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Critical care transport

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https://www.readbyqxmd.com/read/28438218/malaria-elimination-in-lao-pdr-the-challenges-associated-with-population-mobility
#1
REVIEW
Sengchanh Kounnavong, Deyer Gopinath, Bouasy Hongvanthong, Chanthalone Khamkong, Odai Sichanthongthip
Although the Lao People's Democratic Republic (Lao PDR) is comparatively small landlocked country with patterns of both in- and out-migration, its human migration situation has been poorly studied. This is despite all of the country's 18 provinces sharing both official and unofficial border checkpoints with neighboring countries. Economic reforms in the last decade have seen a gradual increase in the promotion of foreign investment, and main towns and transportation networks have been expanding thus offering new opportunities for livelihoods and economic activities...
April 25, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#2
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28419634/contrast-enhanced-ultrasound-and-elastography-imaging-of-the-neonatal-brain-a-review
#3
REVIEW
Christopher Bailey, Thierry A G M Huisman, Robert M de Jong, Misun Hwang
Neonates presenting with neurologic symptoms require rapid, noninvasive imaging with high spatial resolution and tissue contrast. Magnetic resonance imaging (MRI) is currently the most sensitive and specific imaging modality for evaluation of neurological pathology. This modality does come with several challenges in the neonatal population, namely, the need to transport a possibly critically sick neonate to the MRI suite and the necessity of the neonate to remain still for a significant length of time, occasionally requiring sedation...
April 17, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28419552/feasibility-and-utility-of-portable-ultrasound-during-retrieval-of-sick-preterm-infants
#4
Kathryn Browning Carmo, Tracey Lutz, Mark Greenhalgh, Andrew Berry, Martin Kluckow, Nick Evans
AIM: Document the incidence of haemodynamic pathology in critically ill preterm newborns requiring transport. METHOD: A transport neonatologist performed cardiac and cerebral ultrasound before and after transportation of infants born ≤ 30 weeks gestation. RESULTS: 44 newborns were studied 2008 - 2015, 21 transported by road, 19 by helicopter and 4 by fixed wing. Median birth weight 1130g (680-1960g), median gestation 27 weeks (23-30) and 30/44 were male...
April 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28400289/mathematical-modelling-of-liquid-transport-in-swelling-pharmaceutical-immediate-release-tablets
#5
Daniel Markl, Samy Yassin, D Ian Wilson, Daniel J Goodwin, Andrew Anderson, J Axel Zeitler
Oral dosage forms are an integral part of modern health care and account for the majority of drug delivery systems. Traditionally the analysis of the dissolution behaviour of a dosage form is used as the key parameter to assess the performance of a drug product. However, understanding the mechanisms of disintegration is of critical importance to improve the quality of drug delivery systems. The disintegration performance is primarily impacted by the hydration and subsequent swelling of the powder compact. Here we compare liquid ingress and swelling data obtained using terahertz pulsed imaging (TPI) to a set of mathematical models...
April 8, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28388599/abcb1-genotype-is-associated-with-fentanyl-requirements-in-critically-ill-children
#6
Christopher M Horvat, Alicia K Au, Yvette L Conley, Patrick M Kochanek, Lingjue Li, Samuel L Poloyac, Philip E Empey, Robert S B Clark
BACKGROUND: The gene ABCB1 encodes p-glycoprotein, a xenobiotic efflux pump capable of transporting certain opioids, including fentanyl. ABCB1 genotype has been previously associated with patient opioid requirements and may influence fentanyl dosing requirements in critically ill children. METHODS: A diagnostically diverse cohort of 61 children who received a fentanyl infusion while admitted to the pediatric intensive care unit (PICU) were included in this study...
April 7, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28385926/critical-care-air-transport-team-severe-traumatic-brain-injury-short-term-outcomes-during-flight-for-operation-iraqi-freedom-operation-enduring-freedom
#7
L Renee Boyd, J Borawski, J Lairet, A T Limkakeng
INTRODUCTION: Our understanding of the expertise and equipment required to air transport injured soldiers with severe traumatic brain injuries (TBIs) continue to evolve. METHODS: We conducted a retrospective chart review of characteristics, interventions required and short-term outcomes of patients with severe TBI managed by the US Air Force Critical Care Air Transport Teams (CCATTs) deployed in support of Operation Iraqi Freedom and Operation Enduring Freedom between 1 June 2007 and 31 August 2010...
April 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28378030/potassium-regulation-in-the-neonate
#8
Melvin Bonilla-Félix
Potassium, the major cation in intracelluar fluids, is essential for vital biological functions. Neonates maintain a net positive potassium balance, which is fundamental to ensure somatic growth but places these infants, especially those born prematurely, at risk for life-threatening disturbances in potassium concentration [K(+)] in the extracellular fluid compartment. Potassium conservation is achieved by maximizing gastrointestinal absorption and minimizing renal losses. A markedly low glomerular filtration rate, plus adaptations in tubular transport along the nephron, result in low potassium excretion in the urine of neonates...
April 4, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28375994/translating-research-to-practice-providing-critically-ill-children-the-opportunity-to-go-home-or-to-hospice-for-end-of-life-care
#9
Harriett Nelson, Sandra Mott
BACKGROUND: A freestanding quaternary pediatric hospital in New England has been facilitating parents' requests to take their child home or to a hospice facility from an Intensive Care Unit at end of life for the withdrawal of life sustaining measures for the past 16 years. However, knowledge of the aftermath of this decision was very limited. Before responding to a growing interest in making this service more available, an exploratory study was done to learn about the parents' perceptions of the experience over time...
May 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28372709/tachyarrhythmias-and-bradyarrhythmias-differential-diagnosis-and-initial-management-in%C3%A2-the-primary-care-office
#10
REVIEW
Timothy Joseph Byrnes, Otto Costantini
Tachyarrhythmias and bradyarrhythmias are often seen in the outpatient setting. Patients can present minimally symptomatic or in extremis. Accurate diagnosis of the rhythm, plus a detailed clinical history, are critical for best management and optimal outcome. A 12-lead electrocardiogram is the cornerstone for diagnosis. Practitioners must identify patients who need immediate transport to an emergency department versus those who can safely wait for an outpatient specialty referral. This article reviews how to accurately diagnose and differentiate the most common tachyarrhythmias and bradyarrhythmias, the associated symptoms, and important concepts for the initial steps in the office management of such arrhythmias...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28353532/acute-illness-protocol-for-fatty-acid-oxidation-and-carnitine-disorders
#11
Saud H Aldubayan, Lance H Rodan, Gerard T Berry, Harvey L Levy
Inborn errors of metabolism (IEMs) are genetic disorders that disrupt enzyme activity, cellular transport, or energy production. They are individually rare but collectively have an incidence of 1:1000. Most patients with IEMs are followed by a physician with expertise in biochemical genetics (metabolism) but may present outside this setting. Because IEMs can present acutely with life-threatening crises that require specific interventions, it is critical for the emergency medicine physicians, pediatricians, internists, critical care physicians, and biochemical geneticists to be familiar with the initial assessment and management of patients with these disorders...
April 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28340603/blunt-cardiac-injury-due-to-trauma-associated-with-snowboarding-a-case-report
#12
Fuminori Yamaji, Hideshi Okada, Yasuhiro Nakajima, Kodai Suzuki, Takahiro Yoshida, Yosuke Mizuno, Haruka Okamoto, Yuichiro Kitagawa, Taku Tanaka, Shiho Nakano, Sho Nachi, Tomoaki Doi, Keisuke Kumada, Shozo Yoshida, Narihiro Ishida, Katsuya Shimabukuro, Hiroaki Ushikoshi, Izumi Toyoda, Kiyoshi Doi, Shinji Ogura
BACKGROUND: Cardiac trauma is associated with a much higher mortality rate than injuries to other organ systems, even though cardiac trauma is identified in less than 10% of all trauma admissions. Here we report blunt trauma of the left atrium due to snowboarding trauma. CASE PRESENTATION: A 45-year-old Asian man collided with a tree while he was snowboarding and drinking. He lost consciousness temporarily. An air ambulance was requested and he was transported to an advanced critical care center...
March 25, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28336009/case-study-in-critical-care-transport-a-51-year-old-male-with-ludwig-angina
#13
Brittney Bernardoni, Riley Grosso, Elizabeth Powell, Peter V R Tilney
No abstract text is available yet for this article.
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28320079/ketamine-reduces-the-need-for-intubation-in-patients-with-acute-severe-mental-illness-and-agitation-requiring-transport-to-definitive-care-an-observational-study
#14
Cathrin S Parsch, Adrianne Boonstra, David Teubner, Wade Emmerton, Brian McKenny, Daniel Y Ellis
OBJECTIVES: The aim of this study was to review mental health patients transported by a dedicated statewide critical care retrieval team before and after the implementation of a ketamine sedation guideline. METHODS: This is a a retrospective cohort study of mental health patients with acute behavioural disturbance, transported between January 2010 and December 2015. RESULTS: A total of 78 patients were transported in the study period, 50 before and 28 after implementation of the ketamine guideline in June 2013...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28306212/tracheal-extubation-practices-following-adenotonsillectomy-in-children-effects-on-operating-room-efficiency-between-two-institutions
#15
Hiromi Kako, Marco Corridore, Sarah Seo, Charles Elmaraghy, Meredith Lind, Joseph D Tobias
BACKGROUND: Adenotonsillectomy is one of the most commonly performed operative procedures in children. It is imperative to find the most efficient and cost-effective methods of practice to facilitate operating room management while maintaining patient safety. We investigated the efficiency of two different approaches of tracheal extubation in pediatric patients following adenotonsillectomy at two tertiary care pediatric hospitals with large surgical volumes. The primary aim of the study was to determine the difference in the operating room time according to the institutional practice of tracheal extubation in the postanesthesia care unit (PACU) as compared to the operating room...
March 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28291484/post-traumatic-stress-symptoms-in-united-states-air-force-aeromedical-evacuation-nurses-and-technicians
#16
Julie M Swearingen, Tanya M Goodman, Wayne L Chappelle, William T Thompson
Critical Care Air Transport Teams (CCATT) are specialized military medical personnel who provide high-acuity care in an aeromedical environment. The rate of post-traumatic stress disorder (PTSD) symptoms was assessed in CCATT personnel and their rates were compared to general aeromedical evacuation (AE) personnel. As part of a computer-based occupational stress survey, 188 crew members (138 AE nurses and technicians, 50 CCATT nurses and respiratory therapists) completed the PTSD Checklist - Military Version...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291467/a-retrospective-cohort-analysis-of-battle-injury-versus-disease-non-battle-injury-two-validating-flight-surgeons-experience
#17
William P Butler, Lawrence W Steinkraus, Brittany L Fouts, Jennifer L Serres
Today, military combat medical care is the best it has ever been. Regulated U.S. Air Force aeromedical evacuation (AE) is one important reason. The Theater Validating Flight Surgeon (TVFS) validates that a patient is ready for flight. Two TVFSs' experiences, successively deployed in 2007, are the focus of this study. A unique operational worksheet used to manage the AE queue was used for approximately 5 months. A descriptive analysis of the worksheet's 1,389 patients found the majority male (94%), median age 30 years, and mostly Army enlisted soldiers (63%)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291455/measuring-hemodynamic-changes-in-the-ophthalmic-artery-during-applied-force-for-noninvasive-intracranial-pressure-monitoring-test-results-in-a-porcine-model
#18
Max Twedt, Chase Pfeifer, William Thorell, Greg Bashford
Possible traumatic brain injury victims would greatly benefit from a handheld, noninvasive intracranial pressure (ICP) monitoring tool, which a medic could operate in a remote area. Such a device would also benefit the transport of injured soldiers during en route medical care and critical care air transport. This study demonstrates the use of noninvasive blood flow measurements in the eye by ultrasound as a proxy for ICP. ICP was artificially raised in a porcine model and resultant blood flow change in the ophthalmic artery was measured...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28283485/quit-emr-trial-a-prospective-observational-multicentre-study-to-evaluate-quality-and-24%C3%A2-hours-post-transport-morbidity-of-interhospital-transportation-of-critically-ill-patients-study-protocol
#19
Ulrich Strauch, Dennis C J J Bergmans, Joachim Habers, Jochen Jansen, Bjorn Winkens, Dirk J Veldman, Paul M H J Roekaerts, Stefan K Beckers
INTRODUCTION: It is widely accepted that transportation of critically ill patients is high risk. Unfortunately, however, there are currently no evidence-based criteria with which to determine the quality of various interhospital transport systems and their impact on the outcomes for patients. We aim to rectify this by assessing 2 scores which were developed in our hospital in a prospective, observational study. Primarily, we will be examining the Quality of interhospital critical care transportation in the Euregion Meuse-Rhine (QUIT EMR) score, which focuses on the quality of the transport system, and secondarily the SEMROS (Simplified EMR outcome score) which detects changes in the patient's clinical condition in the 24 hours following their transportation...
March 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28263703/supporting-return-to-work-through-appropriate-certification-a-systematic-approach-for-australian-primary-care
#20
Harry Papagoras, Tania Pizzari, Paul Coburn, Kevin Sleigh, Andrew M Briggs
Primary care practitioners play a critical role in supporting return to work (RTW) and minimising the detrimental physical and psychosocial sequelae of unnecessary and prolonged work absence in injured and ill workers. Accurate and consistent certification of capacity is an essential component of this role that has been scrutinised recently given the identified variation in certification practices between and within professions. This Perspective outlines the importance of correct certification of capacity for injured workers and provides a RTW flowchart to support systematised and appropriate certification...
March 7, 2017: Australian Health Review: a Publication of the Australian Hospital Association
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