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https://www.readbyqxmd.com/read/27912248/mean-arterial-blood-pressure-management-of-acute-spinal-cord-injured-patients-during-the-pre-hospital-and-early-admission-period
#1
Jin Wee Tee, Farhaan Altaf, Lise M Belanger, Tamir Ailon, John Street, Scott J Paquette, Michael C Boyd, Charles G Fisher, Marcel F Dvorak, Brian K Kwon
The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5 to 7 days following acute traumatic SCI is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU) or operating room (OR)...
December 2, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27905677/coping-and-caring-support-resources-integral-to-perioperative-nurses-during-the-process-of-organ-procurement-surgery
#2
Zaneta Smith, Gavin Leslie, Dianne Wynaden
AIM AND OBJECTIVE: This paper, discusses and explores the levels of support provided to perioperative nurses' when participating in multi-organ procurement surgery and the impact to their overall well-being. BACKGROUND: Assisting within multi-organ procurement surgical procedures has been recognised to impact on the well-being of perioperative nurses leaving little opportunity for them to recover from their participation or to seek available support resources. To date, this area has remained largely unexplored with limited evidence of how nurses manage and cope with these procedures, in addition to the support received in the workplace...
December 1, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27904258/cost-analysis-of-a-disaster-facility-at-an-apex-tertiary-care-trauma-center-of-india
#3
Sheetal Singh, Shakti Gupta, Anoop Daga, Vijaydeep Siddharth, LaxmiTej Wundavalli
INTRODUCTION: For the Commonwealth Games 2010, Jai Prakash Narayan Apex Trauma Centre (JPNATC) of India had been directed by the Director General Health Services and Ministry of Health and Family Welfare, Government of India, to set up a specialized unit for the definitive management of the injured/unwell athletes, officials, and related personnel coming for the Commonwealth Games in October 2010. The facility included a 20-bedded fully equipped ward, six ICU beds with ventilator capacity, one very very important person observation area, one perioperative management cubicle, and one fully modular and integrated operating room...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27900669/disruptive-behaviour-in-the-perioperative-setting-a-contemporary-review
#4
Alexander Villafranca, Colin Hamlin, Stephanie Enns, Eric Jacobsohn
PURPOSE: Disruptive behaviour, which we define as behaviour that does not show others an adequate level of respect and causes victims or witnesses to feel threatened, is a concern in the operating room. This review summarizes the current literature on disruptive behaviour as it applies to the perioperative domain. SOURCE: Searches of MEDLINE(®), Scopus™, and Google books identified articles and monographs of interest, with backreferencing used as a supplemental strategy...
November 29, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27900417/definition-of-hemodynamic-stability-in-blunt-trauma-patients-a-systematic-review-and-assessment-amongst-dutch-trauma-team-members
#5
S A I Loggers, T W A Koedam, G F Giannakopoulos, E Vandewalle, M Erwteman, W P Zuidema
INTRODUCTION: Trauma is a great contributor to mortality worldwide. One of the challenges in trauma care is early identification and management of bleeding. The circulatory status of blunt trauma patients in the emergency room is evaluated using hemodynamic (HD) parameters. However, there is no consensus on which parameters to use. In this study, we evaluate the used terms and definitions in the literature for HD stability and compare those to the opinion of Dutch trauma team members...
November 30, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#6
REVIEW
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27894498/noncompressible-torso-hemorrhage
#7
REVIEW
Jonathan J Morrison
Noncompressible torso hemorrhage (NCTH) constitutes a leading cause of potentially preventable trauma mortality. NCTH is defined by high-grade injury present in one or more of the following anatomic domains: pulmonary, solid abdominal organ, major vascular or pelvic trauma; plus hemodynamic instability or the need for immediate hemorrhage control. Rapid operative management, as part of a damage control resuscitation strategy, remains the mainstay of treatment. However, endovascular techniques are evolving and may become more mainstream with the advent of hybrid rooms that can deliver concurrent open and radiologic/endovascular management of traumatic hemorrhage...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27891285/complex-perineal-trauma-with-anorectal-avulsion
#8
Adelina Maria Cruceru, Ionut Negoi, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, Mircea Beuran
Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27875660/successful-use-of-targeted-temperature-management-after-repair-of-myocardial-rupture-from-blunt-chest-trauma-a-case-report
#9
Wook-Jin Choi, Yun Seok Kim, Jung Seok Hong, Jeong Won Kim
Targeted temperature management (TTM) improves survival and neurological outcome after nontraumatic cardiac arrest. However, TTM is not used widely after traumatic cardiac arrest because of concerns that it might exacerbate bleeding. We report the use of postarrest TTM after repair of blunt myocardial rupture. A 48-year-old man was admitted after being rescued from a major traffic accident by the local emergency service. Focused sonography showed pericardial fluid without cardiac tamponade. Computed tomography showed a large hematoma in the anterior mediastinum associated with hemopericardium...
November 22, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27875120/new-frontiers-in-robotic-surgery-the-latest-high-tech-surgical-tools-allow-for-superhuman-sensing-and-more
#10
Michele Solis
Over the past 30 years, robots have become standard fixtures in operating rooms. During brain surgery, a NeuroMate robot may guide a neurosurgeon to a target within the pulsing cortex. In orthopedics, a Mako robot sculpts and drills bone during knee and hip replacement surgery. Dominating the general surgery field is the da Vinci robot, a multiarmed device that allows surgeons to conduct precise movements of tools through small incisions that they could not manage with their own hands.
November 2016: IEEE Pulse
https://www.readbyqxmd.com/read/27873446/the-first-two-years-of-activity-of-a-specialized-organ-procurement-centre-report-of-an-innovative-approach-to-improve-organ-donation
#11
Pierre Marsolais, Philippe Durand, Emmanuel Charbonney, Karim Serri, Anne-Marie Lagacé, Francis Bernard, Martin Albert
The number of patients requiring organ transplants continues to outgrow the number of organs donated each year. In an attempt to improve the organ donation process and increase the number of organs available, we created a specialized multidisciplinary team within a specialized Organ Procurement Centre (OPC) with dedicated intensive care unit beds and operating rooms. The OPC was staffed with ICU nurses, operating room nurses, organ donor management ICU physicians and multidisciplinary staff. All organ donors within a designated geographic area were transferred and managed within the OPC...
November 22, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27871589/trainee-experience-and-success-of-urgent-airway-management
#12
Thomas E Schulte, Kyle J Ringenberg, Steven J Lisco, Harlan Sayles, Sasha K Shillcutt
BACKGROUND: There are limited data regarding emergent, non-operating room, intubations performed by all levels of anesthesia residents. This study was a large retrospective review of all non-operating room emergent intubations performed at a single tertiary medical center. The study evaluated the rate of difficult intubations by level of resident training, compared success rates for direct versus video laryngoscopy and evaluated the rate and success of rescue video laryngoscopy following failed direct laryngoscopy...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871545/fiberoptic-guided-intubation-after-insertion-of-the-i-gel-airway-device-in-spontaneously-breathing-patients-with-difficult-airway-predicted-a-prospective-observational-study
#13
Julian Arévalo-Ludeña, Jose Juan Arcas-Bellas, Rafael Alvarez-Rementería, Luis Enrique Muñoz Alameda
STUDY OBJECTIVE: To assess the viability of performing fiberoptic-guided orotracheal intubation through the i-gel airway device previously inserted in spontaneously breathing patients with predicted difficult airway to achieve a patent airway. DESIGN: Prospective observational study. SETTING: Operating room in a tertiary care hospital. PATIENTS: Eighty-five adult patients with at least 3 difficult airway predictors or difficult airway management history were included...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871520/cisatracurium-and-rocuronium-associated-residual-neuromuscular-dysfunction-under-intraoperative-neuromuscular-monitoring-and-postoperative-neostigmine-reversal-a-single-blind-randomized-trial
#14
Paolo Feltracco, Tommaso Tonetti, Stefania Barbieri, Anna Chiara Frigo, Carlo Ori
BACKGROUND: Postoperative residual neuromuscular blockade (RNMB) is a common complication in the postanesthesia care unit (PACU), but also one of the most controversial issues. Many studies and trials demonstrated that some methods and techniques can reduce the incidence and the extent of the phenomenon. STUDY OBJECTIVE: To determine the incidence of RNMB in the PACU at standardized times after extubation with the implementation of a protocol of careful neuromuscular blockade management...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870668/cost-savings-opportunities-in-perioperative-management-of-the-patients-with-orthopaedic-trauma
#15
Alastair E Moody, Catriona E Moody, Peter L Althausen
Considerable opportunities for cost savings exist surrounding the perioperative management of patients with orthopaedic fracture and trauma. Scientific evidence is available to support each potential cost savings measure. Much of these data had been documented for years but has never been adhered to, resulting in millions of dollars in unnecessary testing and treatment. Careful attention to preoperative laboratory testing can save huge amounts of money and expedite medical clearance for injured patients. The use of a dedicated orthopaedic trauma operating room has been shown to improve resource utilization, decrease costs, and surgical complications...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27868091/aftermath-of-grade-3-ureteral-injury-from-passage-of-a-ureteral-access-sheath-disaster-or-deliverance
#16
Roshan M Patel, Zhamshid Okhunov, Kamaljot Kaler, Ralph V Clayman
Background: The ureteral access sheath (UAS) has revolutionized the management of urinary pathology in the upper tract by providing rapid repeatable access to the upper urinary tract. However, in many practices, it remains a controversial tool in endourology given concerns of possible ureteral injury and presumed long-term sequela from those injuries. This case suggests that these concerns may be more hypothetical than real. Case Presentation: A 32-year-old female with a history of recurrent nephrolithiasis presented with left-sided symptomatic renal colic...
2016: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/27853725/a-study-on-performance-and-safety-tests-of-electrosurgical-equipment
#17
A Tavakoli Golpaygani, M M Movahedi, M Reza
INTRODUCTION: Modern medicine employs a wide variety of instruments with different physiological effects and measurements. Periodic verifications are routinely used in legal metrology for industrial measuring instruments. The correct operation of electrosurgical generators is essential to ensure patient's safety and management of the risks associated with the use of high and low frequency electrical currents on human body. MATERIAL AND METHODS: The metrological reliability of 20 electrosurgical equipment in six hospitals (3 private and 3 public) was evaluated in one of the provinces of Iran according to international and national standards...
September 2016: Journal of Biomedical Physics & Engineering
https://www.readbyqxmd.com/read/27852231/a-discrete-event-simulation-model-of-clinical-and-operating-room-efficiency-outcomes-of-sugammadex-versus-neostigmine-for-neuromuscular-block-reversal-in-canada
#18
Ralph P Insinga, Cédric Joyal, Alexandra Goyette, André Galarneau
BACKGROUND: The objective of this analysis is to explore potential impact on operating room (OR) efficiency and incidence of residual neuromuscular blockade (RNMB) with use of sugammadex (Bridion™, Merck & Co., Inc., Kenilworth, NJ USA) versus neostigmine for neuromuscular block reversal in Canada. METHODS: A discrete event simulation (DES) model was developed to compare ORs using either neostigmine or sugammadex for NMB reversal over one month. Selected inputs included OR procedure and turnover times, hospital policies for paid staff overtime and procedural cancellations due to OR time over-run, and reductions in RNMB and associated complications with sugammadex use...
November 16, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27849653/the-role-of-aspirin-desensitization-in-the-management-of-aspirin-exacerbated-respiratory-disease
#19
Bobby A Tajudeen, Joseph S Schwartz, John V Bosso
PURPOSE OF REVIEW: Aspirin-exacerbated respiratory disease (AERD) is a progressive inflammatory disease of the upper and lower airways characterized by marked eosinophilic nasal polyposis, asthma, and respiratory reactions to medications that inhibit the cyclooxygenase pathway. Aspirin desensitization has proven to be an effective tool in the management of this disease when used in a multidisciplinary setting. The purpose of this article is to review the current literature regarding AERD, aspirin desensitization, and share our opinion regarding the most optimal multidisciplinary approach to these complex patients...
November 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27847094/pain-management-in-an-enhanced-recovery-pathway-after-thoracic-surgical-procedures
#20
Reza J Mehran, Linda W Martin, Carla M Baker, Gabriel E Mena, David C Rice
Pain management is the backbone of enhanced recovery after thoracic surgery (ERATS) care maps, which aim to save time in the operating room, shorten hospital stays, and reduce pain-related adverse events. We describe a systematic approach developed at our institutions to manage pain in patients undergoing thoracic surgical procedures.
December 2016: Annals of Thoracic Surgery
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