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Critical care protocols

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https://www.readbyqxmd.com/read/28095883/moderated-online-social-therapy-for-carers-of-young-people-recovering-from-first-episode-psychosis-study-protocol-for-a-randomised-controlled-trial
#1
John Gleeson, Reeva Lederman, Helen Herrman, Peter Koval, Dina Eleftheriadis, Sarah Bendall, Sue M Cotton, Mario Alvarez-Jimenez
BACKGROUND: First-episode psychosis most often has its onset during late adolescence. In caring for the young person, families endure high levels of stress and depression. Meanwhile, the social networks of families often erode. Our group has previously shown that family cognitive behaviour therapy (CBT) leads to significantly improved perceived stress compared with specialist first-episode treatment as usual; however, there are well-known barriers to the dissemination of effective family interventions...
January 17, 2017: Trials
https://www.readbyqxmd.com/read/28095838/communication-with-families-regarding-organ-and-tissue-donation-after-death-in-intensive-care-comfort-protocol-for-an-intervention-study
#2
Julie E Potter, Robert G Herkes, Lin Perry, Rosalind M Elliott, Anders Aneman, Jorge L Brieva, Elena Cavazzoni, Andrew T H Cheng, Michael J O'Leary, Ian M Seppelt, Val Gebski
BACKGROUND: Discussing deceased organ donation can be difficult not only for families but for health professionals who initiate and manage the conversations. It is well recognised that the methods of communication and communication skills of health professionals are key influences on decisions made by families regarding organ donation. METHODS: This multicentre study is being performed in nine intensive care units with follow-up conducted by the Organ and Tissue Donation Service in New South Wales (NSW) Australia...
January 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28093837/effects-of-simulation-education-on-oral-care-practices%C3%A2-%C3%A2-a-randomized-controlled-trial
#3
Miia M Jansson, Hannu P Syrjälä, Pasi P Ohtonen, Merja H Meriläinen, Helvi A Kyngäs, Tero I Ala-Kokko
BACKGROUND: Implementation of evidence-based oral care protocols, nurse education programmes and assessment tools may reduce the risk of developing ventilator-associated pneumonia by increasing critical care nurses' knowledge and skills in adhering to current oral care recommendations. AIMS: To evaluate the longitudinal effects of single-dose simulation education with structured debriefing and verbal feedback on critical care nurses' knowledge and skills in adhering to current oral care recommendations...
January 16, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28092169/national-athletic-trainers-association-position-statement-management-of-acute-skin-trauma
#4
Joel W Beam, Bernadette Buckley, William R Holcomb, Mario Ciocca
OBJECTIVE:   To present recommendations for the cleansing, debridement, dressing, and monitoring of acute skin trauma in patients. BACKGROUND:   Acute skin trauma is common during participation in athletic and recreational activities. Clinical decisions and intervention protocols after injury vary among athletic trainers and are often based on ritualistic practices. An understanding of cleansing, debridement, and dressing techniques; clinical features of infection and adverse reactions; and monitoring of acute skin trauma is critical for certified athletic trainers and other allied health and medical professionals to create a local wound environment that promotes healing and lessens the risk of complications...
January 16, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28089618/24-hour-protein-arginine-and-citrulline-metabolism-in-fed-critically-ill-children-a-stable-isotope-tracer-study
#5
Carlijn T I de Betue, Xiomara C Garcia Casal, Dick A van Waardenburg, Stephen M Schexnayder, Koen F M Joosten, Nicolaas E P Deutz, Marielle P K J Engelen
BACKGROUND & AIMS: The reference method to study protein and arginine metabolism in critically ill children is measuring plasma amino acid appearances with stable isotopes during a short (4-8 h) time period and extrapolate results to 24-h. However, 24-h measurements may be variable due to critical illness related factors and a circadian rhythm could be present. Since only short duration stable isotope studies in critically ill children have been conducted before, the aim of this study was to investigate 24-h appearance of specific amino acids representing protein and arginine metabolism, with stable isotope techniques in continuously fed critically ill children...
January 4, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28086760/education-of-pediatric-subspecialty-fellows-in-transport-medicine-a-national-survey
#6
Geoffrey E Mickells, Denise M Goodman, Ranna A Rozenfeld
BACKGROUND: The transport of critically ill patients to children's hospitals is essential to current practice. The AAP Section on Transport Medicine has raised concerns about future leadership in the field as trainees receive less exposure to transport medicine. This study identifies the priorities of pediatric subspecialty fellows, fellowship directors and nursing directors in transport medicine education. METHODS: Internet based surveys were distributed to fellows, fellowship directors and nursing directors of transport teams affiliated with ACGME-approved fellowships in Neonatal-Perinatal Medicine (NPM), Pediatric Critical Care Medicine (PCCM), and Pediatric Emergency Medicine (PEM)...
January 13, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28076003/reducing-functional-mr-imaging-acquisition-times-by-optimizing-workflow
#7
Wilson B Chwang, Michael Iv, Jason Smith, Aleksandrs Kalnins, Jake Mickelsen, Roland Bammer, Dominik Fleischmann, David B Larson, Max Wintermark, Michael Zeineh
Functional magnetic resonance (MR) imaging is a complex, specialized examination that is able to noninvasively measure information critical to patient care such as hemispheric language lateralization ( 1 ). Diagnostic functional MR imaging requires extensive patient interaction as well as the coordinated efforts of the entire health care team. We observed in our practice at an academic center that the times to perform functional MR imaging examinations were excessively lengthy, making scheduling of the examination difficult...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#8
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28069045/improving-nursing-home-care-through-feedback-on-performance-data-inform-protocol-for-a-cluster-randomized-trial
#9
Matthias Hoben, Peter G Norton, Liane R Ginsburg, Ruth A Anderson, Greta G Cummings, Holly J Lanham, Janet E Squires, Deanne Taylor, Adrian S Wagg, Carole A Estabrooks
BACKGROUND: Audit and feedback is effective in improving the quality of care. However, methods and results of international studies are heterogeneous, and studies have been criticized for a lack of systematic use of theory. In TREC (Translating Research in Elder Care), a longitudinal health services research program, we collect comprehensive data from care providers and residents in Canadian nursing homes to improve quality of care and life of residents, and quality of worklife of caregivers...
January 10, 2017: Trials
https://www.readbyqxmd.com/read/28067012/venous-thromboembolism-in-pediatric-trauma-patients-ten-year-experience-and-long-term-follow-up-in-a-tertiary-care-center
#10
Christine M Leeper, Madhav Vissa, James D Cooper, Lynn M Malec, Barbara A Gaines
BACKGROUND: Pediatric trauma patients are at high risk for development of venous thromboembolism (VTE). Our objective is to describe incidence, risk factors, and timing of development of VTE, anticoagulation complications, and long-term VTE outcomes in a critically injured pediatric population. PROCEDURE: We did a retrospective review of pediatric (0-17 years) trauma admissions to intensive care unit from 2005 to 2014. Our center employs VTE screening and prevention protocols for high-risk patients based on hypercoagulable history, age, injuries, and medical interventions...
January 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28063770/a-post-operative-feeding-protocol-to-improve-outcomes-for-neonates-with-critical-congenital-heart-disease
#11
Jennifer Newcombe, Eileen Fry-Bowers
Neonates with critical congenital heart disease (CCHD) are vulnerable to malnutrition during the post-operative period due to hypermetabolism and hypercatabolism. To improve nutritional outcomes during hospitalization, a nurse led post-operative enteral feeding protocol was implemented at a large U.S. children's hospital. During an eight-month implementation period, twenty-one neonates met protocol inclusion criteria. Days for neonates to achieve goal caloric feedings (120kcal/kg/day) were decreased. A one-way repeated measures analysis of variance showed serum albumin levels and serial anthropometric measurements improved significantly throughout hospitalization (p<0...
January 4, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28061965/report-of-the-acr-s-economics-committee-on-value-based-payment-models
#12
Giles W Boland, Lucille Glenn, Shlomit Goldberg-Stein, Saurabh Jha, Mark Mangano, Samir Patel, Kurt A Schoppe, David Seidenwurm, John Lohnes, Ezequiel Silva, Richard Abramson, Daniel J Durand, Laura Pattie, Pamela Kassing, Richard E Heller
A major outcome of the current health care reform process is the move away from unrestricted fee-for-service payment models toward those that are based on the delivery of better patient value and outcomes. The authors' purpose, therefore, is to critically evaluate and define those components of the overall imaging enterprise that deliver meaningful value to both patients and referrers and to determine how these components might be measured and quantified. These metrics might then be used to lobby providers and payers for sustainable payment solutions for radiologists and radiology services...
January 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28061873/prophylactic-melatonin-for-delirium-in-intensive-care-pro-medic-study-protocol-for-a-randomised-controlled-trial
#13
F Eduardo Martinez, Matthew Anstey, Andrew Ford, Brigit Roberts, Miranda Hardie, Robert Palmer, Lynn Choo, David Hillman, Michael Hensley, Erin Kelty, Kevin Murray, Bhajan Singh, Bradley Wibrow
BACKGROUND: Delirium is an acute state of brain dysfunction characterised by fluctuating inattention and cognitive disturbances, usually due to illness. It occurs commonly in the intensive care unit (ICU), and it is associated with greater morbidity and mortality. It is likely that disturbances of sleep and of the day-night cycle play a significant role. Melatonin is a naturally occurring, safe and cheap hormone that can be administered to improve sleep. The main aim of this trial will be to determine whether prophylactic melatonin administered to critically ill adults, when compared with placebo, decreases the rate of delirium...
January 6, 2017: Trials
https://www.readbyqxmd.com/read/28046075/an-improved-and-secure-anonymous-biometric-based-user-authentication-with-key-agreement-scheme-for-the-integrated-epr-information-system
#14
Jaewook Jung, Dongwoo Kang, Donghoon Lee, Dongho Won
Nowadays, many hospitals and medical institutes employ an authentication protocol within electronic patient records (EPR) services in order to provide protected electronic transactions in e-medicine systems. In order to establish efficient and robust health care services, numerous studies have been carried out on authentication protocols. Recently, Li et al. proposed a user authenticated key agreement scheme according to EPR information systems, arguing that their scheme is able to resist various types of attacks and preserve diverse security properties...
2017: PloS One
https://www.readbyqxmd.com/read/28032779/the-era-of-sport-concussion-evolution-of-knowledge-practice-and-the-role-of-psychology
#15
Julie L Guay, Brittany M Lebretore, Jesse M Main, Katelyn E DeFrangesco, Jessica L Taylor, Sarah M Amedoro
The topic of sport concussion has gained significant prominence over the last 20 years, resulting in dramatic growth in research funding, widespread media coverage, and increased public awareness. Although the knowledge base has greatly expanded, there is still much that is unknown or controversial about the long-term effects of sports-related head injury. Because of the high stakes of mismanaging these injuries, professional sports organizations, federal/state government, and various health-related disciplines have responded with efforts to educate the public and improve treatment and management of this injury...
December 2016: American Psychologist
https://www.readbyqxmd.com/read/28025018/pharmacy-provision-of-sexual-and-reproductive-health-commodities-to-young-people-a-systematic-literature-review-and-synthesis-of-the-evidence
#16
REVIEW
Lianne Gonsalves, Michelle J Hindin
BACKGROUND: We conducted a systematic review of peer-reviewed literature on youth access to, use of and quality of care of sexual and reproductive health (SRH) commodities through pharmacies. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, we searched for publications from 2000 to 2016. To be eligible for inclusion, articles had to address the experiences of young people (aged 25 years and below) accessing SRH commodities (e...
December 23, 2016: Contraception
https://www.readbyqxmd.com/read/28024558/detection-prevention-and-management-of-delirium-in-the-critically-ill-cardiac-patient-and-patients-who-undergo-cardiac-procedures
#17
REVIEW
Rakesh C Arora, George Djaiani, James L Rudolph
Delirium is an acute change in cognitive functioning, characterized by inattention and associated with alterations in awareness and fluctuation in arousal, disorganized thinking, or altered level that preferentially affects older adult patients. In the acutely ill cardiac patient, the incidence of delirium has been reported as high as 73%, depending on the type and sensitivity of delirium assessment. Cardiac patients with delirium experience higher rates of in-hospital and longer-term mortality and are at risk for progressive cognitive impairment, loss of functional independence, and increased hospitalization costs...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28024549/temporary-mechanical-circulatory-support-in-cardiac-critical-care-a-state-of-the-art-review-and-algorithm-for-device-selection
#18
REVIEW
A Dave Nagpal, Rohit K Singal, Rakesh C Arora, Yoan Lamarche
With more than 60 years of continuous development and improvement, a variety of temporary mechanical circulatory support (MCS) devices and implantation strategies exist, each with unique advantages and disadvantages. A thorough understanding of each available device is essential for optimizing patient outcomes in a fiscally responsible manner. In this state of the art review we examine the entire range of commonly available peripheral and centrally cannulated temporary MCS devices, including intra-aortic balloon pumps, the Impella (Abiomed, Danvers, MA) family of microaxial pumps, the TandemHeart (CardiacAssist Inc, Pittsburg, PA) pump and percutaneous cannulas, centrally cannulated centrifugal pumps such as the CentriMag (Thoratec Corp, Pleasanton, CA/St Jude Medical, St Paul, MN/Abbott Laboratories, Abbott Park, IL) and Rotaflow (Maquet Holding BV & Co KG, Rastatt Germany), and extracorporeal membrane oxygenation...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28024548/canadian-cardiovascular-society-canadian-cardiovascular-critical-care-society-canadian-association-of-interventional-cardiology-position-statement-on-the-optimal-care-of-the-postarrest-patient
#19
Graham C Wong, Sean van Diepen, Craig Ainsworth, Rakesh C Arora, Jean G Diodati, Mark Liszkowski, Michael Love, Chris Overgaard, Greg Schnell, Jean-Francois Tanguay, George Wells, Michel Le May
Out of hospital cardiac arrest (OHCA) is associated with a low rate of survival to hospital discharge and high rates of neurological morbidity among survivors. Programmatic efforts to institute and integrate OHCA best care practices from the bystander response through to the in-hospital phase have been associated with improved patient outcomes. This Canadian Cardiovascular Society position statement was developed to provide comprehensive yet practical recommendations to guide the in-hospital care of OHCA patients...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28010166/reappraisal-and-perspectives-of-clinical-drug-drug-interaction-potential-of-%C3%AE-glucosidase-inhibitors-such-as-acarbose-voglibose-and-miglitol-in-the-treatment-of-type-2-diabetes-mellitus
#20
Ranjeet Prasad Dash, R Jayachandra Babu, Nuggehally R Srinivas
1. Amidst the new strategies being developed for the management of Type 2 diabetes mellitus (T2DM) with both established and newer therapies, alpha glucosidase inhibitors (AGIs) has found a place in several treatment protocols. 2. The objectives of the review were: a) to compile and evaluate the various clinical pharmacokinetic drug interaction data for AGIs such as acarbose, miglitol and voglibose; b) provide perspectives on the drug interaction data since it encompasses coadministered drugs in several key areas of comorbidity with T2DM...
December 23, 2016: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
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