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Rapid response teams

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https://www.readbyqxmd.com/read/29039621/supporting-emergency-medical-care-teams-with-an-integrated-status-display-providing-real-time-access-to-medical-best-practices-workflow-tracking-and-patient-data
#1
PoLiang Wu, Min-Young Nam, Jeonghwan Choi, Alex Kirlik, Lui Sha, Richard B Berlin
The work of a hospital's medical staff is safety critical and often occurs under severe time constraints. To provide timely and effective cognitive support to medical teams working in such contexts, guidelines in the form of best practice workflows for healthcare have been developed by medical organizations. However, the high cognitive load imposed in such stressful and rapidly changing environments poses significant challenges to the medical staff or team in adhering to these workflows. In collaboration with physicians and nurses from Carle Foundation Hospital, we first studied and modeled medical team's individual responsibilities and interactions in cardiac arrest resuscitation and decomposed their overall task into a set of distinct cognitive tasks that must be specifically supported to achieve successful human-centered system design...
October 17, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29033819/an-unusual-presentation-of-pyoderma-gangrenosum-leading-to-systemic-inflammatory-response-syndrome
#2
Ali Didan, Alan Donnelly, Hock Chua
This is a report of an atypical presentation of pyoderma gangrenosum (PG) in a 26-year-old male who had a negative septic screen. The patient had a life-threatening presentation requiring an intensive care unit (ICU) admission for vasopressor support. It was thought that the likely cause of circulatory collapse was an overwhelming cytokine reaction or systemic inflammatory response syndrome (SIRS) secondary to extensive PG lesions rather than septic shock. The patient presented with multiple large ulcers, the largest being 4 cm in diameter on the central chest...
September 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/29033602/early-in-hospital-clinical-deterioration-is-not-predicted-by-severity-of-illness-functional-status-or-comorbidity
#3
Janice Wang, Stella S Hahn, Myriam Kline, Rubin I Cohen
BACKGROUND: Prior studies concentrated on unplanned intensive care unit (ICU) transfer to gauge deterioration occurring shortly following hospital admission. However, examining only ICU transfers is not ideal since patients could stabilize with treatment, refuse ICU admission, or not require ICU evaluation. To further explore etiologies of early clinical deterioration, we used rapid response team (RRT) activation within 48 hours of admission as an index of early clinical worsening. METHODS: A retrospective analysis of prospectively gathered admissions from the emergency department in an academic medical center was done...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29033032/ring-vaccination-with-rvsv-zebov-under-expanded-access-in-response-to-an-outbreak-of-ebola-virus-disease-in-guinea-2016-an-operational-and-vaccine-safety-report
#4
Pierre-Stéphane Gsell, Anton Camacho, Adam J Kucharski, Conall H Watson, Aminata Bagayoko, Severine Danmadji, Natalie E Dean, Abdourahamane Diallo, Abdourahmane Diallo, Honora Djidonou, Moussa Doumbia, Godwin Enwere, Elizabeth S Higgs, Thomas Mauget, Diakite Mory, Ximena Riveros, Fofana Thierno Oumar, Alhassane Toure, Andrea S Vicari, Ira M Longini, W J Edmunds, Ana Maria Henao-Restrepo, Marie Paule Kieny, Sakoba Kéïta
BACKGROUND: In March, 2016, a flare-up of Ebola virus disease was reported in Guinea, and in response ring vaccination with the unlicensed rVSV-ZEBOV vaccine was introduced under expanded access, the first time that an Ebola vaccine has been used in an outbreak setting outside a clinical trial. Here we describe the safety of rVSV-ZEBOV candidate vaccine and operational feasibility of ring vaccination as a reactive strategy in a resource-limited rural setting. METHODS: Approval for expanded access and compassionate use was rapidly sought and obtained from relevant authorities...
October 9, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29030935/rapid-response-team-activation-for-pediatric-patients-on-the-acute-pain-service
#5
Maxwell Teets, Dmitry Tumin, Hina Walia, Jenna Stevens, Sharon Wrona, David Martin, Tarun Bhalla, Joseph D Tobias
INTRODUCTION: Untreated pain or overly aggressive pain management may lead to adverse physiologic consequences and activation of the hospital's Rapid Response Team. This study is a quality improvement initiative that attempts to identify patient demographics and patterns associated with Rapid Response Team consultations for patients on the acute pain service. METHODS: A retrospective review of all patients on the acute pain service from February 2011 until June 2015 was cross-referenced with inpatients requiring consultation from the Rapid Response Team...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29029711/surgical-embolectomy-for-massive-and-submassive-pulmonary-embolism-and-pulmonary-thromboendarterectomy-for-chronic-thromboembolic-pulmonary-hypertension
#6
Richard J Shemin
Surgical therapy for massive acute pulmonary embolism has improved with the use of rapid response teams and selective bedside extracorporeal membrane oxygenation initiation. The chronic consequence of unresolved pulmonary embolism is a treatable form of pulmonary hypertension. Pulmonary thromboendarterectomy is a curative operation in selected cases, operated upon in an experienced center with the multidisciplinary team including imaging, pulmonary medicine, and cardiothoracic surgery.
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29028420/the-effect-of-telemedicine-on-resource-utilization-and-hospital-disposition-in-critically-ill-pediatric-transport-patients
#7
Kimberly Fugok, Nicholas B Slamon
PURPOSE: Pediatric transport teams rely on communication to report patient data to medical command officers, who create care plans and determine disposition. Common destinations are the emergency department (ED), pediatric intensive care unit (PICU), or regular inpatient care area (RIPCA). Telephone report does not result in complete understanding of the patient's condition. Further workup in the ED is often required. Telemedicine allows the patient to be directly seen; parents to be interviewed; and laboratory studies, radiographs, and vital signs to be reviewed...
October 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29016408/family-initiated-pediatric-rapid-response-characteristics-impetus-and-outcomes
#8
Aarti C Bavare, Jenilea K Thomas, Elizabeth P Elliott, Angela C Morgan, Jeanine M Graf
BRIEF DESCRIPTION: Family-initiated rapid response (FIRR) empowers families to express concern and seek care from specialized response teams. We studied FIRRs that occurred in a pediatric tertiary hospital over a 3-year period. The main aims were to describe the characteristics and outcomes of FIRRs and compare them with clinician-activated RRs (C-RRs). Of the 1,906 RRs events reviewed, 49 (2.6%) were FIRRs. All FIRRs had appropriate clinical triggers with the most common being uncontrolled pain...
October 6, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28992873/the-rapid-disaster-evaluation-system-rades-a-plan-to-improve-global-disaster-response-by-privatizing-the-assessment-component
#9
Kenneth V Iserson
BACKGROUND: Emergency medicine personnel frequently respond to major disasters. They expect to have an effective and efficient management system to elegantly allocate available resources. Despite claims to the contrary, experience demonstrates this rarely occurs. OBJECTIVES: This article describes privatizing disaster assessment using a single-purposed, accountable, and well-trained organization. The goal is to achieve elegant disaster assessment, rather than repeatedly exhorting existing groups to do it...
September 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#10
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28972807/the-future-of-interventional-neurointerventional-radiology-learning-lessons-from-the-past
#11
Julian Maingard, Hong Kuan Kok, Dinesh Ranatunga, Duncan Mark Brooks, Ronil V Chandra, Michael J Lee, Hamed Asadi
The rapid progression of medical imaging technology and the ability to leverage knowledge from non-invasive imaging means that Interventional Radiologists (IRs) and Interventional Neuroradiologists (INRs) are optimally placed to incorporate minimally invasive interventional paradigms into clinical management to advance patient care. There is ample opportunity to radically change the management options for patients with a variety of diseases through the use of minimally-invasive interventional procedures. However, this will need to be accompanied by an increased clinical role of IRs to become active partners in the clinical management of patients...
October 3, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28969627/information-needs-for-the-rapid-response-team-electronic-clinical-tool
#12
Amelia Barwise, Sean Caples, Jeffrey Jensen, Brian Pickering, Vitaly Herasevich
BACKGROUND: Information overload in healthcare is dangerous. It can lead to critical errors and delays. During Rapid Response Team (RRT) activations providers must make decisions quickly to rescue patients from physiological deterioration. In order to understand the clinical data required and how best to present that information in electronic systems we aimed to better assess the data needs of providers on the RRT when they respond to an event. METHODS: A web based survey to evaluate clinical data requirements was created and distributed to all RRT providers at our institution...
October 2, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28969166/measles-outbreak-in-the-adolescent-population-matter-of-concern
#13
Priya Rathi, Varun Narendra, Vivek Sathiya, Sanjay Kini, Avinash Kumar, Noore Sana, Rohini, Veena G Kamath
INTRODUCTION: Measles is a disease predominantly seen in young children and infants. It is an unusual occurrence of the disease in the adolescent population warranting an investigation. This would help understand the possible cause-effect relation, changing epidemiology of the disease and immunity gaps to initiate targeted interventional strategies. AIM: To determine the time, place and person distribution of an outbreak and calculate the attack rates and vaccine efficacy...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28968661/meningococcal-carriage-following-a-university-serogroup-b-meningococcal-disease-outbreak-and-vaccination-campaign-with-menb-4c-and-menb-fhbp-oregon-2015-2016
#14
Lucy A McNamara, Jennifer Dolan Thomas, Jessica MacNeil, How Yi Chang, Michael Day, Emily Fisher, Stacey Martin, Tasha Poissant, Susanna E Schmink, Evelene Steward-Clark, Laurel Thompson Jenkins, Xin Wang, Anna Acosta
Background: Limited data exist on the impact of the serogroup B meningococcal (MenB) vaccines MenB-FHbp and MenB-4C on meningococcal carriage and herd protection. We therefore assessed meningococcal carriage following a MenB vaccination campaign in response to a university serogroup B meningococcal disease outbreak in 2015. Methods: A convenience sample of students recommended for vaccination provided oropharyngeal swabs and completed questionnaires during four carriage surveys over 11 months...
August 26, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28954630/multi-disciplinary-patient-centered-model-for-the-expedited-provision-of-costly-therapies-in-community-settings-the-case-of-new-medication-for-hepatitis-c
#15
Nitzan Avisar, Yael Heller, Clara Weil, Aviva Ben-Baruch, Shani Potesman-Yona, Ran Oren, Gabriel Chodick, Varda Shalev, Nachman Ash
BACKGROUND: In January 2015, the first interferon-free direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection was approved for inclusion in Israel's national basket of health services. During 2015, HCV genotype 1 patients with advanced liver fibrosis (stage F3-F4) were eligible for treatment with ombitasvir/paritaprevir/ritonavir and dasabuvir (OMB/PTV/r + DSV) provided through the four national health plans. As all health plans committed to identifying eligible patients nationwide, risk-sharing agreements created an additional incentive to develop an innovative model for rapid treatment delivery...
September 28, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28935832/an-electronic-trigger-based-on-care-escalation-to-identify-preventable-adverse-events-in-hospitalised-patients
#16
Viraj Bhise, Dean F Sittig, Viralkumar Vaghani, Li Wei, Jessica Baldwin, Hardeep Singh
BACKGROUND: Methods to identify preventable adverse events typically have low yield and efficiency. We refined the methods of Institute of Healthcare Improvement's Global Trigger Tool (GTT) application and leveraged electronic health record (EHR) data to improve detection of preventable adverse events, including diagnostic errors. METHODS: We queried the EHR data repository of a large health system to identify an 'index hospitalization' associated with care escalation (defined as transfer to the intensive care unit (ICU) or initiation of rapid response team (RRT) within 15 days of admission) between March 2010 and August 2015...
September 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28933343/the-european-medical-corps-first-public-health-team-mission-and-future-perspectives
#17
Joana M Haussig, Ettore Severi, Jonathan Hj Baum, Veerle Vanlerberghe, Amparo Laiseca, Laurent Defrance, Cristina Brailescu, Denis Coulombier, Josep Jansa
The 2013-2016 Ebola epidemic in West Africa challenged traditional international mechanisms for public health team mobilisation to control outbreaks. Consequently, in February 2016, the European Union (EU) launched the European Medical Corps (EMC), a mechanism developed in collaboration with the World Health Organization (WHO) to rapidly deploy teams and equipment in response to public health emergencies inside and outside the EU. Public Health Teams (PHTs), a component of the EMC, consist of experts in communicable disease prevention and control from participating countries and the European Centre for Disease Prevention and Control (ECDC), to support affected countries and WHO in risk assessment and outbreak response...
September 14, 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#18
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28920554/a-pulmonary-embolism-response-team-s-initial-20-month-experience-treating-87-patients-with-submassive-and-massive-pulmonary-embolism
#19
Akhilesh K Sista, Oren A Friedman, Eda Dou, Brendan Denvir, Gulce Askin, Jamie Stern, Jaclyn Estes, Arash Salemi, Ronald S Winokur, James M Horowitz
Pulmonary Embolism Response Teams (PERTs) have emerged to provide rapid multidisciplinary assessment and treatment of PE patients. However, descriptive institutional experience and preliminary outcomes data from such teams are sparse. PERT activations were identified through a retrospective review. Only confirmed submassive or massive PEs were included in the data analysis. In addition to baseline variables, the therapeutic intervention, length of stay (LOS), in-hospital mortality, and bleeding rate/severity were recorded...
September 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28913951/rapid-response-team-patients-triaged-to-remain-on-ward-despite-deranged-vital-signs-missed-opportunities
#20
J Tirkkonen, T Kontula, S Hoppu
BACKGROUND: Rapid response teams (RRTs) triage most patients to stay on ward, even though some of them have deranged vital signs according to RRTs themselves. We investigated the prevalence and outcome of this RRT patient cohort. METHODS: A prospective observational study was conducted in a Finnish tertiary referral centre, Tampere University Hospital. Data on RRT activations were collected between 1 May 2012 and 30 April 2015. Vital signs of patients triaged to stay on ward without treatment limitations were classified according to objective RRT trigger criteria observed during the reviews...
November 2017: Acta Anaesthesiologica Scandinavica
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