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https://www.readbyqxmd.com/read/27832222/stress-and-burnout-among-physicians-prevalence-and-risk-factors-in-a-singaporean-internal-medicine-programme
#1
Kay Choong See, Tow Keang Lim, Ee Heok Kua, Jason Phua, Gerald Sw Chua, Khek Yu Ho
No abstract text is available yet for this article.
October 2016: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/27733188/nurse-performed-screening-for-postextubation-dysphagia-a-retrospective-cohort-study-in-critically-ill-medical-patients
#2
Kay Choong See, Si Yu Peng, Jason Phua, Chew Lai Sum, Johncy Concepcion
BACKGROUND: Swallowing difficulties are common, and dysphagia occurs frequently in intensive care unit (ICU) patients after extubation. Yet, no guidelines on postextubation swallowing assessment exist. We aimed to investigate the safety and effectiveness of nurse-performed screening (NPS) for postextubation dysphagia in the medical ICU. METHODS: We conducted a retrospective cohort study of mechanically ventilated patients who were extubated in a 20-bed medical ICU...
October 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27649510/the-use-of-polymerase-chain-reaction-amplification-for-the-detection-of-viruses-and-bacteria-in-severe-community-acquired-pneumonia
#3
Wen Ting Siow, Evelyn Siew-Chuan Koay, Chun Kiat Lee, Hong Kai Lee, Venetia Ong, Wang Jee Ngerng, Hui Fang Lim, Adeline Tan, Julian Wei-Tze Tang, Jason Phua
BACKGROUND: Pathogens are often not identified in severe community-acquired pneumonia (CAP), and the few studies using polymerase chain reaction (PCR) techniques for virus detection are from temperate countries. OBJECTIVE: This study assesses if PCR amplification improves virus and bacteria detection, and if viral infection contributes to mortality in severe CAP in a tropical setting, where respiratory pathogens have less well-defined seasonality. METHODS: In this cohort study of patients with severe CAP in an intensive care unit, endotracheal aspirates for intubated patients and nasopharyngeal swabs for non-intubated patients were sent for PCR amplification for respiratory viruses...
September 21, 2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27581386/role-of-bmi-airflow-obstruction-st-george-s-respiratory-questionnaire-and-age-index-in-prognostication-of-asian-copd
#4
Hiang Ping Chan, Amartya Mukhopadhyay, Pauline Lee Poh Chong, Sally Chin, Xue Yun Wong, Venetia Ong, Yiong Huak Chan, Tow Keang Lim, Jason Phua
BACKGROUND AND OBJECTIVE: COPD is a complex condition with a heavy burden of disease. Many multidimensional tools have been studied for their prognostic utility but none has been universally adopted as each has its own limitations. We hypothesize that a multidimensional tool examining four domains, health-related quality of life, disease severity, systemic effects of disease and patient factors, would better categorize and prognosticate these patients. METHODS: We first evaluated 300 patients and found four factors that predicted mortality: BMI, airflow obstruction, St George's Respiratory Questionnaire and age (BOSA)...
August 31, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27567896/severe-community-acquired-pneumonia-timely-management-measures-in-the-first-24-hours
#5
REVIEW
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27415975/confirming-nasogastric-tube-placement-is-the-colorimeter-as-sensitive-and-specific-as-x-ray-a-diagnostic-accuracy-study
#6
Siti Zubaidah Mordiffi, Mien Li Goh, Jason Phua, Yiong-Huak Chan
BACKGROUND: The effect of delivering enteral nutrition or medications via a nasogastric tube that is inadvertently located in the tracheobronchial tract can cause respiratory complications. Although radiographic examination is accepted as the gold standard for confirming the position of patients' enteral tubes, it is costly, involves risks of radiation, and is not failsafe. Studies using carbon dioxide sensors to detect inadvertent nasogastric tube placements have been conducted in intensive care settings...
September 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27347762/structure-organization-and-delivery-of-critical-care-in-asian-icus
#7
Yaseen M Arabi, Jason Phua, Younsuck Koh, Bin Du, Mohammad Omar Faruq, Masaji Nishimura, Wen-Feng Fang, Charles Gomersall, Hussain N Al Rahma, Hani Tamim, Hasan M Al-Dorzi, Fahad M Al-Hameed, Neill K J Adhikari, Musharaf Sadat
OBJECTIVES: Despite being the epicenter of recent pandemics, little is known about critical care in Asia. Our objective was to describe the structure, organization, and delivery in Asian ICUs. DESIGN: A web-based survey with the following domains: hospital organizational characteristics, ICU organizational characteristics, staffing, procedures and therapies available in the ICU and written protocols and policies. SETTING: ICUs from 20 Asian countries from April 2013 to January 2014...
October 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27217739/prognostic-utility-of-the-2011-gold-classification-and-other-multidimensional-tools-in-asian-copd-patients-a-prospective-cohort-study
#8
Hiang Ping Chan, Amartya Mukhopadhyay, Pauline Lee Poh Chong, Sally Chin, Xue Yun Wong, Venetia Ong, Yiong Huak Chan, Tow Keang Lim, Jason Phua
BACKGROUND: How well the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification prognosticates for Asian patients with COPD is unknown. OBJECTIVE: The authors aimed to study the predictive utility of the GOLD 2011 classification for exacerbations and mortality as compared with other multidimensional tools in an Asian population. METHODS: In all, 1,110 COPD patients were prospectively followed between March 2008 and March 2013...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27161082/erratum-to-withholding-and-withdrawal-of-life-sustaining-treatments-in-low-middle-income-versus-high-income-asian-countries-and-regions
#9
Jason Phua, Gavin M Joynt, Masaji Nishimura, Yiyun Deng, Sheila Nainan Myatra, Yiong Huak Chan, Nguyen Gia Binh, Cheng Cheng Tan, Mohammad Omar Faruq, Yaseen M Arabi, Bambang Wahjuprajitno, Shih-Feng Liu, Seyed Mohammad Reza Hashemian, Waqar Kashif, Dusit Staworn, Jose Emmanuel Palo, Younsuck Koh
No abstract text is available yet for this article.
May 9, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27071388/withholding-and-withdrawal-of-life-sustaining-treatments-in-low-middle-income-versus-high-income-asian-countries-and-regions
#10
Jason Phua, Gavin M Joynt, Masaji Nishimura, Yiyun Deng, Sheila Nainan Myatra, Yiong Huak Chan, Nguyen Gia Binh, Cheng Cheng Tan, Mohammad Omar Faruq, Yaseen M Arabi, Bambang Wahjuprajitno, Shih-Feng Liu, Seyed Mohammad Reza Hashemian, Waqar Kashif, Dusit Staworn, Jose Emmanuel Palo, Younsuck Koh
PURPOSE: To compare the attitudes of physicians towards withholding and withdrawing life-sustaining treatments in intensive care units (ICUs) in low-middle-income Asian countries and regions with those in high-income ones, and to explore differences in the role of families and surrogates, legal risks, and financial considerations between these countries and regions. METHODS: Questionnaire study conducted in May-December 2012 on 847 physicians from 255 ICUs in 10 low-middle-income countries and regions according to the World Bank's classification, and 618 physicians from 211 ICUs in six high-income countries and regions...
July 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/26976220/resident-research-why-some-do-and-others-don-t
#11
Jason Yongsheng Chan, Kaavya Narasimhalu, Orlanda Goh, Xiaohui Xin, Tien Yin Wong, Julian Thumboo, Ghee Chee Phua
INTRODUCTION: Although research is widely considered to be a relevant and essential skill to resident development, the actual participation rate of residents in research remains low, and the factors associated with participation are unclear. METHODS: We examined the participation rate of junior residents in research, and their attitudes and perceived barriers toward research, via an anonymised survey that was carried out from October to November 2013. The junior residents were from an established Accreditation Council for Graduate Medical Education-accredited internal medicine residency training programme in Singapore...
March 15, 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/26274367/shock-in-the-first-24-h-of-intensive-care-unit-stay-observational-study-of-protocol-based-fluid-management-reply
#12
LETTER
Kay Choong See, Amartya Mukhopadhyay, Tow Keang Lim, Jason Phua
No abstract text is available yet for this article.
September 2015: Shock
https://www.readbyqxmd.com/read/25644706/observation-of-handover-process-in-an-intensive-care-unit-icu-barriers-and-quality-improvement-strategy
#13
Yanika Kowitlawakul, Benjamin S H Leong, Adela Lua, Rana Aroos, Jie Jun Wong, Nicola Koh, Nicholette Goh, Kay Choong See, Jason Phua, Amartya Mukhopadhyay
OBJECTIVE: To describe the characteristics and barriers in the handover process in a medical intensive care unit. DESIGN: A cross-sectional descriptive study using a checklist to observe nurses and doctors during handover of patients in and out of the intensive care unit. SETTING: The study was conducted at a 1000-bed tertiary hospital in Singapore. The unit admits all patients under university medicine clusters, except those needing cardiology services...
April 2015: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/25608139/shock-in-the-first-24-h-of-intensive-care-unit-stay-observational-study-of-protocol-based-fluid-management
#14
Kay Choong See, Amartya Mukhopadhyay, Samuel Chuan-Xian Lau, Sandra Ming-Yien Tan, Tow Keang Lim, Jason Phua
Precision in fluid management for shock could lead to better clinical outcomes. We evaluated the association of protocol-based fluid management with intensive care unit (ICU) and hospital mortality. We performed an observational study of mechanically ventilated patients admitted directly from our emergency department to the ICU from August 2011 to December 2013, who had circulatory shock in the first 24 h of ICU stay (systolic blood pressure <90 mmHg at ICU admission or lactate >4 mmol/L). Patients with onset of shock beyond 24 h of ICU stay were excluded...
May 2015: Shock
https://www.readbyqxmd.com/read/25581712/withholding-and-withdrawal-of-life-sustaining-treatments-in-intensive-care-units-in-asia
#15
Jason Phua, Gavin M Joynt, Masaji Nishimura, Yiyun Deng, Sheila Nainan Myatra, Yiong Huak Chan, Nguyen Gia Binh, Cheng Cheng Tan, Mohammad Omar Faruq, Yaseen M Arabi, Bambang Wahjuprajitno, Shih-Feng Liu, Seyed Mohammad Reza Hashemian, Waqar Kashif, Dusit Staworn, Jose Emmanuel Palo, Younsuck Koh
IMPORTANCE: Little data exist on end-of-life care practices in intensive care units (ICUs) in Asia. OBJECTIVE: To describe physicians' attitudes toward withholding and withdrawal of life-sustaining treatments in end-of-life care and to evaluate factors associated with observed attitudes. DESIGN, SETTING, AND PARTICIPANTS: Self-administered structured and scenario-based survey conducted among 1465 physicians (response rate, 59.6%) who manage patients in ICUs (May-December 2012) at 466 ICUs (response rate, 59...
March 2015: JAMA Internal Medicine
https://www.readbyqxmd.com/read/25421502/differences-in-the-handover-process-and-perception-between-nurses-and-residents-in-a-critical-care-setting
#16
Amartya Mukhopadhyay, Benjamin S H Leong, Adela Lua, Rana Aroos, Jie Jun Wong, Nicola Koh, Nicholette Goh, Kay Choong See, Jason Phua, Yanika Kowitlawakul
AIMS AND OBJECTIVES: To identify the differences in practices and perceptions of handovers between nurses and residents in the critical care setting, so as to improve the quality of the process. BACKGROUND: Critically ill patients with complex problems are ideal for the study of handovers. However, few handover studies have been conducted in intensive care units. DESIGN: Descriptive study using questionnaires. METHODS: We interviewed all nurses and residents involved in handovers of patients admitted to and discharged from a medical intensive care unit over a period of one month...
March 2015: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/25091883/characteristics-of-distractions-in-the-intensive-care-unit-how-serious-are-they-and-who-are-at-risk
#17
Kay Choong See, Jason Phua, Amartya Mukhopadhyay, Tow Keang Lim
INTRODUCTION: Distractions and interruptions of doctor's work, although common and potentially deleterious in the intensive care unit (ICU), are not well studied. METHODS: We used a simple observational method to describe the frequency, sources and severity of such distractions, and explore at-risk situations in the ICU. Independent paired observers separately shadowed eight residents and three fellows for 38 sessions (over 100 hrs) in a 20-bed medical ICU. RESULTS: In total, 444 distractions were noted...
July 2014: Singapore Medical Journal
https://www.readbyqxmd.com/read/24797377/basic-critical-care-echocardiography-by-pulmonary-fellows-learning-trajectory-and-prognostic-impact-using-a-minimally-resourced-training-model
#18
Kay Choong See, Venetia Ong, Jeffrey Ng, Rou An Tan, Jason Phua
OBJECTIVES: The spread of basic critical care echocardiography may be limited by training resources. Another barrier is the lack of information about the learning trajectory and prognostic impact of individual basic critical care echocardiography domains like acute cor pulmonale determination and left ventricular function estimation. We thus developed a minimally resourced training model and studied the latter outcomes. DESIGN: Prospective observational study. SETTING: Twenty-bed medical ICU...
October 2014: Critical Care Medicine
https://www.readbyqxmd.com/read/24506772/bedside-pleural-procedures-by-pulmonologists-and-non-pulmonologists-a-3-year-safety-audit
#19
Kay Choong See, Venetia Ong, Chia Meng Teoh, Oon Cheong Ooi, Louis Sutrisno Widjaja, Sandhya Mujumdar, Jason Phua, Kay Leong Khoo, Pyng Lee, Tow Keang Lim
BACKGROUND AND OBJECTIVE: Pleural procedures such as tube thoracostomy and chest aspirations are commonly performed and carry potential risks of visceral organ injury, pneumothorax and bleeding. In this context limited information exists on the complication rates when non-pulmonologists perform ultrasound-guided bedside pleural procedures. Bedside pleural procedures in our university hospital were audited to compare complication rates between pulmonologists and non-pulmonologists. METHODS: A combined safety approach using standardized training, pleural safety checklists and ultrasound-guidance was initially implemented in a ∼1000-bed academic medical centre...
April 2014: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/24176994/idsa-ats-minor-criteria-aid-pre-intensive-care-unit-resuscitation-in-severe-community-acquired-pneumonia
#20
Hui Fang Lim, Jason Phua, Amartya Mukhopadhyay, Wang Jee Ngerng, Mei Ying Chew, Tiong Beng Sim, Win Sen Kuan, Malcolm Mahadevan, Tow Keang Lim
The effect of employing severity scores to identify severe community-acquired pneumonia (SCAP) cases for early aggressive resuscitation is unknown. Optimising pre-intensive care unit (ICU) care may improve outcomes in patients at risk of SCAP. We conducted a before-and-after study of patients classified into control and intervention groups (January 2004 to December 2007 and January 2008 to December 2010, respectively). Our intervention was two-pronged, using the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) minor criteria to identify SCAP for aggressive emergency department resuscitation...
March 2014: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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