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Trauma sedation

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https://www.readbyqxmd.com/read/28323290/incidence-and-risk-factors-for-delirium-development-in-icu-patients-a-prospective-observational-study
#1
Marcela Kanova, Peter Sklienka, Roman Kula, Michal Burda, Jana Janoutova
BACKGROUND AND AIMS: Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients. METHODS: A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period...
March 14, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28289942/structured-reporting-of-mri-of-the-shoulder-improvement-of-report-quality
#2
Sebastian Gassenmaier, Marco Armbruster, Florian Haasters, Tobias Helfen, Thomas Henzler, Sedat Alibek, Dominik Pförringer, Wieland H Sommer, Nora N Sommer
OBJECTIVES: To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons' satisfaction. METHODS: Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012-2015). All patients underwent shoulder MRI for further assessment and possible surgical planning...
March 13, 2017: European Radiology
https://www.readbyqxmd.com/read/28288325/trochanteric-hip-fracture-during-cardioversion-therapy-a-case-report
#3
J Gómez, J Albareda, L Ezquerra
INTRODUCTION: Trochanteric hip fractures in elderly patients with osteoporosis are commonly caused by low energy trauma. The cardioversion therapy is an extremely rare cause of this type of fracture. PRESENTATION OF CASE: We report the case of a woman with hip fracture after cardioversion. DISCUSSION: We discuss the production mechanism of this injury and the importance of the care of the osteoporotic bone under these therapies. CONCLUSION: The propofol sedation should be complemented with skeletal muscle relaxants in the cardioversion therapy to avoid hip fracture in select patients with osteoporosis...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28255580/clinical-applications-of-contrast-enhanced-ultrasound-in-the-pediatric-work-up-of-focal-liver-lesions-and-blunt-abdominal-trauma-a-systematic-review
#4
REVIEW
Nicolaj Grønbæk Laugesen, Christian Pallson Nolsoe, Jacob Rosenberg
In pediatrics ultrasound has long been viewed more favorably than imaging that exposes patients to radiation and iodinated contrast or requires sedation. It is child-friendly and diagnostic capabilities have been improved with the advent of contrast-enhanced ultrasound (CEUS). The application of CEUS is indeed promising. However, no ultrasound contrast agent manufactured today is registered for pediatric use in Europe. The contrast agent SonoVue(®) has recently been approved by the FDA under the name of Lumason(®) to be used in hepatic investigations in adults and children...
February 2017: Ultrasound International Open
https://www.readbyqxmd.com/read/28251431/48%C3%A2-h-cessation-of-mechanical-ventilation-during-venovenous-extracorporeal-membrane-oxygenation-in-severe-trauma-a-case-report
#5
Justyna Swol, Yann Fülling, Christopher Ull, Matthias Bechtel, Thomas A Schildhauer
A 32-year-old motorcyclist who was hit by a tram subsequently presented with blunt force thoracic trauma, a pelvic fracture and a penetrating injury to the left lower extremity. Coagulopathy persisted following surgery of the leg and pelvic vascular intervention. Bedside thoracotomy was performed to treat pneumothorax and pneumopericardium. Severe hypoxemia secondary to lung failure ensued, which required venovenous extracorporeal membrane oxygenation (VV ECMO) support. On the third day after the trauma, ultra-protective mechanical ventilation was not possible due to non-existent lung compliance; thus, the ventilator was disconnected, and the T-piece was connected to the blocked tracheal tube left in the airway...
March 1, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#6
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28183837/diagnostic-performance-of-ultrafast-brain-mri-for-evaluation-of-abusive-head-trauma
#7
S F Kralik, M Yasrebi, N Supakul, C Lin, L G Netter, R A Hicks, R A Hibbard, L L Ackerman, M L Harris, C Y Ho
BACKGROUND AND PURPOSE: MR imaging with sedation is commonly used to detect intracranial traumatic pathology in the pediatric population. Our purpose was to compare nonsedated ultrafast MR imaging, noncontrast head CT, and standard MR imaging for the detection of intracranial trauma in patients with potential abusive head trauma. MATERIALS AND METHODS: A prospective study was performed in 24 pediatric patients who were evaluated for potential abusive head trauma...
February 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28148613/delirium-in-trauma-patients-prevalence-and-predictors
#8
Kathryn T Von Rueden, Breighanna Wallizer, Paul Thurman, Karen McQuillan, Tiffany Andrews, Jennifer Merenda, Heesook Son
BACKGROUND: Delirium is associated with increased mortality, morbidity, hospital costs, and postdischarge cognitive dysfunction. Most research focuses on nontrauma patients receiving mechanical ventilation in the intensive care unit. OBJECTIVES: To determine the prevalence and predictors of delirium in trauma patients residing in intensive and intermediate care units of an academic medical center. METHODS: Trauma patients were screened for delirium by using the Confusion Assessment Method for the Intensive Care Unit...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28146616/acute-substance-use-as-a-warning-sign-for-suicide-attempts-a-case-crossover-examination-of-the-48-hours-prior-to-a-recent-suicide-attempt
#9
Courtney L Bagge, Guilherme Borges
OBJECTIVE: The extent to which specific categories of acute substance use are short-term risk factors, or warning signs, for suicide attempts is unknown. The aim of the current study was to quantify the near-term effects of sole use and co-use of substances on medically attended suicide attempts. METHODS: The current study used a case-crossover design, comparing substance use within the 24 hours prior to a suicide attempt (case day) to the control day, the matched 24 hours the day prior to the case day...
January 31, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28106673/outcomes-of-pediatric-fractures-managed-with-closed-reduction-by-orthopaedic-residents-in-the-emergency-department
#10
Vivek Natarajan, Ermias Abebe, James Dunlap, Patrick Bosch, Ozgur Dede, W Timothy Ward, James Roach
BACKGROUND: Closed reduction of pediatric fractures is commonly performed by orthopaedic residents using conscious sedation in the emergency department (ED). The purpose of this study was to determine the rate of satisfactory reductions as performed by residents, and to determine the outcomes of these procedures. METHODS: A retrospective review was performed of all fractures that underwent closed reduction under conscious sedation in the ED of a level 1 pediatric trauma center between January 1, 2010 and November 30, 2014...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28098590/analgesia-and-sedation-requirements-in-mechanically-ventilated-trauma-patients-with-acute-preinjury-use-of-cocaine-and-or-amphetamines
#11
Bridgette Kram, Shawn J Kram, Michelle L Sharpe, Michael L James, Maragatha Kuchibhatla, Mark L Shapiro
BACKGROUND: The purpose of this study was to determine whether mechanically ventilated trauma patients with a positive urine drug screen (UDS) for cocaine and/or amphetamines have different opioid analgesic and sedative requirements compared with similar patients with a negative drug screen for these stimulants. METHODS: This retrospective, single-center cohort study at a tertiary care, academic medical and level 1 trauma center in the United States included patients ≥16 years of age who were admitted to an adult intensive care unit with a diagnosis of trauma between 2009 and 2013 with a UDS documented within 24 hours of admission, and were mechanically ventilated for >24 hours...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27959665/retrospective-analysis-of-the-safety-and-cost-implications-of-pediatric-contrast-enhanced-ultrasound-at-a-single-center
#12
Gibran T Yusuf, Maria E Sellars, Annamaria Deganello, David O Cosgrove, Paul S Sidhu
OBJECTIVE: Because of concern over medical ionizing radiation exposure of children, contrast-enhanced ultrasound (CEUS) has generated interest as an inexpensive, ionizing radiation-free alternative to CT and MRI. CEUS has received approval for pediatric hepatic use but remains off-label for a range of other applications. The purposes of this study were to retrospectively analyze adverse incidents encountered in pediatric CEUS and to assess the financial benefits of reducing the number of CT and MRI examinations performed...
February 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27939017/regional-analgesia-in-postsurgical-critically-ill-patients
#13
S Moliner Velázquez, R Rubio Haro, C De Andrés Serrano, J De Andrés Ibáñez
Regional analgesia intrinsically, based on its physiological effects, is routinely used for the perioperative treatment of pain associated with surgical procedures. However, in other areas such as the non-surgical treatment of acute pain for patients in a critical condition, it has not been subjected to specific prospective studies. If we confine ourselves to the physiological effects of the nerve block, in a situation of stress, the indications for regional anaesthesia in this group of patients extend to the management of a wide variety of medical as well as postsurgical conditions, of trauma patients and of other painful procedures performed in the patient's bed...
December 7, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27909609/emergency-difficult-airway-management-in-a-patient-with-severe-epidermolysis-bullosa
#14
Ahmet Selim Özkan, Gülay Erdoğan Kayhan, Sedat Akbaş, Osman Kaçmaz, Mahmut Durmuş
Epidermolysis bullosa (EB) is a rare disease characterised by vesiculobullous lesions with minimal trauma to the skin and mucous membranes. Bleeding, scar tissue, contractures, oedema and lesions that can spread throughout the body can cause a difficult airway and vascular access in patients with EB. Therefore, anaesthetic management in patients with EB is a major problem even for experienced anaesthesiologists. Herein, we report a case of difficult airway management in a patient diagnosed with severe EB who presented for emergency tracheostomy because of respiratory failure under general anaesthesia...
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27856146/early-neurological-wake-up-test-in-intubated-brain-injured-patients-a-long-term-single-centre-experience
#15
Pierre Esnault, Ambroise Montcriol, Erwan D'Aranda, Julien Bordes, Philippe Goutorbe, Henry Boret, Eric Meaudre
BACKGROUND: In prehospital setting, a severe traumatic brain injury (TBI) requires tracheal intubation, sedation and mechanical ventilation pending the initial imagery. An early neurological wake-up test (ENWT), soon after the initial imaging assessment, allows a rapid neurological reassessment. This strategy authorises an initial clinical examination of reference with which will be compared the later examinations. The main objective of this study was to describe the characteristics of the patients who underwent an ENWT, and to determine its causes of failure...
November 14, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27826208/sedation-with-a-remifentanil-infusion-to-facilitate-rapid-awakening-and-tracheal-extubation-in-an-infant-with-a-potentially-compromised-airway
#16
Jeffrey Naples, Mark W Hall, Joseph D Tobias
Sedation is generally required during endotracheal intubation and mechanical ventilation in infants and children. While there are many options for the provision of sedation, the most commonly used agents such as midazolam and fentanyl demonstrate a context-sensitive half-life, which may result in a prolonged effect when these agents are discontinued following a continuous infusion. We present a 20-month-old infant who required endotracheal intubation due to respiratory failure following seizures. At the referring hospital, multiple laryngoscopies were performed with the potential for airway trauma...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27823873/a-prospective-observational-study-of-patients-receiving-intravenous-and-intramuscular-olanzapine-in-the-emergency-department
#17
Jon B Cole, Johanna C Moore, Benjamin J Dolan, Alex O'Brien-Lambert, Brandon J Fryza, James R Miner, Marc L Martel
STUDY OBJECTIVE: Parenteral olanzapine is an emerging therapy for a variety of conditions in the emergency department (ED). Intramuscular administration is standard; however, intravenous administration has been proposed as a safe alternative route. We investigate the safety and efficacy of both intramuscular and intravenous olanzapine in the ED when used for a variety of indications. METHODS: This was a prospective observational study of patients presenting to an urban Level I trauma center ED...
March 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27800539/comparing-two-different-doses-of-intravenous-midazolam-in-pediatric-sedation-and-analgesia
#18
Hassan Barzegari, Kambiz Masoumi, Hassan Motamed, Behzad Zohrevandi, Shima Zeynadini Meymand
INTRODUCTION: Midazolam has turned into a common drug for pediatric procedural sedation and analgesia. However, there is not much data regarding its proper dose and potential side effects in the Iranian children population. Therefore, the present study was done to compare 2 doses of IV midazolam in this regard. METHODS: The present clinical trial was performed to compare 0.1 and 0.3 mg/kg doses of IV midazolam in induction of sedation for head trauma infant patients in need of brain computed tomography (CT) scan...
November 2016: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/27761920/isoflurane-prevents-acquired-epilepsy-in-rat-models-of-temporal-lobe-epilepsy
#19
Guy Bar-Klein, Rebecca Klee, Claudia Brandt, Marion Bankstahl, Pablo Bascuñana, Kathrin Töllner, Hotjensa Dalipaj, Jens P Bankstahl, Alon Friedman, Wolfgang Löscher
OBJECTIVE: Acquired epilepsy is a devastating long-term risk of various brain insults, including trauma, stroke, infections, and status epilepticus (SE). There is no preventive treatment for patients at risk. Attributable to the complex alterations involved in epileptogenesis, it is likely that multitargeted approaches are required for epilepsy prevention. We report novel preclinical findings with isoflurane, which exerts various nonanesthetic effects that may be relevant for antiepileptogenesis...
December 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27718440/an-interesting-case-report-of-vertebral-artery-dissection-following-polytrauma
#20
Vikas Acharya, Suresh Chandrasekaran, Sujit Nair
INTRODUCTION: The authors present an interesting case of a 19-year-old male who presented as a polytrauma patient following a fall from a height. PRESENTATION OF CASE: He was initially managed on the intensive care unit with intracranial pressure bolt monitoring after being intubated and sedated and having his other traumatic injuries stabilized. Upon attempting to wean sedation and extubation a repeat CT scan of the head was undertaken and showed a new area suggested of cerebral infarction, this was a new finding...
October 3, 2016: International Journal of Surgery Case Reports
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