penna, Gianfranco Amicucci
Spontaneous hepatic rupture without underlying liver diseases is uncommon entity. We report a rare case of spontaneous rupture of liver hematoma in patient treated with warfarin end enoxaparin sodium because of pulmonary embolism. Two day after admission the patient complained generalized abdominal pain and hemodynamic instability. The abdominal US and TC scan revealed free fluid and lesion at right liver lobe. The patient, despite intravenous fluid support and blood transfusion, was hemodinamically instable and urgent laparotomy was needed...
January 20, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28630246/ominous-triad-triggered-by-high-dose-glucocorticosteroid-therapy
#13
Sarah Bär, Fritz Daudel, Thomas Zueger
Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28629995/intraosseous-compared-to-intravenous-drug-resuscitation-in-out-of-hospital-cardiac-arrest
#14
Bryan A Feinstein, Benjamin A Stubbs, Tom Rea, Peter J Kudenchuk
AIMS: Although the intraosseous (IO) route is increasingly used for vascular access in out-of-hospital cardiac arrest (OHCA), little is known about its comparative effectiveness relative to intravenous (IV) access. We evaluated clinical outcomes following OHCA comparing drug administration via IO versus IV routes. METHODS: This retrospective cohort study evaluated Emergency Medical Services (EMS)-treated adults with atraumatic OHCA in a large metropolitan EMS system between 9/1/2012-12/31/2014...
June 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28629957/chemical-hand-warmer-packet-ingestion-a-case-of-elemental-iron-exposure
#15
Jessica L Weiland, Leighanne K Sherrow, Deepak A Jayant, Kenneth D Katz
For individuals who work outdoors in the winter or play winter sports, chemical hand warmers are becoming increasingly more commonplace because of their convenience and effectiveness. A 32-year-old woman with a history of chronic pain and bipolar disorder presented to the emergency department complaining of a "warm sensation" in her mouth and epigastrium after reportedly ingesting the partial contents of a chemical hand warmer packet containing between 5 and 8 g of elemental iron. She had been complaining of abdominal pain for approximately 1 month and was prescribed unknown antibiotics the previous day...
June 16, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28629581/impact-of-a-teamstepps-trauma-nurse-academy-at-a-level-1-trauma-center
#16
V Kristen Peters, Ellen M Harvey, Andi Wright, Jennifer Bath, Dan Freeman, Bryan Collier
PROBLEM: Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. METHODS: Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers...
June 16, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28628603/field-and-en-route-resuscitative-endovascular-occlusion-of-the-aorta-a-feasible-military-reality
#17
Viktor A Reva, Tal M Hörer, Andrey I Makhnovskiy, Mikhail V Sokhranov, Igor M Samokhvalov, Joseph J DuBose
BACKGROUND: Severe noncompressible torso hemorrhage remains a leading cause of potentially preventable death in modern military conflicts. Resuscitative endovascular occlusion of the aorta (REBOA) has demonstrated potential as an effective adjunct to the treatment of noncompressible torso hemorrhage in the civilian early hospital and even prehospital settings-but the application of this technology for military prehospital use has not been well described. We aimed to assess the feasibility of both field and en route prehospital REBOA in the military exercise setting, simulating a modern armed conflict...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28628601/the-damage-control-surgery-in-austere-environments-research-group-dcsaerg-a-dynamic-program-to-facilitate-real-time-telementoring-telediagnosis-to-address-exsanguination-in-extreme-and-austere-environments
#18
Andrew W Kirkpatrick, Jessica L McKee, Paul B McBeth, Chad G Ball, Anthony LaPorta, Timothy Broderick, Tim Leslie, David King, Heather E Wright Beatty, Jocelyn Keillor, Homer Tien
Hemorrhage is the most preventable cause of posttraumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or resuscitative surgery in austere environments. Revolutions in technology for remote mentoring of ultrasound and surgery may enhance capabilities to utilize the skill sets of non-physicians. Thus, our research collaborative explored remote mentoring to empower non-physicians to address junctional and torso hemorrhage control in austere environments...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28627649/hypoxia-serves-a-key-function-in-the-upregulated-expression-of-vascular-adhesion-protein%C3%A2-1-in%C3%A2-vitro-and-in-a-rat-model-of-hemorrhagic-shock
#19
Yuxing Zhang, Wei Yi, Jun Yao, Xiaojun Yu, Cheng Qian, Zhiqian Hu
Hemorrhagic shock following major trauma results in mortality, but the function of vascular adhesion protein‑1 (VAP‑1), implicated in intracranial hemorrhage, remains unknown. This study aimed to determine whether expression of the AOC3 gene and its encoded protein, VAP‑1, is altered by hypoxia. Rat hepatic sinusoidal endothelial cells (RHSECs) and rat intestinal microvascular endothelial cells (RIMECs) were transduced with a viral vector carrying AOC3, and AOC3 mRNA expression levels were measured by reverse transcription‑quantitative polymerase chain reaction...
June 8, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28627349/-clinical-application-of-cardiopulmonary-resuscitation-with-abdominal-lifting-and-compression-in-emergency-treatment
#20
Jie Wang, Guolan Wu, Ronghua Yang, Yonghong Wang, Shunping Wang, Honglin Li, Shouhui Wang, Manguo Zhao, Xusheng Li, Yan Peng
OBJECTIVE: To investigate the clinical value of cardiopulmonary resuscitation (CPR) with abdominal lifting and compression on patients with breathing and cardiac arrest induced by severe chest trauma. METHODS: Sixty-six breathing and cardiac arrest patients induced by severe chest trauma admitted to the General Hospital of Jingyuan Coal Industry Group Company from October 2011 to October 2016 were enrolled, and they were divided into abdominal lifting and compression group (n = 32) and unarmed abdominal compression group (n = 34) by random number table...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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