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Rapid response teams

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https://www.readbyqxmd.com/read/29456191/comparative-efficacy-of-low-dose-versus-standard-dose-azithromycin-for-patients-with-yaws-a-randomised-non-inferiority-trial-in-ghana-and-papua-new-guinea
#1
Michael Marks, Oriol Mitjà, Christian Bottomley, Cynthia Kwakye, Wendy Houinei, Mathias Bauri, Paul Adwere, Abdul A Abdulai, Fredrick Dua, Laud Boateng, James Wangi, Sally-Ann Ohene, Regina Wangnapi, Shirley V Simpson, Helen Miag, Kennedy K Addo, Laud A Basing, Damien Danavall, Kai H Chi, Allan Pillay, Ronald Ballard, Anthony W Solomon, Cheng Y Chen, Sibauk V Bieb, Yaw Adu-Sarkodie, David C W Mabey, Kingsley Asiedu
BACKGROUND: A dose of 30 mg/kg of azithromycin is recommended for treatment of yaws, a disease targeted for global eradication. Treatment with 20 mg/kg of azithromycin is recommended for the elimination of trachoma as a public health problem. In some settings, these diseases are co-endemic. We aimed to determine the efficacy of 20 mg/kg of azithromycin compared with 30 mg/kg azithromycin for the treatment of active and latent yaws. METHODS: We did a non-inferiority, open-label, randomised controlled trial in children aged 6-15 years who were recruited from schools in Ghana and schools and the community in Papua New Guinea...
February 15, 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29415710/maternal-mental-health-priorities-help-seeking-behaviors-and-resources-in-post-conflict-settings-a-qualitative-study-in-eastern-uganda
#2
Wietse A Tol, BreeOna Ebrecht, Rebecca Aiyo, Sarah M Murray, Amanda J Nguyen, Brandon A Kohrt, Sheila Ndyanabangi, Stephen Alderman, Seggane Musisi, Juliet Nakku
BACKGROUND: Limited knowledge exists to inform the selection and introduction of locally relevant, feasible, and effective mental health interventions in diverse socio-cultural contexts and health systems. We examined stakeholders' perspectives on mental health-related priorities, help-seeking behaviors, and existing resources to guide the development of a maternal mental health component for integration into non-specialized care in Soroti, eastern Uganda. METHODS: We employed rapid ethnographic methods (free listing and ranking; semi-structured interviews; key informant interviews and pile sorting) with community health workers (n = 24), primary health workers (n = 26), perinatal women (n = 24), traditional and religious healers (n = 10), and mental health specialists (n = 9)...
February 7, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29415364/assessment-of-potential-opioid-toxicity-and-response-to-naloxone-by-rapid-response-teams-at-an-urban-melbourne-hospital
#3
Bharathy Gunasekaran, Jennifer Weil, Tom Whelan, John Santamaria, Mark Boughey
Opioid prescriptions have significantly increased in recent years and are used for a wide variety of indications. Electronic medical records of 45 patients who received naloxone by a rapid response team over an 18-month period were retrospectively reviewed. This study found inconsistencies in the management of possible opioid toxicity with variation in the total naloxone dose and number of doses administered. This highlights the importance of a standardised protocol for recognition and management of opioid overdose...
February 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29406182/guidelines-for-the-management-of-tracheal-intubation-in-critically-ill-adults
#4
A Higgs, B A McGrath, C Goddard, J Rangasami, G Suntharalingam, R Gale, T M Cook
These guidelines describe a comprehensive strategy to optimize oxygenation, airway management, and tracheal intubation in critically ill patients, in all hospital locations. They are a direct response to the 4 th National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society, which highlighted deficient management of these extremely vulnerable patients leading to major complications and avoidable deaths. They are founded on robust evidence where available, supplemented by expert consensus opinion where it is not...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29389465/a-novel-bedside-focused-ward-surveillance-and-response-system
#5
Frank Sebat, Mary Anne Vandegrift, Sid Childers, Geoffrey K Lighthall
BACKGROUND: Rapid response systems (RRSs) have been universally adopted in much of the developed world; yet, despite broad implementation, their success has often been limited. Even with successful systems, there is a small body of evidence regarding effective organizational elements that are responsible for improved outcomes. New organizational processes were implemented that restructured the existing RRS, and the impact on the number of rapid response team (RRT) alerts, cardiac arrest, and mortality rates was evaluated...
February 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29386716/guidelines-for-medical-management-of-nuclear-radiation-emergencies
#6
REVIEW
Velu Nair, D N Karan, C S Makhani
Management of victim of radiation injury poses a wide spectrum of challenges to the health care provider starting with the evaluation of the damage, the kind of hospitalization and treatment and the regular monitoring of the patient. Undesirable clinical outcomes are probable if prodromal stage evolves rapidly and is severe. Critical systems like neurovascular, gastrointestinal, haematopoietic and cutaneous are afflicted in Acute Radiation Syndrome. Three main elements which are essential for assessment of prognosis and selection of treatment are vomiting onset time, kinetics of depletion of lymphocyte, and chromosome abnormalities...
October 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/29355793/position-of-the-french-working-group-on-perioperative-haemostasis-gihp-on-viscoelastic-tests-what-role-for-which-indication-in-bleeding-situations
#7
Stéphanie Roullet, Emmanuel de Maistre, Brigitte Ickx, Normand Blais, Sophie Susen, David Faraoni, Delphine Garrigue, Fanny Bonhomme, Anne Godier, Dominique Lasne
PURPOSE: Viscoelastic tests (VETs), thromboelastography (TEG®) and thromboelastometry (ROTEM®) are global tests of coagulation performed on whole blood. They evaluate the mechanical strength of a clot as it builds and develops after coagulation itself. The time required to obtain haemostasis results remains a major problem for clinicians dealing with bleeding, although some teams have developed a rapid laboratory response strategy. Indeed, the value of rapid point-of-care diagnostic devices such as VETs has increased over the years...
January 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29350541/using-cell-phone-technology-to-investigate-a-deliberate-bacillus-anthracis-release-scenario
#8
Arik Eisenkraft, Amichay Afriat, Yechiel Hubary, Ron Lev, Hayim Shaul, Ran D Balicer
Unusual biological events and outbreaks require rapid epidemiologic investigation and contact tracing procedures, allowing optimal handling of resources. Currently, these are resource intensive, time consuming, and extremely complex, requiring large teams of trained and prepared personnel. The goal of this study was to determine whether a technological alternative to the classic systems, based on the use of mobile phones and a unique algorithm, could perform a complete epidemiologic investigation in a setting of a bioterrorism scenario...
January 19, 2018: Health Security
https://www.readbyqxmd.com/read/29347952/the-german-quality-network-sepsis-study-protocol-for-the-evaluation-of-a-quality-collaborative-on-decreasing-sepsis-related-mortality-in-a-quasi-experimental-difference-in-differences-design
#9
Daniel Schwarzkopf, Hendrik Rüddel, Matthias Gründling, Christian Putensen, Konrad Reinhart
BACKGROUND: While sepsis-related mortality decreased substantially in other developed countries, mortality of severe sepsis remained as high as 44% in Germany. A recent German cluster randomized trial was not able to improve guideline adherence and decrease sepsis-related mortality within the participating hospitals, partly based on lacking support by hospital management and lacking resources for documentation of prospective data. Thus, more pragmatic approaches are needed to improve quality of sepsis care in Germany...
January 18, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29346176/rapid-response-to-scan-or-not-to-scan-the-utility-of-noncontrast-ct-head-for-altered-mental-status
#10
Purujit J Thacker, Mansha Sethi, Jonathan Sternlieb, Doron Schneider, Mary Naglak, Rajeshkumar R Patel
OBJECTIVES: The aims of the study were the following: (1) to determine how often computed tomography (CT) scans of the head are obtained on rapid responses called for altered mental status (AMS), (2) to determine whether CT imaging of the head is required during all rapid responses called for AMS, (3) to determine which patients would benefit from CT scans of the head in this setting, (4) to note whether an adequate neurologic exam was documented, (5) to determine the cost of CT scans that did not change management, and (6) to examine the role of medications leading to AMS...
January 17, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29341963/role-of-the-anesthesiologist-intensivist-outside-the-icu-opportunity-to-add-value-for-the-hospital-or-an-unnecessary-distraction
#11
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29304039/establishing-ebola-virus-disease-evd-diagnostics-using-genexpert-technology-at-a-mobile-laboratory-in-liberia-impact-on-outbreak-response-case-management-and-laboratory-systems-strengthening
#12
Philomena Raftery, Orla Condell, Christine Wasunna, Jonathan Kpaka, Ruth Zwizwai, Mahmood Nuha, Mosoka Fallah, Maxwell Freeman, Victoria Harris, Mark Miller, April Baller, Moses Massaquoi, Victoria Katawera, John Saindon, Philip Bemah, Esther Hamblion, Evelyn Castle, Desmond Williams, Alex Gasasira, Tolbert Nyenswah
The 2014-16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening...
January 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29303946/use-of-rapid-response-teams-in-psychiatry-variables-that-impact-safety
#13
Ryan Greytak, Joanna Y Wang, Yea-Jen Hsu, Jill Marsteller, Geetha Jayaram
OBJECTIVE: The addition of rapid response teams (RRTs) has emerged as a treatment option for medically deteriorating psychiatric inpatients. The goal of this study was to identify risk factors for use of RRTs at the time of initial psychiatric evaluation and develop measures to predict use of this emergent medical intervention. We have not located any studies that have previously addressed this issue. METHODS: We studied the use of RRTs and code teams (CTs) on inpatient general and specialty psychiatric services in a large urban academic psychiatric hospital...
November 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/29302603/what-are-the-ethical-dimensions-in-the-profession-of-intensive-care-specialist
#14
REVIEW
Jean-Pierre Quenot, Fiona Ecarnot, Nicolas Meunier-Beillard, Auguste Dargent, Jean-Pierre Eraldi, François Bougerol, Audrey Large, Pascal Andreu, Jean-Philippe Rigaud
Two essential components of the profession of a medical doctor are the constant review of the patient's therapeutic project, and collaboration between healthcare professionals. The profession of intensive care unit (ICU) physician goes further in terms of responsibility, vis-à-vis the intensive treatments dispensed to the patients, and the physician's responsibilities towards the patient's family and the caregiving team, also bearing in mind that ICU care is costly in terms of human and financial resources...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298314/improving-mapping-for-ebola-response-through-mobilising-a-local-community-with-self-owned-smartphones-tonkolili-district-sierra-leone-january-2015
#15
Laura M Nic Lochlainn, Ivan Gayton, Georgios Theocharopoulos, Robin Edwards, Kostas Danis, Ronald Kremer, Karline Kleijer, Sumaila M Tejan, Mohamed Sankoh, Augustin Jimissa, Jane Greig, Grazia Caleo
BACKGROUND: During the 2014-16 Ebola virus disease (EVD) outbreak, the Magburaka Ebola Management Centre (EMC) operated by Médecins Sans Frontières (MSF) in Tonkolili District, Sierra Leone, identified that available district maps lacked up-to-date village information to facilitate timely implementation of EVD control strategies. In January 2015, we undertook a survey in chiefdoms within the MSF EMC catchment area to collect mapping and village data. We explore the feasibility and cost to mobilise a local community for this survey, describe validation against existing mapping sources and use of the data to prioritise areas for interventions, and lessons learned...
2018: PloS One
https://www.readbyqxmd.com/read/29297390/methodology-for-a-mixed-methods-multi-country-study-to-assess-recognition-of-and-response-to-maternal-and-newborn-illness
#16
Allisyn C Moran, Danielle Charlet, Supriya Madhavan, Kumudha Aruldas, Marie Donaldson, Fatuma Manzi, Monica Okuga, Alfonso Rosales, Vandana Sharma, Michael Celone, Neal Brandes, James M Sherry
BACKGROUND: Although maternal and newborn mortality have decreased 44 and 46% respectively between 1990 and 2015, achievement of ambitious Sustainable Development Goal targets requires accelerated progress. Mortality reduction requires a renewed focus on the continuum of maternal and newborn care from the household to the health facility. Although barriers to accessing skilled care are documented for specific contexts, there is a lack of systematic evidence on how women and families identify maternal and newborn illness and make decisions and subsequent care-seeking patterns...
December 21, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29283868/a-review-of-the-essential-components-of-quality-palliative-care-in-the-home
#17
Hsien Seow, Daryl Bainbridge
OBJECTIVE: The home is an important and often preferable setting of palliative care. While much research has demonstrated the benefits of specialized palliative homecare on patient and system outcomes, there has been little delineation of the underlying components of these efficacious programs. We synthesized the essential elements of palliative homecare from a combined review of successful programs, perspectives of patients and caregivers, and views of healthcare providers in palliative care...
January 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29280908/expanding-the-presence-of-primary-services-at-rapid-response-team-activations-a-quality-improvement-project
#18
Alice Gallo de Moraes, John C OʼHoro, Ronaldo A Sevilla-Berrios, Gina Iacovella, Andrea Lenhertz, Julie Schmidt, Jennifer Elmer, Richard Oeckler, Sean Caples, Jeffrey B Jensen
Rapid response teams (RRTs) were implemented to provide critical care services for deteriorating patients outside of intensive care units. To date, research on RRT has been conflicting, with some studies showing significant mortality benefit and reduction in cardiac arrest events and others showing no benefit. However, studies have consistently showed improved outcomes when RRTs work closely with primary services. Baseline data analysis at our institution found that primary services were present only on 50% of RRT activations...
January 2018: Quality Management in Health Care
https://www.readbyqxmd.com/read/29279338/rapid-response-teams-in-pediatric-patients-well-intentioned-but-do-they-really-help
#19
EDITORIAL
Joshua Koch, Sandeep R Das
No abstract text is available yet for this article.
January 2, 2018: Circulation
https://www.readbyqxmd.com/read/29278987/impact-of-pharmacist-intervention-on-selection-and-timing-of-appropriate-antimicrobial-therapy-in-septic-shock
#20
Melanie E Laine, Jeremy D Flynn, Alexander H Flannery
BACKGROUND: Current guidelines for septic shock management recommend administration of appropriate, broad-spectrum antimicrobials within 1 hour of recognition. OBJECTIVE: To evaluate the interventions pharmacists make as part of a sepsis response team and to determine if these interventions increase the proportion of patients with appropriate empiric antimicrobial therapy. METHODS: A retrospective cohort study was undertaken reviewing adult patients in a large, academic medical center with confirmed septic shock who had an order for a "sepsis bundle," which includes notification of a pharmacist to assess adequacy of empiric therapy...
February 2018: Journal of Pharmacy Practice
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