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Critical care transport

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https://www.readbyqxmd.com/read/29759850/differences-in-prehospital-patient-assessments-for-pediatric-versus-adult-patients
#1
Sriram Ramgopal, Jonathan Elmer, Jeremiah Escajeda, Christian Martin-Gill
OBJECTIVE: To evaluate whether completion of vital signs assessments in pediatric transports by emergency medical services (EMS) differs by patient age. STUDY DESIGN: We reviewed records by 20 agencies in a regional EMS system in Southwestern Pennsylvania between April 1, 2013 and December 31, 2016. We abstracted demographics, vital signs (systolic blood pressure, heart rate, respiratory rate), clinical, and transport characteristics. We categorized age as neonates (≤30 days), infants (1 month to <1 year), toddler (1 to <2 years), early childhood (2 to <6 years), middle childhood (6 to <12 years), adolescent (12 to <18 years), and adult (≥18 years)...
May 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29753877/developing-a-decision-support-system-for-patients-with-severe-infection-conditions-in-prehospital-care
#2
Niclas Johansson, Carl Spindler, John Valik, Veronica Vicente
OBJECTIVE: To develop and validate a prehospital decision support system (DSS) for the emergency medical services (EMS), enabling identification and steering of patients with critical infectious conditions - severe respiratory tract infections, severe CNS-infections and sepsis - to a specialized emergency department (ED) for infectious diseases. METHODS: The development process has involved four consecutive steps. The first step was gathering data from the electronic Patient Care Record on patients transported by the EMS, to identify retrospectively appropriate patient categories for steering...
May 10, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29735235/transport-of-a-prone-position-acute-respiratory-distress-syndrome-patient
#3
David Hersey, Tobias Witter, George Kovacs
We report the case of a non-physician based critical care transport team (registered nurse and paramedic) that successfully initiated prone positioning of a severe acute respiratory distress patient prior to transport to an extracorporeal membrane oxygenation capable teaching hospital. With the increasing use of advanced treatments such as extracorporeal membrane oxygenation, prone positioning, and continuous renal replacement therapy for severe acute respiratory distress syndrome (ARDS), the necessity to transport these patients to specialized hospitals will correspondingly increase...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29735232/the-effect-of-team-configuration-on-the-incidence-of-adverse-events-in-pediatric-critical-care-transport
#4
Emily Colyer, Megan Sorensen, Shirley Wiggins, Leeza Struwe
OBJECTIVE: Specialty pediatric transport teams are widely used for pediatric interfacility transport in the United States, with little industry consensus on optimal team configuration. The aim of this study is to assess the quality of the nurse/paramedic specialty team configuration as indirectly measured by the rate of adverse events in these transports. METHODS: Retrospective analysis of pediatric transport data from a hospital-based dedicated pediatric/neonatal transport team was conducted for patients transported in 2016...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29716799/emergency-and-critical-care-applications-for-contrast-enhanced-ultrasound
#5
REVIEW
Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D Huang, Jason T Nomura, Srikar Adhikari
INTRODUCTION: Contrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography. METHODS: We performed a literature search and report clinical experience to provide an introduction to CEUS and describe its current applications for point-of-care indications...
April 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29699897/development-of-regional-extracorporeal-life-support-system-the-importance-of-innovative-simulation-training
#6
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Aleksander Pawlak, Marcin Zieliński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
BACKGROUND: Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 30% to 60%. Extracorporeal Membrane Oxygenation (ECMO) can be used as a "bridge to recovery". ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure, while minimizing iatrogenic ventilator-induced lung injury. In the critical care settings, ECMO is shown to improve survival rates and outcomes in patients with severe ARDS...
April 18, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29695299/emergency-transportation-interventions-for-reducing-adverse-pregnancy-outcomes-in-low-and-middle-income-countries-a-systematic-review-protocol
#7
John Ehiri, Halimatou Alaofè, Ibitola Asaolu, Joy Chebet, Ekpereonne Esu, Martin Meremikwu
BACKGROUND: Transportation interventions seek to decrease delay in reaching a health facility for emergency obstetric care and are, thus, believed to contribute to reductions in such adverse pregnancy and childbirth outcomes as maternal deaths, stillbirths, and neonatal mortality in low- and middle-income countries (LMICs). However, there is limited empirical evidence to support this hypothesis. The objective of the proposed review is to summarize and critically appraise evidence regarding the effect of emergency transportation interventions on outcomes of labor and delivery in LMICs...
April 25, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29667297/the-glutathione-cycle-glutathione-metabolism-beyond-the-%C3%AE-glutamyl-cycle
#8
REVIEW
Anand Kumar Bachhawat, Shambhu Yadav
Glutathione was discovered in 1888, over 125 years ago. Since then, our understanding of various functions and metabolism of this important molecule has grown over these years. But it is only now, in the last decade, that a somewhat complete picture of its metabolism has emerged. Glutathione metabolism has till now been largely depicted and understood by the γ-glutamyl cycle that was proposed in 1970. However, new findings and knowledge particularly on the transport and degradation of glutathione have revealed that many aspects of the γ-glutamyl cycle are incorrect...
April 17, 2018: IUBMB Life
https://www.readbyqxmd.com/read/29664874/traumatic-brain-injury-and-infectious-encephalopathy-in-children-from-four-resource-limited-settings-in-africa
#9
Ericka L Fink, Amelie von Saint Andre-von Arnim, Rashmi Kumar, Patrick T Wilson, Tigist Bacha, Abenezer Tirsit Aklilu, Tsegazeab Laeke Teklemariam, Shubhada Hooli, Lisine Tuyisenge, Easmon Otupiri, Anthony Fabio, John Gianakas, Patrick M Kochanek, Derek C Angus, Robert C Tasker
OBJECTIVES: To assess the frequency, interventions, and outcomes of children presenting with traumatic brain injury or infectious encephalopathy in low-resource settings. DESIGN: Prospective study. SETTING: Four hospitals in Sub-Saharan Africa. PATIENTS: Children age 1 day to 17 years old evaluated at the hospital with traumatic brain injury or infectious encephalopathy. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated the frequency and outcomes of children presenting consecutively over 4 weeks to any hospital department with traumatic brain injury or infectious encephalopathy...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29653128/serotonin-specific-lesions-of-the-dorsal-raphe-disrupt-maternal-aggression-and-caregiving-in-postpartum-rats
#10
M Allie Holschbach, Erika V Vitale, Joseph S Lonstein
The behavioral modifications associated with early motherhood, including high aggression, caring for young, and low anxiety are all affected by acute pharmacological manipulation of serotonin signaling. However, the effects on these behaviors of permanently disrupting serotonin signaling at one of its primary sources, the dorsal raphe (DR), have not been examined in detail. To address this, serotonin-specific lesions centered on the dorsomedial DR (DRdm; subregion most implicated in emotional behaviors) were induced at mid-pregnancy (day 15) or early postpartum (day 2) in rats using a saporin-conjugated neurotoxin targeting the serotonin transporter (Anti-SERT-SAP)...
April 10, 2018: Behavioural Brain Research
https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#11
Christopher D Shank, Beverly C Walters, Mark N Hadley
Acute traumatic spinal cord injury (SCI) affects more than 250,000 people in the USA, with approximately 17,000 new cases each year. It continues to be one of the most significant causes of trauma-related morbidity and mortality. Despite the introduction of primary injury prevention education and vehicle safety devices, such as airbags and passive restraint systems, traumatic SCI continues to have a substantial impact on the healthcare system. Over the last three decades, there have been considerable advancements in the management of patients with traumatic SCI...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29644796/hematite-photoanode-with-complex-nanoarchitecture-providing-tunable-gradient-doping-and-remarkable-low-onset-potential-for-advanced-pec-water-splitting
#12
Hyo-Jin Ahn, Anandarup Goswami, Francesca Riboni, Stepan Kment, Alberto Naldoni, Shiva Mohajernia, Radek Zboril, Patrik Schmuki
Over the past years, α-Fe2O3 (hematite) has re-emerged as a promising photoanode material in photoelectrochemical (PEC) water splitting. In spite of considerable success in obtaining relatively high solar conversion efficiency, the main drawbacks hindering practical application at hematite are related to an intrinsically hampered charge transport and a sluggish kinetics of the oxygen evolution reaction on the photoelectrode surface. In the present work, we report a strategy how to synergistically address both these critical limitations...
April 12, 2018: ChemSusChem
https://www.readbyqxmd.com/read/29606685/en-route-critical-care-transfer-from-a-role-2-to-a-role-3-medical-treatment-facility-in-afghanistan
#13
Amanda M Staudt, Shelia C Savell, Kimberly A Biever, Jennifer D Trevino, Krystal K Valdez-Delgado, Mithun Suresh, Jennifer M Gurney, Stacy A Shackelford, Joseph K Maddry, Elizabeth A Mann-Salinas
BACKGROUND: En route care is the transfer of patients requiring combat casualty care within the US military evacuation system. No reports have been published about en route care of patients during transfer from a forward surgical facility (role 2) to a combat support hospital (role 3) for comprehensive care. OBJECTIVE: To describe patients transferred from a role 2 to a role 3 US military treatment facility in Afghanistan. METHODS: A retrospective review of data from the Joint Trauma System Role 2 Database was conducted...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29606684/en-route-care-provided-by-us-navy-nurses-in-iraq-and-afghanistan
#14
Virginia S Blackman, Benjamin D Walrath, Lauren K Reeves, Alejandra G Mora, Joseph K Maddry, Zsolt T Stockinger
BACKGROUND: US Navy nurses provide en route care for critically injured combat casualties without having a formal program for training, utilization, or evaluation. Little is known about missions supported by Navy nurses. OBJECTIVES: To characterize the number and types of patients transported and skill sets required by Navy nurses during 2 combat support deployments. METHODS: All interfacility casualty transfers between 2 separate facilities in Iraq and Afghanistan were assessed...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29606673/pressure-injury-development-in-patients-treated-by-critical-care-air-transport-teams-a-case-control-study
#15
Susan F Dukes, Genny M Maupin, Marilyn E Thomas, Darcy L Mortimer
BACKGROUND: The US Air Force transports critically ill patients from all over the world, with transport times commonly ranging from 6 to 11 hours. Few outcome measures have been tracked for these patients. Traditional methods to prevent pressure injuries in civilian hospitals are often not feasible in the military transport environment. OBJECTIVES: The incidence rate and risk factors are described of en route-related pressure injuries for patients overseen by the Critical Care Air Transport Team...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29606672/critical-care-performance-in-a-simulated-military-aircraft-cabin-environment
#16
Margaret M McNeill
BACKGROUND: Critical Care Air Transport Teams care for 5% to 10% of injured patients who are transported on military aircraft to definitive treatment facilities. Little is known about how the aeromedical evacuation environment affects care. OBJECTIVES: To determine the effects of 2 stressors of flight, altitude-induced hypoxia and aircraft noise, and to examine the contributions of fatigue and clinical experience on cognitive and physiological performance of the Critical Care Air Transport Team...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29592818/social-support-needs-among-adolescents-living-with-hiv-in-transition-from-pediatric-to-adult-care-in-cambodia-findings-from-a-cross-sectional-study
#17
Graham Toth, Gitau Mburu, Sovannary Tuot, Vohith Khol, Chanrith Ngin, Pheak Chhoun, Siyan Yi
BACKGROUND: Understanding the circumstances of adolescents living with HIV is critical in designing adolescent-friendly services that will facilitate successful transition from pediatric to adult care. This study describes access, utilization and ongoing social support needs among adolescents living with HIV aged 15-17 in transition from pediatric to adult HIV care in Cambodia. METHODS: A cross-sectional study was conducted among 328 adolescents, randomly selected from 11 antiretroviral therapy (ART) clinics across the country...
March 28, 2018: AIDS Research and Therapy
https://www.readbyqxmd.com/read/29589329/tactical-neurocritical-care
#18
Julio A Chalela, Patrick E Britell
Neurocritical care is usually practiced in the comfort of an intensive care unit within a tertiary care medical center. Physicians deployed to the frontline with the US military or allied military are required to use their critical care skills and their neurocritical skills in austere environments with limited resources. Due to these factors, tactical critical care and tactical neurocritical care differ significantly from traditional critical care. Operational constraints, the tactical environment, and resource availability dictate that tactical neurocritical care be practiced within a well-defined, mission-constrained framework...
March 27, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29579572/impact-of-physician-less-pediatric-critical-care-transport-making-a-decision-on-team-composition
#19
Atsushi Kawaguchi, Charlene C Nielsen, L Duncan Saunders, Yutaka Yasui, Allan de Caen
PURPOSE: To explore the impact of a physician non-accompanying pediatric critical care transport program, and to identify factors associated with the selection of specific transport team compositions. MATERIALS AND METHODS: Children transported to a Canadian academic children's hospital were included. Two eras (Physician-accompanying Transport (PT)-era: 2000-07 when physicians commonly accompanied the transport team; and Physician-Less Transport (PLT)-era: 2010-15 when a physician non-accompanying team was increasingly used) were compared with respect to transport and PICU outcomes...
March 20, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29575208/the-rural-mother-s-experience-of-caring-for-a-child-with-a-chronic-health-condition-an-integrative-review
#20
REVIEW
Sally Bristow, Debra Jackson, Linda Shields, Kim Usher
AIM AND OBJECTIVES: The focus of the literature review was to identify and review the literature on rural mothers' experiences in caring for a child with a chronic health condition. BACKGROUND: Families living with a child who has a chronic health condition experience many challenges; these are often amplified for families living in rural areas, where issues such as the distance from services adds further challenges the family must manage. Like many children, rural children with chronic health conditions are primarily cared for by their mothers...
March 25, 2018: Journal of Clinical Nursing
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