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Rapid response teams

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https://www.readbyqxmd.com/read/28734561/avoiding-adult-in-hospital-cardiac-arrest-a-retrospective-cohort-study-to-determine-preventability
#1
Gordon Bingham, Irma Bilgrami, Mandy Sandford, Sarah Larwill, Judit Orosz, Carl Luckhoff, Tony Kambourakis
INTRODUCTION: This study had three main aims. Develop a methodology for reviewing in-hospital cardiac arrests (IHCA). Assess appropriateness and potential preventability of IHCAs. Identify areas for improvement within the rapid response system (RRS). DESIGN: A retrospective cohort study of IHCA identified from an existing organisational electronic database of medical emergency (MET) and Code Blue team activation. Potential preventability of IHCA and Code Blue team activation were established by an expert panel based on a standardised case review process with descriptive and content analyses for each IHCA event...
July 19, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28731933/continuous-capnography-reduces-the-incidence-of-opioid-induced-respiratory-rescue-by-hospital-rapid-resuscitation-team
#2
Mindy Stites, Jennifer Surprise, Jennifer McNiel, David Northrop, Martin De Ruyter
OBJECTIVE: The aim of this study was to determine the impact of end tidal carbon dioxide or capnography monitoring in patients requiring patient-controlled analgesia (PCA) on the incidence of opioid-induced respiratory depression (OIRD) in the setting of rapid response. METHODS: A retrospective analysis was conducted in an urban tertiary care facility on the incidence of OIRD in the setting of rapid response as defined by a positive response to naloxone from January 2012 to December 2015...
July 20, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#3
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716022/crisis-resolution-and-home-treatment-stakeholders-views-on-critical-ingredients-and-implementation-in-england
#4
Nicola Morant, Brynmor Lloyd-Evans, Danielle Lamb, Kate Fullarton, Eleanor Brown, Beth Paterson, Hannah Istead, Kathleen Kelly, David Hindle, Sarah Fahmy, Claire Henderson, Oliver Mason, Sonia Johnson
BACKGROUND: Crisis resolution teams (CRTs) can provide effective home-based treatment for acute mental health crises, although critical ingredients of the model have not been clearly identified, and implementation has been inconsistent. In order to inform development of a more highly specified CRT model that meets service users' needs, this study used qualitative methods to investigate stakeholders' experiences and views of CRTs, and what is important in good quality home-based crisis care...
July 17, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28707273/team-communication-patterns-in-emergency-resuscitation-a-mixed-methods-qualitative-analysis
#5
Lisa Anne Calder, George Mastoras, Mitra Rahimpour, Benjamin Sohmer, Brian Weitzman, A Adam Cwinn, Tara Hobin, Avi Parush
BACKGROUND: In order to enhance patient safety during resuscitation of critically ill patients, we need to optimize team communication and enhance team situational awareness but little is known about resuscitation team communication patterns. The objective of this study is to understand how teams communicate during resuscitation; specifically to assess for a shared mental model (organized understanding of a team's relationships) and information needs. METHODS: We triangulated 3 methods to evaluate resuscitation team communication at a tertiary care academic trauma center: (1) interviews; (2) simulated resuscitation observations; (3) live resuscitation observations...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28693453/an-account-of-the-ebola-virus-disease-outbreak-in-nigeria-implications-and-lessons-learnt
#6
Akaninyene Otu, Soter Ameh, Egbe Osifo-Dawodu, Enoma Alade, Susan Ekuri, Jide Idris
BACKGROUND: The 2014 Ebola virus disease (EVD) outbreak remains unprecedented both in the number of cases, deaths and geographic scope. The first case of EVD was confirmed in Lagos Nigeria on 23 July 2014 and spread to involve 19 laboratory-confirmed EVD cases. The EVD cases were not limited to Lagos State as Rivers State recorded 2 confirmed cases of EVD with 1 out of the 2 dying. Swift implementation of public health measures were sufficient to forestall a country -wide spread of this dreaded disease...
July 10, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28687637/inpatient-derived-vital-sign-parameters-implementation-an-initiative-to-decrease-alarm-burden
#7
Alaina K Kipps, Sarah F Poole, Cheryl Slaney, Shannon Feehan, Christopher A Longhurst, Paul J Sharek, Veena V Goel
OBJECTIVES: To implement data-driven vital sign parameters to reduce bedside monitor alarm burden. METHODS: Single-center, quality-improvement initiative with historical controls assessing the impact of age-based, inpatient-derived heart rate (HR) and respiratory rate (RR) parameters on a 20-bed acute care ward that serves primarily pediatric cardiology patients. The primary outcome was the number of alarms per monitored bed day (MBD) with the aim to decrease the alarms per MBD...
July 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/28673223/proceedings-of-the-12th-international-conference-on-rapid-response-systems-and-medical-emergency-teams
#8
D Jones, J Holmes, J Currey, E Fugaccia, A J Psirides, M Y Singh, G J Fennessy, K Hillman, D V Pilcher, R Bellomo, M DeVita
Rapid Response Teams (RRTs) have been introduced into hospitals worldwide in an effort to improve the outcomes of deteriorating hospitalised patients. Recently, there has been increased awareness of the need to develop systems other than RRTs for deteriorating patients. In May 2016, the 12th International Conference on Rapid Response Systems and Medical Emergency Teams was held in Melbourne. This represented a collaboration between the newly constituted International Society for Rapid Response Systems (iSRRS) and the Australian and New Zealand Intensive Care Society...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28665445/medical-rehabilitation-in-disaster-relief-towards-a-new-perspective
#9
Bhasker Amatya, Mary Galea, Jianan Li, Fary Khan
With increasing frequency of natural disasters, there has been greater focus recently on the importance and role of rehabilitation services in disaster management. In past disasters, rehabilitative needs were often neglected, with emphasis on acute response plans focused on saving lives and treating acute injuries. There was a lack of, or inadequate, rehabilitation-inclusive disaster response plans and rehabilitation services in many disaster-prone developing countries. The World Health Organization (WHO) Emergency Medical Team (EMT) initiative recognizes rehabilitation as an integral part of medical response and patient-centred care in disaster settings...
June 30, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28663136/can-salivary-testosterone-and-cortisol-reactivity-to-a-mid-week-stress-test-discriminate-a-match-outcome-during-international-rugby-union-competition
#10
Blair T Crewther, Neil Potts, Liam P Kilduff, Scott Drawer, Christian J Cook
OBJECTIVES: Evidence suggests that stress-induced changes in testosterone and cortisol are related to future competitive behaviours and team-sport outcomes. Therefore, we examined whether salivary testosterone and cortisol reactivity to a mid-week stress test can discriminate a match outcome in international rugby union competition. DESIGN: Single group, quasi-experimental design with repeated measures. METHOD: Thirty-three male rugby players completed a standardised stress test three or four days before seven international matches...
June 2, 2017: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/28659194/out-of-hospital-cardio-pulmonary-arrest-is-there-a-role-for-the-primary-healthcare-teams
#11
Shlomo Vinker
Out of hospital cardiac arrest (OHCA) remains a major cause of morbidity and mortality. The survival rates are poor and even more frustrating are the rates of neurologically favorable outcomes at hospital discharge. In a recent IJHPR article, Einav et al. concluded that many primary care clinics are underequipped and the physicians underprepared to initiate life-saving services. The chance of having an OHCA in a primary care clinic is very low. But although the impact is small, primary care teams as well as other out-of-hospital healthcare personal should be familiar with the telephone number for summoning emergency medical services (EMS), be aware of the location of the defibrillator in their clinic, and know how to use it...
June 28, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28656784/the-spectrum-of-mitral-valve-pathologies-relevance-for-surgical-and-structural-interventions
#12
Sho Torii, Maria E Romero, Hiroyoshi Mori, Emanuel Harari, Frank D Kolodgie, Aloke V Finn, Renu Virmani
The mitral valve apparatus, both functionally and morphologically is composed of a constellation of individual structures, including the annulus, anterior and posterior leaflets, chordae tendineae, and papillary muscles. Most also include the left ventricular wall and the left atrium which are essential for the valve to function normally. Areas covered: The commonest conditions responsible for mitral valve dysfunction in the Western World are degenerative and functional mitral regurgitation, which are discussed in detail...
July 4, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28656602/rapid-response-team-calls-to-obstetric-patients-in-a-busy-quaternary-maternity-hospital
#13
Timothy M Crozier, Pauline Galt, Stuart J Wilson, Euan M Wallace
AIMS: There is limited published information regarding intensive care unit (ICU) led rapid response team (RRT) calls to obstetric patients. We examined the characteristics of RRT calls to obstetric patients at a tertiary teaching hospital. METHODS: Details of calls to pregnant and postpartum patients between October 2010 and June 2014 were obtained from the hospital RRT database. Each was retrospectively examined for data on patient demographics, call trigger, interventions and outcomes...
June 28, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28636449/zika-virus-in-ontario-evaluating-a-rapid-risk-assessment-tool-for-emerging-infectious-disease-threats
#14
Ryan Van Meer, Karin Hohenadel, Alanna Fitzgerald-Husek, Bryna Warshawsky, Doug Sider, Brian Schwartz, Mark P Nelder
To determine the Ontario-specific risk of local and travel-related Zika virus transmission in the context of a public health emergency of international concern, Public Health Ontario (PHO) completed a rapid risk assessment (RRA) on January 29, 2016, using a newly developed RRA guidance tool. The RRA concluded that risk of local mosquito-borne transmission was low, with a high risk of imported cases through travel. The RRA was updated 3 times based on predetermined triggers. An independent evaluation assessed both the application of the RRA guidance tool (process evaluation) and the usefulness of the RRA (outcome evaluation)...
May 2017: Health Security
https://www.readbyqxmd.com/read/28628619/south-african-ebola-diagnostic-response-in-sierra-leone-a-modular-high-biosafety-field-laboratory
#15
Janusz T Paweska, Petrus Jansen van Vuren, Gunther H Meier, Chantel le Roux, Ousman S Conteh, Alan Kemp, Cardia Fourie, Prabha Naidoo, Serisha Naicker, Phumza Ohaebosim, Nadia Storm, Orienka Hellferscee, Lisa K Ming Sun, Busisiwe Mogodi, Nishi Prabdial-Sing, Desiree du Plessis, Deidre Greyling, Shayne Loubser, Mark Goosen, Stewart D McCulloch, Terence P Scott, Alexandra Moerdyk, Wesley Dlamini, Kelfala Konneh, Idrissa L Kamara, Dauda Sowa, Samuel Sorie, Brima Kargbo, Shabir A Madhi
BACKGROUND: In August 2014, the National Institute for Communicable Diseases (NICD) in South Africa established a modular high-biosafety field Ebola diagnostic laboratory (SA FEDL) near Freetown, Sierra Leone in response to the rapidly increasing number of Ebola virus disease (EVD) cases. METHODS AND FINDINGS: The SA FEDL operated in the Western Area of Sierra Leone, which remained a "hotspot" of the EVD epidemic for months. The FEDL was the only diagnostic capacity available to respond to the overwhelming demand for rapid EVD laboratory diagnosis for several weeks in the initial stages of the EVD crisis in the capital of Sierra Leone...
June 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28612657/improving-care-for-advanced-copd-through-practice-change-experiences-of-participation-in-a-canadian-spread-collaborative
#16
Jennifer Y Verma, Claudia Amar, Shannon Sibbald, Graeme M Rocker
Chronic obstructive pulmonary disease (COPD) is a leading cause of death, morbidity, and health-care spending. The Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ has proved highly beneficial for patients and the health-care system. With direct investment of <$1-million CAD, a pan-Canadian quality improvement collaborative (QIC) supported the spread of INSPIRED to 19 teams in the 10 Canadian provinces contingent upon participation in evaluation. The collaborative evaluation followed a mixed-methods summative approach relying on collated quantitative data, team documents, and surveys sent to core members of the 19 teams...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28610940/establishment-of-a-research-pharmacy-to-support-ebola-clinical-research-in-liberia
#17
Jerome F Pierson, Matthew Carl Kirchoff, Rev Tijli Tyee, Michael J Montello, Julie K Rhie
OBJECTIVE: This article describes the establishment of a research pharmacy to support the Partnership for Research on Ebola Vaccines in Liberia (PREVAIL) vaccine study for Ebola virus disease. SETTING: This article describes the establishment of the pharmacy element to support the overall research program during an Ebola outbreak in Monrovia, Liberia, in 2014 and 2015. PRACTICE INNOVATION: The need for the rapid establishment of infrastructure to support the Liberia-United States joint clinical research partnership in response to the emerging Ebola virus disease provided the opportunity for collaboration among Liberian and U...
July 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28607235/meeting-the-current-and-future-health-care-needs-of-sri-lanka-s-ageing-population
#18
Dilhar Samaraweera, Shiromi Maduwage
Sri Lanka is one of the fastest-ageing countries in the world. This rapid demographic transition is expected to result in one quarter of the population being elderly by the year 2041. Profound challenges face the country as a result, especially with respect to planning adequate elderly-oriented services in the social-care and health-care sectors. In response to this need, many initiatives have been put in place to promote and protect the welfare of older people, and these rights have been inscribed in law. Within the health sector, despite the wealth of policies and initiatives in recent years, it is clear that the existing health infrastructure and systems still require strengthening, reorientation and coordination, to meet the needs of the growing population of elderly individuals...
September 2016: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28606591/safety-and-immunogenicity-of-the-rvsv%C3%A2-g-zebov-gp-ebola-virus-vaccine-candidate-in-healthy-adults-a-phase-1b-randomised-multicentre-double-blind-placebo-controlled-dose-response-study
#19
D Gray Heppner, Tracy L Kemp, Brian K Martin, William J Ramsey, Richard Nichols, Emily J Dasen, Charles J Link, Rituparna Das, Zhi Jin Xu, Eric A Sheldon, Teresa A Nowak, Thomas P Monath
BACKGROUND: The 2014 Zaire Ebola virus outbreak highlighted the need for a safe, effective vaccine with a rapid onset of protection. We report the safety and immunogenicity of the recombinant vesicular stomatitis virus-Zaire Ebola virus envelope glycoprotein vaccine (rVSV∆G-ZEBOV-GP) across a 6 log10 dose range in two sequential cohorts. METHODS: In this phase 1b double-blind, placebo-controlled, dose-response study we enrolled and randomly assigned healthy adults (aged 18-61 years) at eight study sites in the USA to receive a single injection of vaccine or placebo, administered by intramuscular injection...
June 9, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28588996/implementing-one-health-as-an-integrated-approach-to-health-in-rwanda
#20
Thierry Nyatanyi, Michael Wilkes, Haley McDermott, Serge Nzietchueng, Isidore Gafarasi, Antoine Mudakikwa, Jean Felix Kinani, Joseph Rukelibuga, Jared Omolo, Denise Mupfasoni, Adeline Kabeja, Jose Nyamusore, Julius Nziza, Jean Leonard Hakizimana, Julius Kamugisha, Richard Nkunda, Robert Kibuuka, Etienne Rugigana, Paul Farmer, Philip Cotton, Agnes Binagwaho
It is increasingly clear that resolution of complex global health problems requires interdisciplinary, intersectoral expertise and cooperation from governmental, non-governmental and educational agencies. 'One Health' refers to the collaboration of multiple disciplines and sectors working locally, nationally and globally to attain optimal health for people, animals and the environment. One Health offers the opportunity to acknowledge shared interests, set common goals, and drive toward team work to benefit the overall health of a nation...
January 2017: BMJ Global Health
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