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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/29053103/ultrasound-functional-imaging-in-an-i-ex-vivo-i-beating-porcine-heart-platform
#2
Niels J Petterson, Louis S Fixsen, Marcel C M Rutten, Nico H J Pijls, Frans N van de Vosse, Richard G P Lopata
In recent years, novel ultrasound functional imaging (UFI) techniques have been introduced to assess cardiac function by measuring, e.g., cardiac output (CO) and/or myocardial strain. Verification and reproducibility assessment in a realistic setting remain major issues. Simulations and phantoms are often unrealistic, whereas in vivo measurements often lack crucial hemodynamic parameters or ground truth data, or suffer from the large physiological and clinical variation between patients when attempting clinical validation...
October 20, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29052826/fournier-s-gangrene-a-retrospective-analysis-of-25-patients
#3
Metin Yücel, Adnan Özpek, Fatih Başak, Ali Kılıç, Ethem Ünal, Sema Yüksekdağ, Aylin Acar, Gürhan Baş
BACKGROUND: Fournier's gangrene is a surgical emergency that progresses rapidly and insidiously and results in high morbidity and mortality rates unless it is immediately diagnosed and managed. Here we analyze the outcomes of patients who were followed up and treated for Fournier's gangrene. METHODS: We conducted a retrospective analysis of the medical data of 25 patients operated on for Fournier's gangrene between January 2010 and June 2015. The diagnosis of Fournier's gangrene was made by performing a physical examination...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29052820/evaluation-of-different-treatment-protocols-for-combined-injury-induced-lung-injury-in-rabbits
#4
Xiao Bing Li
BACKGROUND: This study aims to evaluate the effectiveness of different treatment regimens on combined injury-induced lung injury. METHODS: Rabbits were subjected to non-lethal closed-chest bilateral lung contusion followed by a 30% total body surface area scald burn. The rabbits were randomly assigned to resuscitation groups that maintained a minimum mean arterial blood pressure of 70 mmHg using one of the following three methods: normal saline plus polygeline injection in a ratio of 1:1 (1:1G), normal saline plus polygeline injection in a ratio of 1:2 (1:2G), and normal saline plus polygeline injection in a ratio of 1:3 (1:3G), After injury, lung injury was assessed using lung wet-to-dry (W/D) weight ratio, enzyme-linked immunosorbent assay, and real-time PCR...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29051871/bilateral-divergent-shoulder-s-fracture-dislocation-case-in-an-ischemic-stroke-patient
#5
Atchi Walla, Faré Gnandi-Piou, Pilakimwé Egbohou, Komi Assogba, Mawuko Quacoe
INTRODUCTION: The literature review revealed that nowadays only about 15 cases of bilateral shoulder dislocation associated with the fracture of the upper end of the humerus have been published. The triad of lesional mechanism designated by the triple syndrome E composed of epilepsy, electrocution, and external trauma was the circumstances noted in which these fractures dislocations occur with migration of the two humeral heads either forward or backward. CASE REPORT: An architect of 36-year-old, right-handed, was admitted in emergency department for loss of knowledge of progressive installation...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29051106/can-teamwork-and-situational-awareness-sa-in-ed-resuscitations-be-improved-with-a-technological-cognitive-aid-design-and-a-pilot-study-of-a-team-situation-display
#6
A Parush, G Mastoras, A Bhandari, K Momtahan, K Day, B Weitzman, B Sohmer, A Cwinn, S J Hamstra, L Calder
Effective teamwork in ED resuscitations, including information sharing and situational awareness, could be degraded. Technological cognitive aids can facilitate effective teamwork. OBJECTIVE: This study focused on the design of an ED situation display and pilot test its influence on teamwork and situational awareness during simulated resuscitation scenarios. MATERIAL AND METHODS: The display design consisted of a central area showing the critical dynamic parameters of the interventions with an events time-line below it...
October 16, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29050836/emergency-department-nurses-experience-of-performing-cpr-in-south-korea
#7
Mi-Ran Lee, Chiyoung Cha
BACKGROUND: Emergency Department (ED) nurses often confront unexpected cardiopulmonary resuscitation (CPR) with little information about the patients. METHODS: This qualitative study explored the experience of performing CPR among ED nurses. Data collection took place between May and June 2016 using an online advertisement to recruit 17 ED nurses. Each participant was interviewed for 40-90min. Interviews were recorded and transcribed verbatim. Data analysis was conducted using a conventional content-analysis method...
October 16, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/29049294/impact-of-dynamic-changes-of-elevated-bilirubin-on-survival-in-patients-on-veno-arterial-extracorporeal-life-support-for-acute-circulatory-failure
#8
Miriam Freundt, Dirk Lunz, Alois Philipp, Bernd Panholzer, Matthias Lubnow, Christine Friedrich, Leopold Rupprecht, Stephan Hirt, Assad Haneya
AIMS: Veno-arterial extracorporeal life support (ECLS) is an established method to stabilize acute circulatory failure. Parameters and data on when to ideally wean circulatory support are limited. Bilirubin is a marker of end-organ damage. Therefore, the purpose of this large study was to evaluate the impact of dynamic changes of elevated bilirubin levels on survival in patients on ECLS. METHODS AND RESULTS: We reviewed 502 consecutive cases of ECLS from 2007 to 2015...
2017: PloS One
https://www.readbyqxmd.com/read/29049235/comparing-the-protective-performances-of-3-types-of-n95-filtering-facepiece-respirators-during-chest-compressions-a-randomized-simulation-study
#9
Hyungoo Shin, Jaehoon Oh, Tae Ho Lim, Hyunggoo Kang, Yeongtak Song, Sanghyun Lee
OBJECTIVE: Healthcare providers in emergency departments should wear respirators for infection protection. However, the wearer's vigorous movements during cardiopulmonary resuscitation may affect the protective performance of the respirator. Herein, we aimed to assess the effects of chest compressions (CCs) on the protective performance of respirators. METHODS: This crossover study evaluated 30 healthcare providers from 1 emergency department who performed CC with real-time feedback...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049137/effects-of-dextran-70-and-albumin-on-coagulation-in-experimental-hemorrhage-in-the-guinea-pig
#10
Ulf Schött, Thomas Kander, Peter Bentzer
BACKGROUND: Dextran-70 is a more potent plasma volume expander than albumin but use has been hampered because of it's antithrombotic properties. However, also albumin has antithrombotic properties and little is known about relative effects of these two colloids on coagulation in-vivo when controlling for differences in efficacy as plasma volume expanders. AIM: Compare effects of dextran-70 and albumin on coagulation at a dose resulting in equal plasma volume expansion...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29049132/one-year-survival-after-in-hospital-cardiac-arrest-does-pre-arrest-sepsis-matter
#11
Pia Koivikko, Olli Arola, Outi Inkinen, Minna Tallgren
AIM: Cardiac arrest is not a common complication of sepsis, although sepsis has been recognized as one condition behind cardiac arrest. Our aim was to evaluate the prevalence of sepsis among patients with in-hospital cardiac arrest (IHCA), and to determine if sepsis is associated with inferior outcome after IHCA. METHODS: All consecutive emergency team dispatches in Turku University Hospital in 2011-2014 (n = 607) were reviewed retrospectively to identify the patients undergoing cardiopulmonary resuscitation (CPR) for IHCA (n = 301)...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29049106/do-not-resuscitate-and-the-surgical-patient-not-a-contradiction-in-terms
#12
Elizabeth L Whitlock, Rondall K Lane
No abstract text is available yet for this article.
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29048264/counseling-parents-at-risk-of-delivery-of-an-extremely-premature-infant-differing-strategies
#13
Marlyse F Haward, Annie Janvier, John M Lorenz, Baruch Fischhoff
BACKGROUND: It is not known how neonatologists address the affective and cognitive loads on parents deciding whether to resuscitate infants born extremely preterm. This study explores expert neonatologists' views on these decision-making processes and their own roles in counseling parents. METHODS: Semi-structured interviews asked internationally recognized experts to share their perspectives on perinatal consultations. Their responses were subjected to thematic analysis...
October 19, 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/29047413/itactic-implementing-treatment-algorithms-for-the-correction-of-trauma-induced-coagulopathy-study-protocol-for-a-multicentre-randomised-controlled-trial
#14
Kjersti Baksaas-Aasen, Lewis Gall, Simon Eaglestone, Claire Rourke, Nicole P Juffermans, J Carel Goslings, Paal Aksel Naess, Susan van Dieren, Sisse Rye Ostrowski, Jakob Stensballe, Marc Maegele, Simon J Stanworth, Christine Gaarder, Karim Brohi, Per I Johansson
BACKGROUND: Traumatic injury is the fourth leading cause of death globally. Half of all trauma deaths are due to bleeding and most of these will occur within 6 h of injury. Haemorrhagic shock following injury has been shown to induce a clotting dysfunction within minutes, and this early trauma-induced coagulopathy (TIC) may exacerbate bleeding and is associated with higher mortality and morbidity. In spite of improved resuscitation strategies over the last decade, current transfusion therapy still fails to correct TIC during ongoing haemorrhage and evidence for the optimal management of bleeding trauma patients is lacking...
October 18, 2017: Trials
https://www.readbyqxmd.com/read/29046809/hospital-resuscitation-teams-a-review-of-the-risks-to-the-healthcare-worker
#15
REVIEW
Stephen M Vindigni, Juan N Lessing, David J Carlbom
BACKGROUND: "Code blue" events and related resuscitation efforts involve multidisciplinary bedside teams that implement specialized interventions aimed at patient revival. Activities include performing effective chest compressions, assessing and restoring a perfusing cardiac rhythm, stabilizing the airway, and treating the underlying cause of the arrest. While the existing critical care literature has appropriately focused on the patient, there has been a dearth of information discussing the various stresses to the healthcare team...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29046084/penetrating-neck-injuries-a-guide-to-evaluation-and-management
#16
J L Nowicki, B Stew, E Ooi
Introduction Penetrating neck injury is a relatively uncommon trauma presentation with the potential for significant morbidity and possible mortality. There are no international consensus guidelines on penetrating neck injury management and published reviews tend to focus on traditional zonal approaches. Recent improvements in imaging modalities have altered the way in which penetrating neck injuries are now best approached with a more conservative stance. A literature review was completed to provide clinicians with a current practice guideline for evaluation and management of penetrating neck injuries...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29045248/the-evolution-of-donation-after-circulatory-death-donor-kidney-repair-in-the-united-kingdom
#17
Sarah A Hosgood, Michael L Nicholson
PURPOSE OF REVIEW: The increasing reliance on marginal donors has driven research to investigate ways to repair and improve the quality of kidneys for transplantation. Normothermic perfusion technologies provide an opportunity for improved preservation, organ assessment and resuscitation/repair of damaged kidneys. This review describes the evolution of normothermic perfusion in kidney transplantation in the United Kingdom. RECENT FINDINGS: One hour of normothermic perfusion can be used to restore function and improve early graft function of extended criteria donor kidneys...
October 17, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29045241/taking-assent-to-new-heights-a-case-report-on-do-not-resuscitate-status-in-pediatric-palliative-care-procedures
#18
Heather A Ballard, Santhanam Suresh
Dying adolescents presenting for palliative procedures have complicated developmental and ethical issues, especially when reconsidering do-not-resuscitate orders. Though the American Academy of Pediatrics has guidelines, there is limited information in the literature on how to take care of these patients. We describe the case of a 14-year-old patient presenting to the interventional radiology suite for management of superior vena cava syndrome. The patient's goals of treatment were elucidated through a comprehensive care team consisting of the procedural and oncology teams...
October 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29044938/hot-off-the-press-prehospital-advanced-cardiac-life-support-for-out-of-hospital-cardiac-arrest
#19
Corey Heitz, Justin Morgenstern, William K Milne
This retrospective cohort study examined the rate of survival to hospital discharge among adult patients with out of hospital cardiac arrest (OHCA), comparing patients who received care only from basic cardiac life support (BCLS) trained emergency medical service (EMS) crews to patients who had an advanced cardiac life support (ACLS) trained EMS crew on scene at some point during the resuscitation. There was no difference in the primary outcome of rate of survival to hospital discharge (10.9% with ACLS care and 10...
October 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29044790/acute-appendicitis
#20
REVIEW
Mark D Stringer
Acute appendicitis is the most common reason for abdominal surgery in children. Luminal obstruction of the appendix progresses to suppurative inflammation and perforation, which causes generalised peritonitis or an appendix mass/abscess. Classical features include periumbilical pain that migrates to the right iliac fossa, anorexia, fever, and tenderness and guarding in the right iliac fossa. Atypical presentations are particularly common in preschool children. A clinical diagnosis is possible in most cases, after a period of active observation if necessary; inflammatory markers and an ultrasound scan are useful investigations when the diagnosis is uncertain...
October 17, 2017: Journal of Paediatrics and Child Health
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