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Critical care transport

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https://www.readbyqxmd.com/read/29146024/effect-of-serum-albumin-concentration-on-neurological-outcome-after-out-of-hospital-cardiac-arrest-from-the-critical-comprehensive-registry-of-intensive-cares-for-ohca-survival-study-in-osaka-japan
#1
Tasuku Matsuyama, Taku Iwami, Tomoki Yamada, Koichi Hayakawa, Kazuhisa Yoshiya, Taro Irisawa, Yoshio Abe, Tetsuro Nishimura, Toshifumi Uejima, Yasuo Ohishi, Takeyuki Kiguchi, Masashi Kishi, Masafumi Kishimoto, Shota Nakao, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Junichi Izawa, Tomonari Shimamoto, Toshihiro Hatakeyama, Tomoko Fujii, Junya Sado, Takeshi Shimazu, Takashi Kawamura, Tetsuhisa Kitamura
The aim of this study was to assess whether serum albumin concentration upon hospital arrival had prognostic indications on out-of-hospital cardiac arrest (OHCA). This prospective, multicenter observational study conducted in Osaka, Japan (the CRITICAL [Comprehensive Registry of Intensive Cares for OHCA Survival] study), enrolled all patients with consecutive OHCA transported to 14 participating institutions. We included adult patients aged ≥18 years with nontraumatic OHCA who achieved return of spontaneous circulation and whose serum albumin concentration was available from July 2012 to December 2014...
October 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29135898/acute-illness-protocol-for-urea-cycle-disorders
#2
Lance H Rodan, Saud H Aldubayan, 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 up 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 physician, internist, and critical care physician as well as the biochemical geneticist to have information on the initial assessment and management of patients with these disorders...
November 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29132597/retrospective-review-of-pediatric-transport-where-do-our-patients-go-after-transport
#3
REVIEW
Emily Krennerich, Curtis G Sitler, Manish Shah, Fong Lam, Jeanine Graf
OBJECTIVE: This review describes disposition of transported children and identifies contributing factors affecting optimal patient placement. The study describes timing and patient placement indicators in transport patients to identify areas of improvement, re-education, and training. METHODS: A retrospective chart review for transports via our pediatric specialty transport team from January 1, 2012, to December 31, 2014, was performed. Patients were identified by the transport quality assurance performance improvement database, hospital electronic medical records, and transport medical records...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29132595/remote-ecls-implantation-and-transport-for-retrieval-of-cardiogenic-shock-patients
#4
Sabina P W Guenther, Stefan Buchholz, Frank Born, Stefan Brunner, René Schramm, Dominik J Hoechter, Vera von Dossow, Maximilian Pichlmaier, Christian Hagl, Nawid Khaladj
OBJECTIVE: Extracorporeal life support (ECLS) emerges as a salvage option in therapy refractory cardiogenic shock but is limited to highly specialized tertiary care centers. Critically ill patients are often too unstable for conventional transport. Mobile ECLS programs for remote implantation and subsequent air or ground-based transport for patient retrieval could solve this dilemma and make full-spectrum advanced cardiac care available to patients in remote hospitals in whom shock otherwise might be fatal...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29130405/what-is-the-role-of-community-at-the-end-of-life-for-people-dying-in-advanced-age-a-qualitative-study-with-bereaved-family-carers
#5
Merryn Gott, Janine Wiles, Tess Moeke-Maxwell, Stella Black, Lisa Williams, Ngaire Kerse, Gabriella Trussardi
BACKGROUND: New public health approaches to palliative care prioritise the role of community at end of life. However, little is known about community support for the increasing numbers of people dying in advanced age. AIM: To explore the role of community at end of life for people dying in advanced age from the perspective of their bereaved family caregivers. DESIGN: A constructionist framework underpinned a qualitative research design. Data were analysed using critical thematic analysis...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29123878/investigation-of-japan-disaster-medical-assistance-team-response-guidelines-assuming-catastrophic-damage-from-a-nankai-trough-earthquake
#6
Hideaki Anan, Hisayoshi Kondo, Osamu Akasaka, Kenichi Oshiro, Mitsunobu Nakamura, Tetsuro Kiyozumi, Norihiko Yamada, Masato Homma, Kazuma Morino, Shinichi Nakayama, Yasuhiro Otomo, Yuichi Koido
Aim: Transporting critically ill patients outside of disaster-affected areas for treatment is an important activity of Japan Disaster Medical Assistance Teams (DMATs). We investigated whether this activity is possible after possible catastrophic damage from a Nankai Trough earthquake. Methods: Japan was divided into three areas based on the level of predicted damage (definitely, possibly, and non-affected areas). A survey of DMATs and the locations of emergency base hospitals and intensive care units (ICUs) in each area was carried out, and the ability to support disaster areas was investigated...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122111/temperature-sensitive-medications-in-interfacility-transport-the-ice-pack-myth
#7
Jason Clancy, Cassandra Karish, Meghan Roddy, Judith J Sicilia, Michael T Bigham
INTRODUCTION: Critical Care Transport teams use various strategies to maintain temperature sensitive drugs and equipment at optimal temperature. The purpose of this study was to examine the effectiveness of current passive refrigeration of temperature sensitive transport medications/equipment. METHODS: Initially, we performed a retrospective review of transport durations. Subsequently, an experimental paradigm was created using a temperature probe inside of the transport cooler packs utilizing various configurations and initial starting temperatures with high and low "in range" temperature margins of 8°C (max) and 2°C (min)...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29101687/community-perspectives-on-emergency-department-use-and-care-for-american-indian-children
#8
Wyatt J Pickner, Katherine M Ziegler, Jessica D Hanson, Nathaniel R Payne, Heather G Zook, Anupam B Kharbanda, Tess L Weber, Jaymi N Russo, Susan E Puumala
Emergency department (ED) utilization by American Indian (AI) children is among the highest in the nation. Numerous health disparities have been well documented in AI children, but limited information is available on parental experiences of care for AI children in the ED. Our objective was to understand parental attitudes towards ED care for AI children. Focus groups were held with AI parents/caregivers at five sites in the Upper Midwest. Traditional content analysis was used to identify themes. A total of 70 parents participated in ten focus groups...
November 3, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/29095391/acute-illness-protocol-for-maple-syrup-urine-disease
#9
Lance H Rodan, Saud H Aldubayan, 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 up 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 physician, pediatrician, internist, and critical care physician as well as the biochemical geneticist to have information on the initial assessment and management of patients with these disorders...
October 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#10
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29062574/analysis-of-adverse-events-during-intrahospital-transportation-of-critically-ill-patients
#11
Francielli Mary Pereira Gimenez, Wesley Henrique Bueno de Camargo, Ana Clara Beraldo Gomes, Thaylla Sumyre Nihei, Monique Walicheki Maria Andrade, Maria Laura de A F Sé Valverde, Larissa D' Epiro de Souza Campos, Debora Carvalho Grion, Josiane Festti, Cintia Magalhães Carvalho Grion
PURPOSE: To describe adverse events occurring during intrahospital transportation of adult patients hospitalized in an Intensive Care Unit (ICU) and to evaluate the association with morbidity and mortality. METHOD: Prospective cohort study from July 2014 to July 2015. Data collection comprised clinical data, prognostic scores, length of stay, and outcome at hospital discharge. Data was collected on transport and adverse events. Adverse events were classified according to the World Health Organization following the degree of damage...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29046271/client-focused-security-assessment-of-mhealth-apps-and-recommended-practices-to-prevent-or-mitigate-transport-security-issues
#12
Jannis Müthing, Thomas Jäschke, Christoph M Friedrich
BACKGROUND: Mobile health (mHealth) apps show a growing importance for patients and health care professionals. Apps in this category are diverse. Some display important information (ie, drug interactions), whereas others help patients to keep track of their health. However, insufficient transport security can lead to confidentiality issues for patients and medical professionals, as well as safety issues regarding data integrity. mHealth apps should therefore deploy intensified vigilance to protect their data and integrity...
October 18, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29034303/validation-of-capillary-blood-analysis-and-capillary-testing-mode-on-the-epoc-point-of-care-system
#13
Jing Cao, Rachel Edwards, Janette Chairez, Sridevi Devaraj
BACKGROUND: Laboratory test in transport is a critical component of patient care, and capillary blood is a preferred sample type particularly in children. This study evaluated the performance of capillary blood testing on the epoc Point of Care Blood Analysis System (Alere Inc). METHODS: Ten fresh venous blood samples was tested on the epoc system under the capillary mode. Correlation with GEM 4000 (Instrumentation Laboratory) was examined for Na+, K+, Cl-, Ca2+, glucose, lactate, hematocrit, hemoglobin, pO2, pCO2, and pH, and correlation with serum tested on Vitros 5600 (Ortho Clinical Diagnostics) was examined for creatinine...
December 2017: Pract Lab Med
https://www.readbyqxmd.com/read/29028420/the-effect-of-telemedicine-on-resource-utilization-and-hospital-disposition-in-critically-ill-pediatric-transport-patients
#14
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/29023218/out-of-hospital-pediatric-patient-safety-events-results-of-the-csi-chart-review
#15
Garth Meckler, Matthew Hansen, William Lambert, Kerth O'Brien, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events. METHODS: As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29019293/evolution-of-the-concept-of-oxygen-transport-in-the-critically-ill-with-a-focus-on-children-after-cardiopulmonary-bypass
#16
Jia Li
The concept of oxygen transport, defined as the relation between oxygen consumption (VO2) and delivery (DO2), is of fundamental importance in critically ill patients. The past 200 years have witnessed a stepwise progressive improvement in the understanding of pathophysiological disturbances in the balance of DO2 and VO2 in critically ill patients including those after cardiopulmonary bypass surgery. Intermittent spectacular technological achievements have accelerated the rate of progress. Therapeutic advances have been particularly impressive during the recent decades...
October 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29017631/infants-born-with-critical-chd-in-arizona-and-capacities-of-birth-centres-for-screening-and-management
#17
Lydia Villa, Brent Bjornsen, Heather Giacone, Erica M Weidler, Ekta Bajaj, Andrew Muth, Melanie Kennedy, Timothy Flood, Dianna Contreras, Joseph Spadafino, Ashish Shah
OBJECTIVES: The aims of this study were to identify locations of births in Arizona with critical CHD, as well as to assess the current use of pulse-oximetry screening and capacities of birth centres to manage a positive screen. Study design Infants (n=487) with a potentially critical CHD were identified from the Arizona Department of Health Services from 2012 and 2013; charts were retrospectively reviewed. Diagnosis was confirmed using echocardiographies. ArcGIS was used to generate maps to visualise the location of treating facility and mother's residence...
October 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29017451/multiplex-pcr-point-of-care-testing-versus-routine-laboratory-based-testing-in-the-treatment-of-adults-with-respiratory-tract-infections-a-quasi-randomised-study-assessing-impact-on-length-of-stay-and-antimicrobial-use
#18
Denise Andrews, Yumela Chetty, Ben S Cooper, Manjinder Virk, Stephen K Glass, Andrew Letters, Philip A Kelly, Malur Sudhanva, Dakshika Jeyaratnam
BACKGROUND: Laboratory-based respiratory pathogen (RP) results are often available too late to influence clinical decisions such as hospitalisation or antibiotic treatment due to time delay in transport of specimens and testing schedules. Ward-based i.e. point of care (POC) testing providing rapid results may alter the clinical management pathway. METHODS: FilmArray® RP polymerase chain reaction (PCR) systems were placed in three in-patient and out-patient medical areas...
October 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28979100/acceptability-of-community-based-adherence-clubs-among-health-facility-staff-in-south-africa-a-qualitative-study
#19
Ndumiso Tshuma, Ofentse Mosikare, Jessica A Yun, Olufunke A Alaba, Meera S Maheedhariah, Keith Muloongo, Peter S Nyasulu
BACKGROUND: Patient retention in care for HIV/AIDS is a critical challenge for antiretroviral treatment programs. Community-based adherence programs (CBAPs) as compared to health care facility-based adherence programs have been considered as one of the options to provide treatment maintenance support for groups of patients on antiretroviral therapy. Such an approach provides a way of enhancing self-management of the patient's condition. In addition, CBAPs have been implemented to support antiretroviral treatment expansion in resource-limited settings...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28978010/the-network-of-dab2ip-mir-138-in-regulating-drug-resistance-of-renal-cell-carcinoma-associated-with-stem-like-phenotypes
#20
Eun-Jin Yun, Jiancheng Zhou, Chun-Jung Lin, Shan Xu, John Santoyo, Elizabeth Hernandez, Chih-Ho Lai, Ho Lin, Dalin He, Jer-Tsong Hsieh
Targeted therapy is a standard of care for metastatic renal cell carcinoma (RCC) but the response rate is not overwhelmed, which only prolongs a short survival of patients due to the onset of therapeutic resistance. Although the mechanisms are not fully understood, the presence of cancer initiating cells (CIC) may underlie the drug resistance. Nevertheless, identifying CIC phenotypes with its biomarkers in RCC appear to be diverse and controversial from many reports. In this study, we took a different approach to focus on the regulatory mechanism in RCC-CIC and unveil DAB2IP-mediated miR-138 expression that plays a critical role in modulating stem-like phenotypes in RCC via targeting the ABC transporter (ABCA13) as well as oncogenic histone methyltransferase EZH2 while down regulation of miR-138 gene expression in RCC is due to epigenetic gene silencing by DNA methyltransferase 1 (DNMT1)...
September 15, 2017: Oncotarget
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