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Rapid response teams

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https://www.readbyqxmd.com/read/28447391/transcriptional-response-of-escherichia-coli-to-ammonia-and-glucose-fluctuations
#1
Joana Danica Simen, Michael Löffler, Günter Jäger, Karin Schäferhoff, Andreas Freund, Jakob Matthes, Jan Müller, Ralf Takors
In large-scale production processes, metabolic control is typically achieved by limited supply of essential nutrients such as glucose or ammonia. With increasing bioreactor dimensions, microbial producers such as Escherichia coli are exposed to changing substrate availabilities due to limited mixing. In turn, cells sense and respond to these dynamic conditions leading to frequent activation of their regulatory programmes. Previously, we characterized short- and long-term strategies of cells to adapt to glucose fluctuations...
April 26, 2017: Microbial Biotechnology
https://www.readbyqxmd.com/read/28445242/increased-mortality-and-length-of-stay-associated-with-medical-emergency-team-review-in-hospitalized-pediatric-patients-a-retrospective-cohort-study
#2
Brianna McKelvie, James Dayre McNally, Jason Chan, Franco Momoli, Christa Ramsay, Anna-Theresa Lobos
OBJECTIVE: Rapid response systems using medical emergency teams reduce hospital wide cardiorespiratory arrest and mortality. While rapid response systems improve hospital-wide outcomes, children receiving medical emergency team review may still be at increased risk for morbidity and mortality. The study purpose was to compare the length of stay and mortality rate in children receiving a medical emergency team review with those of other hospitalized children. DESIGN: Retrospective cohort study...
April 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28434554/the-simulation-based-assessment-of-pediatric-rapid-response-teams
#3
James J Fehr, Mary E McBride, John R Boulet, David J Murray
OBJECTIVE: To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. STUDY DESIGN: A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs...
April 20, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#4
John W Scott, Jeanne D'Arc Nyinawankusi, Samuel Enumah, Rebecca Maine, Eric Uwitonze, Yihan Hu, Ignace Kabagema, Jean Claude Byiringiro, Robert Riviello, Sudha Jayaraman
INTRODUCTION: Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. MATERIALS AND METHODS: The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28415972/community-based-survey-during-rabies-outbreaks-in-rangjung-town-trashigang-eastern-bhutan-2016
#5
Tenzin Tenzin, Jamyang Namgyal, Sangay Letho
BACKGROUND: Rabies is a highly fatal disease transmitted through the bite of a rabid animal. Human deaths can be prevented by prompt administering of rabies vaccine and rabies immunoglobulin following the exposure. An assessment of community knowledge, awareness and practices on rabies is important during outbreak to understand their preparedness and target educational messages and response activities by the rapid response team. METHODS: A rabies outbreak has occurred in Rangjung town, eastern Bhutan on 4 October 2016...
April 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28412015/managing-sepsis-electronic-recognition-rapid-response-teams-and-standardized-care-save-lives
#6
Faheem W Guirgis, Lisa Jones, Rhemar Esma, Alice Weiss, Kaitlin McCurdy, Jason Ferreira, Christina Cannon, Laura McLauchlin, Carmen Smotherman, Dale F Kraemer, Cynthia Gerdik, Kendall Webb, Jin Ra, Frederick A Moore, Kelly Gray-Eurom
PURPOSE: Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. MATERIALS AND METHODS: Retrospective review of patients ≥18years treated for sepsis. RESULTS: There were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p=0.94) and Charlson Comorbidity Scores (2...
April 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28409600/postpartum-hemorrhage-prevention-and-treatment
#7
Ann Evensen, Janice M Anderson, Patricia Fontaine
Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective component of this practice. Oxytocin is more effective than misoprostol for prevention and treatment of uterine atony and has fewer adverse effects. Routine episiotomy should be avoided to decrease blood loss and the risk of anal laceration...
April 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28409055/enhanced-surveillance-for-the-third-united-nations-conference-on-small-island-developing-states-apia-samoa-september-2014
#8
Paul White, Salanieta Saketa, Alexis Durand, Saine Vaai-Nielsen, Tile Ah Leong-Lui, Take Naseri, Ailuai Matalima, Filipina Amosa, Alize Mercier, Christelle Lepers, Vjesh Lal, Richard Wojcik, Sheri Lewis, Adam Roth, Yvan Souares, Onofre Edwin Merilles, Damian Hoy
The Ministry of Health in Samoa, in partnership with the Pacific Community, successfully implemented enhanced surveillance for the high-profile Third United Nations Conference on Small Island Developing States held concurrently with the popular local Teuila festival during a widespread chikungunya outbreak in September 2014. Samoa's weekly syndromic surveillance system was expanded to 12 syndromes and 10 sentinel sites from four syndromes and seven sentinel sites; sites included the national hospital, four private health clinics and three national health service clinics...
January 2017: Western Pacific Surveillance and Response Journal: WPSAR
https://www.readbyqxmd.com/read/28401688/goals-of-patient-care-system-change-with-video-based-education-increases-rates-of-advance-cardiopulmonary-resuscitation-decision-making-and-discussions-in-hospitalised-rehabilitation-patients
#9
Claire Johnson, Jeffrey Chong, Anne Wilkinson, Barbara Hayes, Sonia Tait, Nicholas Waldron
BACKGROUND: Advance CPR discussions and decision-making are not routine clinical practice in the hospital setting. Frail older patients may be at risk of non-beneficial CPR. AIM: To assess the utility and safety of two interventions to increase CPR decision-making, documentation and communication for hospitalised older patients. METHODS: A pre-post study tested two interventions: i) standard ward-based education forums with CPR content; and ii) a combined, two-pronged strategy with 'Goals of Patient Care' (GoPC) system change and structured video-based workshop; against usual practice (ie no formal training)...
April 12, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28401327/pulmonary-embolism-response-teams
#10
REVIEW
Maya Serhal, Ihab S Haddadin, Gustavo A Heresi, Deborah A Hornacek, Mehdi H Shishehbor, John R Bartholomew
Pulmonary embolism (PE) is a common thrombotic event that is variable in its presentation. Depending on the patients' risk for mortality, guidelines provide several treatment strategies including thrombolysis, catheter-directed therapies, pulmonary embolectomy, anticoagulation, and inferior vena cava filters. However, there is considerable disagreement between guidelines regarding the optimal treatment strategy for patients, particularly for those with intermediate-risk PE. In order to provide rapid and individualized care, PE response teams (PERT) have been developed...
April 11, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28398992/translating-technical-support-into-country-action-the-role-of-the-interagency-task-team-on-the-prevention-and-treatment-of-hiv-infection-in-pregnant-women-mothers-and-children-in-the-global-plan-era
#11
Chewe Luo, Gottfried Hirnschall, Jessica Rodrigues, Sostena Romano, Shaffiq Essajee, Braeden Rogers, Elizabeth McCarthy, Albert Mwango, Nalinee Sangrujee, Michelle R Adler, James C Houston, Judite O Langa, Marilena Urso, Omotayo Bolu, Gilbert Tene, Jean B Elat Nfetam, Etienne Kembou, Benjamin R Phelps
While the Interagency Task Team on the Prevention and Treatment of HIV Infection in Pregnant Women, Mothers, and Children (IATT) partnership existed before the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan), its reconfiguration was critical to coordinating provision of technical assistance that positively influenced country decision-making and program performance. This article describes how the Global Plan anchored the work of the IATT and, in turn, how the IATT's technical assistance helped to accelerate achievement of the Global Plan targets and milestones...
May 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28395091/morbidity-among-the-israeli-defense-force-response-team-during-nepal-post-earthquake-mission-2015
#12
Tamar Lachish, Aviad Bar, Heli Alalouf, Ofer Merin, Eli Schwartz
Background: On 25 April 2015, a 7.8-magnitude earthquake struck Nepal. Soon after, the Israel Defense Force (IDF) dispatched a rapid-response team and opened a tertiary field hospital in Kathmandu. There is limited data regarding the spectrum of diseases among rescue teams to disease-stricken areas. The aim of this study was to assess the morbidity among the field-hospital staff during the mission. Methods: The rescue team was deployed for a 2-week mission in Kathmandu...
March 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28382678/recognising-and-responding-to-in-hospital-clinical-deterioration-an-integrative-review-of-interprofessional-practice-issues
#13
REVIEW
Emily Allen, Doug Elliott, Debra Jackson
AIMS AND OBJECTIVES: To identify, appraise and synthesise current evidence regarding organisation-wide interprofessional practice issues that facilitate or inhibit effective recognition and response to clinical deterioration, using a theoretical Rapid Response System (RRS) model. BACKGROUND: Recognition and response to clinical deterioration, in adult general medical-surgical ward patients, is embedded as a routine interprofessional practice in acute healthcare organisations worldwide...
April 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28375502/pro-prevention-of-acute-kidney-injury-time-for-teamwork-and-new-biomarkers
#14
Claudio Ronco, Lilia Rizo-Topete, Mara Serrano-Soto, Kianoush Kashani
Acute kidney injury (AKI) is a common condition in critically ill patients. Multiple studies have identified AKI as a strong independent risk factor for higher morbidity and mortality. AKI is often multifactorial, asymptomatic and difficult to predict. In recent years, the discovery of several AKI biomarkers, including the recent validation and approval of cell cycle arrest biomarkers (NephroCheck, Astute Medical, San Diego, CA, USA), has provided additional tools to detect patients at high risk of AKI and improve their outcomes...
March 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28373258/european-prospective-cohort-study-on-enterobacteriaceae-showing-resistance-to-carbapenems-eureca-a-protocol-of-a-european-multicentre-observational-study
#15
Belén Gutiérrez-Gutiérrez, Jesús Sojo-Dorado, José Bravo-Ferrer, Nienke Cuperus, Marlieke de Kraker, Tomislav Kostyanev, Lul Raka, George Daikos, Jan Feifel, Laura Folgori, Alvaro Pascual, Herman Goossens, Seamus O'Brien, Marc J M Bonten, Jesús Rodríguez-Baño
INTRODUCTION: The rapid worldwide spread of carbapenem-resistant Enterobacteriaceae (CRE) constitutes a major challenge. The aim of the EUropean prospective cohort study on Enterobacteriaceae showing REsistance to CArbapenems (EURECA), which is part of the Innovative Medicines Initiative Joint Undertaking (IMI JU) funded COMBACTE-CARE project, is to investigate risk factors for and outcome determinants of CRE infections to inform randomised clinical trial designs and to provide a historical cohort that could eventually be used for future comparisons with new drugs targeting CRE...
April 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28359769/regular-in-situ-simulation-training-of-paediatric-medical-emergency-team-leads-to-sustained-improvements-in-hospital-response-to-deteriorating-patients-improved-outcomes-in-intensive-care-and-financial-savings
#16
Ulf Theilen, Laura Fraser, Patricia Jones, Paul Leonard, Dave Simpson
AIM OF THE STUDY: The introduction of a paediatric Medical Emergency Team (pMET) was accompanied by weekly in-situ simulation team training. Key ward staff participated in team training, focusing on recognition of the deteriorating child, teamwork and early involvement of senior staff. Following an earlier study [1], this investigation aimed to evaluate the long-term impact of ongoing regular team training on hospital response to deteriorating ward patients, patient outcome and financial implications...
March 28, 2017: Resuscitation
https://www.readbyqxmd.com/read/28358179/perioperative-cardiac-arrest-in-the-operating-room-environment-a-review-of-the-literature
#17
Jochen Hinkelbein, Janusz Andres, Karl-Christian Thies, Edoardo De Robertis
Cardiac arrest in the operating room (OR) environment is a rare but potentially catastrophic event with mortality rates of more than 50%. Cardiac arrest during anaesthesia and the immediate postoperative period is distinct from non-operative settings or other in-hospital cardiac arrests since it is almost always witnessed and often anticipated. Contributing factors are known, and the event is generally rapidly recognized, as patients are usually under full monitoring. The nature of the cardiac arrest in the OR environment is also different as it is not only related to the patient's conditions but likewise to the anaesthetic and the surgical procedure...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28333831/deployed-skills-training-for-whole-blood-collection-by-a-special-operations-expeditionary-surgical-team
#18
Linda C Benavides, Iain M Smith, Jerome M Benavides, Douglas M Bowley, Heidi A Doughty, Jonathan B Lundy
BACKGROUND: Non-compressible hemorrhage is the leading cause of potentially preventable battlefield death. Combining casualty retrieval from the battlefield and damage control resuscitation (DCR) within the "golden hour" increases survival. However, transfusion requirements may exceed the current blood component stocks held by forward surgical teams. Warm fresh whole blood (WFWB) is an alternative. We report WFWB transfusion training developed by and delivered to a US Golden Hour Offset Surgical Treatment Team (GHOST-T) and the resulting improvement in confidence with WFWB transfusion...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28325091/nuts-and-bolts-of-running-a-pulmonary-embolism-response-team-results-from-an-organizational-survey-of-the-national-pert%C3%A2-consortium-members
#19
Geoffrey Barnes, Jay Giri, D Mark Courtney, Soophia Naydenov, Todd Wood, Rachel Rosovsky, Kenneth Rosenfield, Christopher Kabrhel
OBJECTIVES: Pulmonary embolism response teams (PERT) are developing rapidly to operationalize multi-disciplinary care for acute pulmonary embolism patients. Our objective is to describe the core components of PERT necessary for newly developing programs. METHODS: An online organizational survey of active National PERT™ Consortium members was performed between April and June 2016. Analysis, including descriptive statistics and Kruskal-Wallis tests, was performed on centers self-reporting a fully operational PERT program...
March 31, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28296456/improving-patient-safety-through-the-use-of-nursing-surveillance
#20
Karen K Giuliano
Surveillance and monitoring each represent a distinct process in patient care. Monitoring involves observation, measurement, and recording of physiological parameters, while surveillance is a systematic, goal-directed process based on early detection of signs of change, interpretation of the clinical implications of such changes, and initiation of rapid, appropriate interventions. Through use of an illustrative clinical example based on Early Warning System scoring and rapid response teams, this article seeks to distinguish between nurse monitoring and surveillance to demonstrate the impact of surveillance on improving both care processes and patient care...
February 2017: Biomedical Instrumentation & Technology
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