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https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#1
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28422907/adequacy-and-accuracy-of-non-trauma-center-computed-tomography-what-are-we-missing
#2
Morgan Bonds, Stephen Hersperger, Tabitha Garwe, Robert Fails, Sigrid Johannesen, Christina Kim, Ademola A Adeseye, Jason Lees, William Havron
BACKGROUND: Timely and appropriate use of computed tomography (CT) scans is critical to the evaluation of traumatic injuries. The objective of this study was to assess the adequacy of CT scans performed at non-trauma centers (NTCs) as they pertain to the management of trauma patients. METHODS: Adult patients transferred to our ACS-verified level 1 trauma center from any NTC between May and December 2012 were enrolled prospectively. Available CT images from NTCs were reviewed in a blinded fashion by our facility's trauma radiologist; his interpretations were compared with those from the NTC...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422779/the-utility-of-high-fidelity-simulation-for-training-critical-care-fellows-in-the-management-of-extracorporeal-membrane-oxygenation-emergencies-a-randomized-controlled-trial
#3
Bishoy M Zakhary, Lily M Kam, Brian S Kaufman, Kevin J Felner
OBJECTIVE: Although extracorporeal membrane oxygenation volume has increased, proficiency in the technology requires extensive training. We compared traditional water-drill-based extracorporeal membrane oxygenation training with simulation-based extracorporeal membrane oxygenation training with the hypothesis that simulation-based training is superior. DESIGN: Randomized controlled trial. SETTING: Academic medical center. SUBJECTS: Pulmonary/critical care fellows...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#4
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28412550/the-competition-between-cathodic-oxygen-and-ozone-reduction-and-its-role-in-dictating-the-reaction-mechanisms-of-an-electro-peroxone-process
#5
Guangsen Xia, Yujue Wang, Bin Wang, Jun Huang, Shubo Deng, Gang Yu
Previous studies indicate that effective generation of hydrogen peroxide (H2O2) from cathodic oxygen (O2) reduction is critical for the improved water treatment performance (e.g., enhanced pollutant degradation and reduced bromate formation) during the electro-peroxone (E-peroxone) process (a combined process of electrolysis and ozonation). However, undesired reactions (e.g., O3, H2O2, and H2O reductions) may occur in competition with O2 reduction at the cathode. To get a better understanding of how these side reactions would affect the process, this study investigated the cathodic reaction mechanisms during electrolysis with O2/O3 gas mixture sparging using various electrochemical techniques (e...
April 4, 2017: Water Research
https://www.readbyqxmd.com/read/28412028/-effectiveness-of-erlotinib-in-critical-care-unit-in-patients-with-non-small-cell-lung-cancer-with-egfr-mutation
#6
M Dewolf, C Dayen, C Garoute, W Khamis, M Fourrier, F Rousselle, M Sadki, F Le Meunier, R Suguenot, E Lecuyer, H Bentayeb, Y Douadi, P Berna
INTRODUCTION: The search for mutations epidermal growth factor receptor (EGFR) has changed the therapeutic approach and prognosis of non-small cell lung cancer (NSCLC). The effectiveness of tyrosine kinase inhibitors (TKI) has been demonstrated orally in patients with EGFR mutation. We report the case of a patient for whom treatment with TKI was started effectively in a Critical Care Unit. OBSERVATION: A patient of 59 years is followed for a stage IV lung adenocarcinoma with metastases in liver, brain, adrenal, lung and pleura...
April 12, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28411508/interventions-to-support-people-with-dementia-and-their-caregivers-during-the-transition-from-home-care-to-nursing-home-care-a-systematic-review
#7
REVIEW
Christian Müller, Sindy Lautenschläger, Gabriele Meyer, Astrid Stephan
BACKGROUND: During the transition of people with dementia from home to nursing home family caregivers often feel burdened. OBJECTIVES: We aimed to 1) identify interventions which support people with dementia and their caregivers in the transition from home care to nursing home care, 2) synthesize the evidence for efficacy of these interventions, and 3) examine whether the identified interventions have been systematically developed, evaluated and implemented according to the Medical Research Council guidance on complex interventions...
April 3, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28411289/evaluating-automated-rules-for-rapid-response-system-alarm-triggers-in-medical-and-surgical-patients
#8
Santiago Romero-Brufau, Bruce W Morlan, Matthew Johnson, Joel Hickman, Lisa L Kirkland, James M Naessens, Jeanne Huddleston
BACKGROUND: The use of rapid response systems (RRS), which were designed to bring clinicians with critical care expertise to the bedside to prevent unnecessary deaths, has increased. RRS rely on accurate detection of acute deterioration events. Early warning scores (EWS) have been used for this purpose but were developed using heterogeneous populations. Predictive performance may differ in medical vs surgical patients. OBJECTIVE: To evaluate the performance of published EWS in medical vs surgical patient populations...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28410848/improving-access-to-image-guided-procedures-at-an-integrated-rural-critical-access-hospital-ultrasound-guided-thyroid-biopsy-program
#9
Thang Q Le, Yadiel Sánchez, Alexander S Misono, Sanjay Saini, Anand M Prabhakar
PURPOSE: Critical access hospitals face difficulty providing all services locally and may need to refer patients off-site for additional care. Providing on-site minimally invasive biopsies, may obviate visits to tertiary or quaternary care centers. This study aims to assess feasibility and outcomes of an ultrasound-guided thyroid biopsy program in a critical access hospital. METHODS: In this HIPAA compliant, IRB approved study, the Interventional Radiology (IR) database of a 19-bed, island, rural, critical access hospital without onsite pathology services affiliated with our quaternary care institution was retrospectively reviewed to identify all thyroid biopsies that were performed on site since inception of the service in April 2014 through August 2016...
February 16, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28402414/inter-sectoral-transfer-of-the-food-for-life-settings-framework-in-england
#10
Selena Gray, Matthew Jones, Robin Means, Judy Orme, Hannah Pitt, Debra Salmon
Organisational settings such as schools, workplaces and hospitals are well recognised as key environments for health promotion. Whilst there is extensive literature on specific types of settings, little empirical research has investigated the transfer of frameworks between sectors. This study analyses Food for Life, an England-wide healthy and sustainable food programme that evolved in schools and is being adapted for children's centres, universities, care homes, and hospital settings. Following a case study design, we interviewed 85 stakeholders in nine settings...
April 11, 2017: Health Promotion International
https://www.readbyqxmd.com/read/28401615/development-validation-and-testing-of-a-nursing-home-to-emergency-room-transfer-nhert-checklist
#11
Hsiu-Hsin Tsai, Yun-Fang Tsai
AIMS AND OBJECTIVES: To develop and test the feasibility of an instrument to support patients' nursing home to emergency room transfer (NHERT). BACKGROUND: Transfers from a nursing home care facility to an acute care facility such as a hospital emergency room are common. However, the prevalence of an information gap for transferring residents' health data to acute care facility is high. An evidenced based transfer instrument, which could fill this gap, is lacking...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28398589/reducing-the-incidence-of-pressure-ulcers-in-critical-care-units-a-4-year-quality-improvement
#12
Annette Richardson, Joanna Peart, Stephen E Wright, Iain J McCullagh
Quality problem: Critical care patients often have several risk factors for pressure ulceration and implementing prevention interventions have been shown to decrease risk. Initial assessment: We identified a high incidence of pressure ulcers in the four adult critical care units in our organization. Therefore, avoiding pressure ulceration was an important quality priority. Choice of solution: We undertook a quality improvement programme aimed at reducing the incidence of pressure ulceration using an evidence-based bundle approach...
April 7, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28388370/will-we-ever-agree-on-protein-requirements-in-the-intensive-care-unit
#13
L John Hoffer, Roland N Dickerson, Robert G Martindale, Stephen A McClave, Juan B Ochoa Gautier
The precise value of the normal adult protein requirement has long been debated. For many reasons-one of them being the difficulty of carrying out long-term nutrition experiments in free-living people-uncertainty is likely to persist indefinitely. By contrast, the controlled environment of the intensive care unit and relatively short trajectory of many critical illnesses make it feasible to use hard clinical outcome trials to determine protein requirements for critically ill patients in well-defined clinical situations...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28372914/interhospital-transfer-in-patients-on-ecmo-support-an-essential-tool-for-a-critical-care-network
#14
Aitor Uribarri, Ignacio Cruz-González, María José Dalmau, María Concepción Rubia-Martín, Miriam Ochoa, Pedro L Sánchez
No abstract text is available yet for this article.
March 31, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28371889/development-and-implementation-of-a-risk-identification-tool-to-facilitate-critical-care-transitions-for-high-risk-surgical-patients
#15
Rebecca L Hoffman, Jason Saucier, Serena Dasani, Tara Collins, Daniel N Holena, Meghan Fitzpatrick, Boris Tsypenyuk, Niels D Martin
Quality problem: Patients recently discharged from the intensive care unit (ICU) are at high risk for clinical deterioration. Initial assessment: Unreliable and incomplete handoffs of complex patients contributed to preventable ICU readmissions. Respiratory decompensation was responsible for four times as many readmissions as other causes. Choice of solution: Form a multidisciplinary team to address care coordination surrounding the transfer of patients from the ICU to the surgical ward...
March 22, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28363300/microsurgical-reconstruction-of-the-burned-hand-and-upper-extremity
#16
REVIEW
Mauricio De la Garza, Michael Sauerbier, Germann Günter, Curtis L Cetrulo, Reuben A Bueno, Robert C Russell, Michael W Neumeister
Improvements in critical care and burn victim resuscitation have led to increased survival of burned patients. Initial resuscitation, early excision of burned tissues, prevention of burn wound sepsis, and wound coverage remain mainstays of care. Many burn wounds require complex reconstruction. This is particularly important in the hand. Coverage of tendons, ligaments, joints, vessels, nerves, and bones of the hand requires healthy vascularized tissue to maintain viability and function. Local flaps or regional flaps may be within the burn zone of injury...
May 2017: Hand Clinics
https://www.readbyqxmd.com/read/28359062/a-regional-evaluation-of-survival-of-infants-with-end-stage-renal-disease
#17
Sarah A Twichell, John Fiascone, Munish Gupta, Michael Prendergast, Nancy Rodig, Anne Hansen
BACKGROUND: Information regarding morbidity and mortality of infants born with end-stage renal disease (ESRD) requiring dialysis early in life is critical to optimize patient care and better counsel families. OBJECTIVE: We evaluated outcomes of infants born regionally with ESRD, and those within our broader catchment area referred for dialysis. STUDY DESIGN: We screened deaths at 5 regional referral hospitals, identifying infants with ESRD who did not survive to transfer for dialysis...
March 31, 2017: Neonatology
https://www.readbyqxmd.com/read/28328691/factors-associated-with-discharge-home-after-transfer-to-a-pediatric-emergency-department
#18
Erin R Peebles, Michael R Miller, Tim P Lynch, Janice A Tijssen
OBJECTIVES: The transfer of children from community emergency departments (EDs) to tertiary care pediatric EDs for investigations, interventions, or a second opinion is common. In order to improve health care system efficiency, we must have a better understanding of this population and identify areas for education and capacity building. METHODS: We conducted a retrospective chart review of all patients (aged 0-17 years) who were transferred from community ED to a pediatric ED from November 2013 to November 2014...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28314625/transthyretin-concentrations-in-acute-stroke-patients-predict-convalescent-rehabilitation
#19
Naofumi Isono, Yuki Imamura, Keiko Ohmura, Norihide Ueda, Shinji Kawabata, Motomasa Furuse, Toshihiko Kuroiwa
OBJECTIVE: For stroke patients, intensive nutritional management is an important and effective component of inpatient rehabilitation. Accordingly, acute care hospitals must detect and prevent malnutrition at an early stage. Blood transthyretin levels are widely used as a nutritional monitoring index in critically ill patients. Here, we had analyzed the relationship between the transthyretin levels during the acute phase and Functional Independence Measure in stroke patients undergoing convalescent rehabilitation...
March 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28296663/acute-decompensation-in-pediatric-cardiac-patients-outcomes-after-rapid-response-events
#20
Aarti C Bavare, Kimia S Rafie, Patricia X Bastero, Joseph L Hagan, Paul A Checchia
OBJECTIVE: We studied rapid response events after acute clinical instability outside ICU settings in pediatric cardiac patients. Our objective was to describe the characteristics and outcomes after rapid response events in this high-risk cohort and elucidate the cardiac conditions and risk factors associated with worse outcomes. DESIGN: A retrospective single-center study was carried out over a 3-year period from July 2011 to June 2014. SETTING: Referral high-volume pediatric cardiac center located within a tertiary academic pediatric hospital...
March 14, 2017: Pediatric Critical Care Medicine
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