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https://www.readbyqxmd.com/read/29210043/accidental-awareness-during-general-anaesthesia-a-narrative-review
#1
REVIEW
S R Tasbihgou, M F Vogels, A R Absalom
Unintended accidental awareness during general anaesthesia represents failure of successful anaesthesia, and so has been the subject of numerous studies during the past decades. As return to consciousness is both difficult to describe and identify, the reported incidence rates vary widely. Similarly, a wide range of techniques have been employed to identify cases of accidental awareness. Studies which have used the isolated forearm technique to identify responsiveness to command during intended anaesthesia have shown remarkably high incidences of awareness...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29202769/impact-of-systolic-blood-pressure-limits-on-the-diagnostic-value-of-triage-algorithms
#2
Tobias Neidel, Nicolas Salvador, Axel R Heller
BACKGROUND: Major incidents are characterized by a lack of resources compared to an overwhelming number of casualties, requiring a prioritization of medical treatment. Triage algorithms are an essential tool for prioritizing the urgency of treatment for patients, but the evidence to support one over another is very limited. We determined the influence of blood pressure limits on the diagnostic value of triage algorithms, considering if pulse should be palpated centrally or peripherally...
December 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29185935/dha-mediates-the-protective-effect-of-fish-consumption-on-new-episodes-of-depression-among-women
#3
John L Reeves, Petr Otahal, Costan G Magnussen, Terry Dwyer, Antti J Kangas, Pasi Soininen, Mika Ala-Korpela, Alison J Venn, Kylie J Smith
In a longitudinal cohort study of young Australian adults, we reported that for women higher baseline levels of fish consumption were associated with reduced incidence of new depressive episodes during the 5-year follow-up. Fish are high in both n-3 fatty acids and tyrosine. In this study, we seek to determine whether n-3 fatty acids or tyrosine explain the observed association. During 2004-2006, a FFQ (nine fish items) was used to estimate weekly fish consumption among 546 women aged 26-36 years. A fasting blood sample was taken and high-throughput NMR spectroscopy was used to measure 233 metabolites, including serum n-3 fatty acids and tyrosine...
November 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/29170331/34%C3%A2-a-systematic-literature-review-of-the-pre-hospital-lessons-identified-following-mass-casualty-deliberate-bombing-incidents
#4
Thomas Cooke, Adam Chesters, Gareth Grier
BACKGROUND: Since the end of World War II, there has been an emergence of explosives used amongst civilian populations resulting in mass-casualty incidents. The development of pre-hospital medical systems, worldwide, has resulted in an increased response at these incidents. However, information about the pre-hospital medical response is sparse and not collated. This review aimed to collect and appraise the literature on the pre-hospital management of mass-casualty bombing incidents. The primary objective was to identify and discuss the common themes highlighted as problems in the pre-hospital medical response...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29164607/virtual-morality-in-the-helping-professions-simulated-action-and-resilience
#5
Kathryn B Francis, Michaela Gummerum, Giorgio Ganis, Ian S Howard, Sylvia Terbeck
Recent advances in virtual technologies have allowed the investigation of simulated moral actions in aversive moral dilemmas. Previous studies have employed diverse populations to explore these actions, with little research considering the significance of occupation on moral decision-making. For the first time, in this study we have investigated simulated moral actions in virtual reality made by professionally trained paramedics and fire service incident commanders who are frequently faced with and must respond to moral dilemmas...
November 22, 2017: British Journal of Psychology
https://www.readbyqxmd.com/read/29155649/sustainable-model-for-public-health-emergency-operations-centers-for-global-settings
#6
S Arunmozhi Balajee, Omer G Pasi, Alain Georges M Etoundi, Peter Rzeszotarski, Trang T Do, Ian Hennessee, Sharifa Merali, Karen A Alroy, Tran Dac Phu, Anthony W Mounts
Capacity to receive, verify, analyze, assess, and investigate public health events is essential for epidemic intelligence. Public health Emergency Operations Centers (PHEOCs) can be epidemic intelligence hubs by 1) having the capacity to receive, analyze, and visualize multiple data streams, including surveillance and 2) maintaining a trained workforce that can analyze and interpret data from real-time emerging events. Such PHEOCs could be physically located within a ministry of health epidemiology, surveillance, or equivalent department rather than exist as a stand-alone space and serve as operational hubs during nonoutbreak times but in emergencies can scale up according to the traditional Incident Command System structure...
October 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29150782/nitrous-oxide-added-at-the-end-of-isoflurane-anesthesia-hastens-early-recovery-without-increasing-the-risk-for-postoperative-nausea-and-vomiting-a-randomized-clinical-trial
#7
Boris Mraovic, Tatjana Simurina, Tong J Gan
BACKGROUND: Nitrous oxide (N2O) has been reported to increase the risk of postoperative nausea and vomiting (PONV) in a dose-dependent manner. We investigated the effect of adding N2O at the end of isoflurane inhalational anesthesia on the recovery and incidence of PONV. Our hypothesis was that N2O would reduce the time to early recovery without increasing the incidence of PONV. METHODS: After obtaining ethics committee approval and written informed consent, 100 women at American Society of Anesthesiologists physical status I-III and scheduled for laparoscopic-assisted vaginal hysterectomy were randomized into two groups (G) according to the carrier gas: GO2 (air in 30% oxygen) and GN2O (the same mixture until the last 30 min of surgery, when 70% N2O in 30% oxygen was used)...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29120311/alberta-s-provincial-take-home-naloxone-program-a-multi-sectoral-and-multi-jurisdictional-response-to-overdose
#8
Lisa K Freeman, Stacey Bourque, Nick Etches, Karin Goodison, Claire O'Gorman, Kay Rittenbach, Christopher A Sikora, Mark Yarema
SETTING: Alberta is a prairie province located in western Canada, with a population of approximately 4.3 million. In 2016, 363 Albertans died from apparent drug overdoses related to fentanyl, an opioid 50-100 times more toxic than morphine. This surpassed the number of deaths from motor vehicle collisions and homicides combined. INTERVENTION: Naloxone is a safe, effective, opioid antagonist that may quickly reverse an opioid overdose. In July 2015, a committee of community-based harm reduction programs in Alberta implemented a geographically restricted take-home naloxone (THN) program...
November 9, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/29058969/public-health-and-the-pope-s-visit-to-philadelphia-2015
#9
James W Buehler, Jessica Caum, Steven J Alles
Pope Francis visited Philadelphia for 2 days during September 2015. Preparedness functions managed by the Philadelphia Department of Public Health (PDPH) were similar to those of other mass gatherings but also required accommodation of special security arrangements and the location of public events in central areas of the city. Public health planning involved collaborations with multiple city, state, and federal agencies and neighboring jurisdictions. PDPH preparations encompassed incident command procedures, contingency planning, disease surveillance and prevention, food safety, vector control, BioWatch air sampling, volunteer management for first-aid services, and continuity of operations...
September 2017: Health Security
https://www.readbyqxmd.com/read/29056025/-analysis-on-on-site-rescue-and-traumatic-features-of-victims-involved-in-gas-explosion-accident-in-hangzhou
#10
X G Wang, R H Jin, F P Liu, C M Han
Objective: To investigate the situations of on-site rescue and traumatic features of victims involved in gas explosion accident in Hangzhou, so as to provide more data support for emergency medical rescues of the similar incidents of massive casualty. Methods: Two medical workers with a certain clinical experience were sent to Hangzhou 120 emergency medical centers to collect data of the on-site rescue on 21st July, 2017, including ambulance call-outs, on-site command and traffic conditions, and on-site triage and evacuation of the victims...
October 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28939650/muscle-sympathetic-nerve-responses-to-passive-and-active-one-legged-cycling-insight-into-the-contributions-of-central-command
#11
Connor J Doherty, Anthony V Incognito, Karambir Notay, Matthew J Burns, Joshua T Slysz, Jeremy D Seed, Massimo Nardone, Jamie F Burr, Philip J Millar
The contribution of central command to the peripheral vasoconstrictor response during exercise has been investigated using primarily handgrip exercise. The purpose of the present study was to compare muscle sympathetic nerve activity (MSNA) responses during passive (involuntary) and active (voluntary) zeroload cycling to gain insight into the effects of central command on sympathetic outflow during dynamic exercise. Hemodynamic measurements and contralateral leg MSNA (microneurography) were collected in eighteen young healthy participants at rest and during 2 minutes of passive and active zeroload one-legged cycling...
September 22, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28937323/clinical-characteristics-and-temporal-profile-of-recovery-in-patients-with-favorable-outcomes-at-6-months-after-severe-traumatic-brain-injury
#12
Aditya Vedantam, Claudia S Robertson, Shankar P Gopinath
OBJECTIVE Early withdrawal of life-sustaining treatment due to expected poor prognosis is responsible for the majority of in-house deaths in severe traumatic brain injury (TBI). With increased focus on the decision and timing of withdrawal of care in patients with severe TBI, data on early neurological recovery in patients with a favorable outcome is needed to guide physicians and families. METHODS The authors reviewed prospectively collected data obtained in 1241 patients with head injury who were treated between 1986 and 2012...
September 22, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28926171/biliary-reconstructive-techniques-and-associated-anatomic-variants-in-adult-living-donor-liver-transplantations-the-adult-to-adult-living-donor-liver-transplantation-cohort-study-experience
#13
Talia B Baker, Michael A Zimmerman, Nathan P Goodrich, Benjamin Samstein, Elizabeth A Pomfret, James J Pomposelli, Brenda W Gillespie, Carl L Berg, Jean C Emond, Robert M Merion
Living donor liver transplantation (LDLT) is a technically demanding endeavor, requiring command of the complex anatomy of partial liver grafts. We examined the influence of anatomic variation and reconstruction techniques on surgical outcomes and graft survival in the 9-center Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). Data from 272 adult LDLT recipients (2011-2015) included details on anatomic characteristics and types of intraoperative biliary reconstruction. Associations were tested between reconstruction technique and complications, which included first biliary complication (BC; leak, stricture, or biloma) and first vascular complication (VC; hepatic artery thrombosis [HAT] or portal vein thrombosis [PVT])...
December 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28903813/rebooting-healthcare-information-technology-downtime-management
#14
Julie Bulson, Mark Van Dyke, Nicole Skibinski
Healthcare, like many other industries, has become reliant on technology to manage daily operations. Often, technology downtimes are managed within the information technology departments to ensure the technical staff can return the hardware or software to the end users as quickly as possible. However, if managed strictly through IT departments, such incidents lack critical communication components and an understanding of the impact on end users. This paper argues that such technological incidents need to be managed not just rapidly but also in conjunction with the emergency preparedness department...
January 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28894534/exploring-the-perception-of-aid-organizations-staff-about-factors-affecting-management-of-mass-casualty-traffic-incidents-in-iran-a-grounded-theory-study
#15
Javad Bazeli, Aidin Aryankhesal, Davoud Khorasani-Zavareh
BACKGROUND: Traffic incidents are of main health issues all around the world and cause countless deaths, heavy casualties, and considerable tangible and intangible damage. In this regard, mass casualty traffic incidents are worthy of special attention as, in addition to all losses and damage, they create challenges in the way of providing health services to the victims. AIM: The present study is an attempt to explore the challenges and facilitators in management of mass casualty traffic incidents in Iran...
July 2017: Electronic Physician
https://www.readbyqxmd.com/read/28892452/science-in-emergency-response-at-cdc-structure-and-functions
#16
John Iskander, Dale A Rose, Neelam D Ghiya
Recent high-profile activations of the US Centers for Disease Control and Prevention (CDC) Emergency Operations Center (EOC) include responses to the West African Ebola and Zika virus epidemics. Within the EOC, emergency responses are organized according to the Incident Management System, which provides a standardized structure and chain of command, regardless of whether the EOC activation occurs in response to an outbreak, natural disaster, or other type of public health emergency. By embedding key scientific roles, such as the associate director for science, and functions within a Scientific Response Section, the current CDC emergency response structure ensures that both urgent and important science issues receive needed attention...
September 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28892449/emergency-preparedness-in-the-workplace-the-flulapalooza-model-for-mass-vaccination
#17
Melanie D Swift, Muktar H Aliyu, Daniel W Byrne, Keqin Qian, Paula McGown, Patricia O Kinman, Katherine Louise Hanson, Demoyne Culpepper, Tamara J Cooley, Mary I Yarbrough
OBJECTIVES: To explore whether an emergency preparedness structure is a feasible, efficient, and sustainable way for health care organizations to manage mass vaccination events. METHODS: We used the Hospital Incident Command System to conduct a 1-day annual mass influenza vaccination event at Vanderbilt University Medical Center over 5 successive years (2011-2015). Using continuous quality improvement principles, we assessed whether changes in layout, supply management, staffing, and documentation systems improved efficiency...
September 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28870277/lessons-learned-from-implementing-an-incident-command-system-during-a-local-multiagency-response-to-a-legionnaires-disease-cluster-in-sydney-nsw
#18
Emma Quinn, Travers Johnstone, Zeina Najjar, Toni Cains, Geoff Tan, Essi Huhtinen, Sven Nilsson, Stuart Burgess, Matthew Dunn, Leena Gupta
The incident command system (ICS) provides a common structure to control and coordinate an emergency response, regardless of scale or predicted impact. The lessons learned from the application of an ICS for large infectious disease outbreaks are documented. However, there is scant evidence on the application of an ICS to manage a local multiagency response to a disease cluster with environmental health risks. The Sydney Local Health District Public Health Unit (PHU) in New South Wales, Australia, was notified of 5 cases of Legionnaires' disease during 2 weeks in May 2016...
September 5, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28822713/incidence-of-cross-infection-in-liver-transplant-patients-risk-factors-and-role-of-nursinge
#19
M Carmen Cierco Garrido, Raquel García Muñoz, Immaculada Pérez Castro, Miquel Sanz Moncusi
OBJECTIVE: To determine the incidence and risk factors of infection in liver transplant recipients immediately post-transplant, during admission to a liver transplant unit during the immediate post-transplant admission. METHODOLOGY: Descriptive, prospective study performed in the Liver Transplant Unit of Hospital Clínic, Barcelona. All liver transplant recipients between January 2012 and August 2015 (n=241) were included. Statistical analysis was performed with R Commander...
August 16, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28810955/embedded-mental-health-promotion-of-psychological-hygiene-within-a-submarine-squadron
#20
James Rapley, John Chin, Brian McCue, Mathew Rariden
INTRODUCTION: Psychological fitness is an important component to operational unit readiness and success. Embedding behavioral health providers can reduce unplanned personnel losses (UPL) as a result of psychological stress. The U.S. Submarine Forces implemented the Submarine Squadron 6 (CSS-6) Embedded Mental Health Pilot (EMHP) Program to address this type of UPL, which is classified as a Code 2 loss. The aim of the study is to evaluate the effectiveness of the EMHP Program at reducing UPL by improving psychological readiness through expedited access to care...
July 2017: Military Medicine
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