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https://www.readbyqxmd.com/read/28934782/the-dose-dependent-effects-of-ketoprofen-on-dynamic-pain-after-open-heart-surgery
#1
Vedat Eljezi, Claire Biboulet, Henri Boby, Pierre Schoeffler, Bruno Pereira, Christian Duale
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce postoperative pain, in both static (i.e., at rest) and dynamic contexts (e.g., during coughing or mobilization), and reduced doses could improve their efficacy/tolerance balance. OBJECTIVES: To test this hypothesis of efficacy after open heart surgery, in which NSAIDs are poorly used, particularly for safety concerns. STUDY DESIGN: Randomized, double-blind trial. SETTING: Single-center, French university hospital...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28933805/perioperative-administration-of-buffered-versus-non-buffered-crystalloid-intravenous-fluid-to-improve-outcomes-following-adult-surgical-procedures
#2
REVIEW
Sohail Bampoe, Peter M Odor, Ahilanandan Dushianthan, Elliott Bennett-Guerrero, Suzie Cro, Tong J Gan, Michael Pw Grocott, Michael Fm James, Michael G Mythen, Catherine Mn O'Malley, Anthony M Roche, Kathy Rowan, Edward Burdett
BACKGROUND: Perioperative fluid strategies influence clinical outcomes following major surgery. Many intravenous fluid preparations are based on simple solutions, such as normal saline, that feature an electrolyte composition that differs from that of physiological plasma. Buffered fluids have a theoretical advantage of containing a substrate that acts to maintain the body's acid-base status - typically a bicarbonate or a bicarbonate precursor such as maleate, gluconate, lactate, or acetate...
September 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28928576/relative-efficacy-of-ultrasound-guided-ilioinguinal-iliohypogastric-nerve-block-versus-transverse-abdominis-plane-block-for-postoperative-analgesia-following-lower-segment-cesarean-section-a-prospective-randomized-observer-blinded-trial
#3
L Vamsee Kiran, T Sivashanmugam, V R Hemanth Kumar, N Krishnaveni, S Parthasarathy
BACKGROUND: Quality of postoperative analgesia after cesarean section makes difference to mother in child bonding, early ambulation, and discharge. Ilioinguinal iliohypogastric (ILIH) and transverse abdominis plane (TAP) block had been tried to reduce the opioid analgesics, but the relative efficacy is unknown. Hence, this study was designed to compare the efficacy of these two regional analgesic techniques in sparing postoperative rescue analgesic requirement following lower segment cesarean section (LSCS)...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927439/barriers-and-facilitators-towards-implementing-the-sepsis-six-care-bundle-bliss-1-a-mixed-methods-investigation-using-the-theoretical-domains-framework
#4
Neil Roberts, Guy Hooper, Fabiana Lorencatto, Wendell Storr, Michael Spivey
BACKGROUND: The 'Sepsis 6', a care bundle of basic, but vital, measures (e.g. intravenous fluid, antibiotics) has been implemented to improve sepsis treatment. However, uptake has been variable. Tools from behavioral sciences, such as the Theoretical Domains Framework (TDF) may be used to understand and address such implementation issues. This study used a behavioral science approach to identify barriers and facilitators towards Sepsis Six implementation at a case study hospital. METHODS: Semi-structured interviews based on the TDF were conducted with a sample group of consultants, junior doctors and nurses from Emergency Department, Medical and Surgical Admissions, to explore barriers/facilitators to Sepsis Six performance...
September 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28919813/a-prospective-double-blinded-randomized-comparison-of-ultrasound-guided-femoral-nerve-block-with-lateral-femoral-cutaneous-nerve-block-versus-standard-anesthetic-management-for-pain-control-during-and-after-traumatic-femur-fracture-repair-in-the-pediatric-population
#5
Nicole M Elsey, Joseph D Tobias, Kevin E Klingele, Ralph J Beltran, Tarun Bhalla, David Martin, Giorgio Veneziano, Julie Rice, Dmitry Tumin
BACKGROUND: Traumatic injury of the femur resulting in femoral fracture may result in significant postoperative pain. As with other causes of acute pain, regional anesthesia may offer a benefit over conventional therapy with intravenous opioids. This study prospectively assesses the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. MATERIALS AND METHODS: Seventeen pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture fulfilled the study criteria and were randomly assigned to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28894074/-development-and-testing-of-a-mastery-learning-program-of-nursing-skills-for-undergraduate-nursing-students
#6
SoMi Park, Hea Kung Hur, Ki Kyong Kim, Hee Young Song
PURPOSE: This study was undertaken to develop and test a mastery learning program of nursing skills for undergraduate nursing students. METHODS: In this methodological study, first, the preliminary draft of a mastery learning program to provide training for nursing skills was developed based on Bloom's framework for mastery learning. Second, to test the developed program, a single-blinded, nonequivalent control group nonsynchronized study was conducted on 50 senior nursing students in a University selected by convenient sampling...
August 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28888685/predictive-factors-of-hospital-stay-mortality-and-functional-recovery-after-surgery-for-hip-fracture-in-elderly-patients
#7
T Pareja Sierra, I Bartolomé Martín, J Rodríguez Solís, L Bárcena Goitiandia, M Torralba González de Suso, M D Morales Sanz, M Hornillos Calvo
OBJECTIVES: Due to its high prevalence and serious consequences it is very important to be well aware of factors that might be related to medical complications, mortality, hospital stay and functional recovery in elderly patients with hip fracture. MATERIAL AND METHODS: A prospective study of a group of 130 patients aged over 75 years admitted for osteoporotic hip fracture. Their medical records, physical and cognitive status prior to the fall, fracture type and surgical treatment, medical complications and functional and social evolution after hospitalization were evaluated...
September 6, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28885520/caring-for-trauma-patients-with-coexisting-heart-failure
#8
Karen Bergman Schieman, Kelley Pattison, Conor Early
The coexisting conditions of traumatic injury coupled with a comorbid condition such as heart failure create a complex scenario for the trauma nurse to manage. Initial care of the trauma patient includes following the Advanced Trauma Life Support guidelines and managing the airway, breathing, and circulation (ABC) of the patient. Once the airway is secure and breathing is managed, the team addresses circulation. At this point in the patient's care, the team typically does not know which, if any, comorbid conditions exist...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28885479/high-dose-subcutaneous-immunoglobulin-in-patients-with-multifocal-motor-neuropathy-a-nursing-perspective
#9
Vilija M Rasutis, Hans D Katzberg, Vera Bril
Multifocal motor neuropathy (MMN), an immune neuromuscular condition causing progressive weakness, usually responds to immune-mediated treatments, including intravenous immunoglobulin (IVIG). Fifteen patients with MMN receiving IVIG were enrolled in an open-label, single-center trial and switched to 20% subcutaneous immunoglobulin (SCIG) using a smooth transition protocol (ie, changing the therapy without interruption or impact on the intended outcome of the therapy). Patients received individualized training and support based on motivation and ability to learn, follow directions, and maintain compliance...
September 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/28880941/a-structured-training-program-for-health-workers-in-intravenous-treatment-with-fluids-and-antibiotics-in-nursing-homes-a-modified-stepped-wedge-cluster-randomised-trial-to-reduce-hospital-admissions
#10
Maria Romøren, Svein Gjelstad, Morten Lindbæk
OBJECTIVES: Hospitalization is potentially detrimental to nursing home patients and resource demanding for the specialist health care. This study assessed if a brief training program in administrating intravenous fluids and antibiotics in nursing homes could reduce hospital transfers and ensure high quality care locally. DESIGN: A pragmatic and modified cluster randomized stepped-wedge trial with randomization on nursing home level. PARTICIPANTS: 330 cases in 296 nursing home residents from 30 nursing homes were included...
2017: PloS One
https://www.readbyqxmd.com/read/28873076/women-awaken-faster-than-men-after-electroencephalogram-monitored-propofol-sedation-for-colonoscopy-a-prospective-observational-study
#11
Andrea Riphaus, Mark Slottje, Jan Bulla, Carolin Keil, Christian Mentzel, Vera Limbach, Barbara Schultz, Christian Unzicker
BACKGROUND: Sedation for colonoscopy using intravenous propofol has become standard in many Western countries. OBJECTIVE: Gender-specific differences have been shown for general anaesthesia in dentistry, but no such data existed for gastrointestinal endoscopy. DESIGN: A prospective observational study. SETTING: An academic teaching hospital of Hannover Medical School. PATIENTS: A total of 219 patients (108 women and 111 men) scheduled for colonoscopy...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28873028/randomized-prospective-evaluation-of-intraoperative-intravenous-acetaminophen-in-pediatric-adenotonsillectomy
#12
Christopher A Roberts, Shivani Shah-Becker, Ashley O'Connell Ferster, Aaron Baker, Lauren E Stahl, Khaled Sedeek, Michele M Carr
Objective To establish the safety and efficacy of single-dose intraoperative intravenous (IV) acetaminophen in postoperative pain management following adenotonsillectomy in addition to a standardized regimen of oral pain medication. Study Design Randomized, controlled prospective clinical trial. Setting Single academic medical center. Subjects and Methods Patients between the ages of 3 and 17 years scheduled for tonsillectomy or adenotonsillectomy by a single surgeon between December 2014 and November 2016 were recruited...
September 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28872476/do-user-applied-safety-labels-on-medication-syringes-reduce-the-incidence-of-medication-errors-during-rapid-medical-response-intervention-for-deteriorating-patients-on-wards-a-systematic-search-and-review
#13
John Mikhail, Hugh Grantham, Lindy King
INTRODUCTION: Intravenous medication errors (MEs) occur during medical emergency situations. An initiative, not yet in common practice, that could address these errors is safety labeling. The aim of this review was to identify and appraise research evidence related to the impact of user-applied medication safety labeling on reducing the incidence of MEs during rapid medical response intervention for patient deterioration in the ward setting. METHOD: A systematic search and review framework was used to conduct the review...
September 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28864435/patterns-of-instability-associated-with-endotracheal-suctioning-in-infants-with-single-ventricle-physiology
#14
Lyvonne N Tume, Paul Baines, Rafael Guerrero, Robert Johnson, Paul Ritson, Elaine Scott, Philip Arnold, Laura Walsh
BACKGROUND: In infants with single-ventricle physiology, endotracheal suctioning poses risks because of the instability between pulmonary and systemic blood flow. OBJECTIVE: To examine processes and adverse events associated with endotracheal suctioning in the first 48 hours after 3 surgical procedures: the Norwood or Norwood-Sano procedure, pulmonary artery banding, and the modified Blalock-Taussig shunt. METHODS: Prospective observational study in a pediatric intensive care unit...
September 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28862480/national-characteristics-of-emergency-medical-services-responses-for-older-adults-in-the-united-states
#15
Hieu V Duong, Lauren Nicholas Herrera, Justin Xavier Moore, John Donnelly, Karen E Jacobson, Jestin N Carlson, N Clay Mann, Henry E Wang
OBJECTIVE: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. METHODS: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses...
September 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28854896/acute-rhabdomyolysis-and-delayed-pericardial-effusion-in-an-italian-patient-with-ebola-virus-disease-a-case-report
#16
Emanuele Nicastri, Antonio Brucato, Nicola Petrosillo, Gianluigi Biava, Timothy M Uyeki, Giuseppe Ippolito
BACKGROUND: During the 2013-2016 West Africa Ebola virus disease (EVD) epidemic, some EVD patients, mostly health care workers, were evacuated to Europe and the USA. CASE PRESENTATION: In May 2015, a 37-year old male nurse contracted Ebola virus disease in Sierra Leone. After Ebola virus detection in plasma, he was medically-evacuated to Italy. At admission, rhabdomyolysis was clinically and laboratory-diagnosed and was treated with aggressive hydration, oral favipiravir and intravenous investigational monoclonal antibodies against Ebola virus...
August 30, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28812473/implementation-of-a-pathway-for-the-treatment-of-fever-and-neutropenia-in-pediatric-patients-with-cancer
#17
Joy Vanderway, Catherine Vincent, Susan M Walsh, Jennifer Obrecht
Fever and neutropenia is an oncologic emergency. Time-to-antibiotics (TTA) refers to the amount of time from initial provider evaluation for fever and neutropenia to intravenous antibiotic administration. Research supports that rapid time-to-antibiotics (RTTA) is associated with improved patient outcomes. This quality improvement project evaluated the success of implementing an RTTA pathway in pediatric oncology patients with fever and neutropenia. The setting was an advanced practice nurse-managed pediatric ambulatory infusion center where patients with fever and neutropenia were often evaluated and treated...
September 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/28802868/development-and-implementation-of-an-ultrasound-guided-peripheral-intravenous-catheter-program-for-emergency-nurses
#18
Courtney Edwards, Jodi Jones
PROBLEM: Emergency medical care often necessitates placement of peripheral intravenous (PIV) catheters. When traditional methods for obtaining PIV access are not successful, ultrasound guidance is a rescue technique for peripheral vascular placement that improves the quality of patient care. METHODS: The aim of this training program was to develop a process where emergency nurses would be competent to perform ultrasound guided PIV to improve the quality of patient care delivered while reducing throughput time...
August 9, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28800617/improved-usability-of-a-multi-infusion-setup-using-a-centralized-control-interface-a-task-based-usability-test
#19
Frank Doesburg, Fokie Cnossen, Willem Dieperink, Wouter Bult, Anne Marie de Smet, Daan J Touw, Maarten W Nijsten
The objective of this study was to assess the usability benefits of adding a bedside central control interface that controls all intravenous (IV) infusion pumps compared to the conventional individual control of multiple infusion pumps. Eighteen dedicated ICU nurses volunteered in a between-subjects task-based usability test. A newly developed central control interface was compared to conventional control of multiple infusion pumps in a simulated ICU setting. Task execution time, clicks, errors and questionnaire responses were evaluated...
2017: PloS One
https://www.readbyqxmd.com/read/28799984/lidocaine-spray-as-a-local-analgesic-for-intravenous-cannulation-a-randomized-clinical-trial
#20
Joris Datema, Jeroen Veldhuis, Jolita Bekhof
OBJECTIVES: Lidocaine spray is an effective analgesic of mucous membranes. Lidocaine spray is also used during intravenous (i.v.) cannulation, especially in children. However, the analgesic effect of lidocaine spray during i.v. cannulation has not been studied. We aimed to assess the analgesic effectiveness of lidocaine spray during i.v. cannulation. METHODS: We conducted a randomized, double-blinded, placebo-controlled trial in seventeen healthy adults who received an i...
August 10, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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