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https://www.readbyqxmd.com/read/28314516/impact-of-an-intrahospital-mobile-thrombolysis-team-on-3-month-clinical-outcomes-in-patients-benefiting-from-intravenous-thrombolysis-for-acute-ischemic-stroke
#1
B Hebant, A Triquenot-Bagan, E Guegan-Massardier, O Ozkul-Wermester, L Grangeon, D Maltête
INTRODUCTION/OBJECTIVE: The benefits of thrombolysis in patients presenting with acute ischemic stroke (IS) are highly time-dependent. The aim of our study was to evaluate the clinical benefit, after 3 months, of an intrahospital mobile thrombolysis team (MTT) for thrombolysis in IS. PATIENTS AND METHODS: A total of 95 consecutive patients treated with IV tPA for acute IS at the neurology department of Rouen University Hospital between 1 January and 31 December 2015 were retrospectively identified...
March 14, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28295465/quantification-of-piritramide-in-human-colostrum
#2
A Van Eeckhaut, P Vanfleteren, J Van Schoors, Y Van Wanseele, J Poelaert, Y Michotte
WHAT IS KNOWN AND OBJECTIVE: In our university hospital (UZBrussel), one of the options to control post-operative pain after a Caesarean section under general anaesthesia is to administer piritramide by patient-controlled intravenous analgesia (PCIA). As no information is available about the possible transfer of this synthetic narcotic analgesic into breastmilk, women are frequently advised not to breastfeed their newborn. A sensitive liquid chromatographic (LC) method coupled with UV detection will therefore be developed and validated for the quantification of piritramide in colostrum samples to evaluate the presence of the analgesic in the first milk...
March 13, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28277412/the-use-of-a-triage-based-protocol-for-oral-rehydration-in-a-pediatric-emergency-department
#3
Marissa A Hendrickson, Jennifer Zaremba, Andrew R Wey, Philippe R Gaillard, Anupam B Kharbanda
BACKGROUND: Guidelines recommend oral rehydration therapy (ORT) and avoidance of laboratory tests and intravenous fluids for mild to moderate dehydration in children with gastroenteritis; oral ondansetron has been shown to be an effective adjunct. OBJECTIVES: The aim of this study was to determine if a triage-based, nurse-initiated protocol for early provision of ondansetron and ORT could safely improve the care of pediatric emergency department (ED) patients with symptoms of gastroenteritis...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28276273/comparative-analysis-of-length-of-stay-hospitalization-costs-opioid-use-and-discharge-status-among-spine-surgery-patients-with-postoperative-pain-management-including-intravenous-versus-oral-acetaminophen
#4
Ryan N Hansen, An T Pham, Elaine A Böing, Belinda Lovelace, George J Wan, Timothy E Miller
BACKGROUND: Recovery from spine surgery is oriented toward restoring functional health outcomes while reducing resource use. Optimal pain management is a key to reaching these objectives. We compared outcomes of spine surgery patients who received standard pain management including intravenous (IV) acetaminophen (APAP) vs. oral APAP. METHODS: We performed a retrospective analysis of the Premier database (January 2012 to September 2015) comparing spine surgery patients who received pain management with IV APAP to those who received oral APAP, with no exclusions based on additional pain management...
March 9, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28274772/a-double-blind-randomised-controlled-trial-of-ibuprofen-compared-with-placebo-for-uncomplicated-cellulitis-of-the-upper-or-lower-limb
#5
Joshua S Davis, Carol Mackrow, Paula Binks, Wendy Fletcher, Pascale Dettwiller, Catherine Marshall, Jane Day, William Pratt, Steven Yc Tong
OBJECTIVES: Cellulitis is a common skin infection resulting in inflammation that may take weeks to resolve despite appropriate antibiotics. It is unclear whether the adjunctive use of non-steroidal anti-inflammatory drugs hastens the resolution of inflammation in patients with cellulitis. METHODS: We conducted a double-blind, randomised controlled trial comparing ibuprofen 400mg three times daily for five days with identical placebo in adults with uncomplicated cellulitis of the upper or lower limb who were treated with intravenous cefazolin via an outpatient parenteral antibiotic treatment service at one of two Australian hospitals...
March 5, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28267083/toxic-epidermal-necrolysis-like-reaction-after-hematopoietic-stem-cell-transplantation-in-children
#6
Maura Faraci, Stefano Giardino, Edoardo Lanino, Giuseppe Morreale, Emilia Ghibaudo, Monica Francesia Berta, Marco Risso, Elio Castagnola, Mimmo Ripaldi, Andrea Moscatelli, Giovanni Ghigliotti
This study report clinical course, etiology, management, and long-term outcome of children who developed toxic epidermal necrolysis-like reaction (TEN-LR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively collected children with TEN-LR occurring after allo-HSCT performed in 2 pediatric bone marrow units between 2005 and 2014. We identified 6 cases of TEN-LR of 322 patients (1.8%). Possible triggers of TEN included antibiotics, antiepileptics, antimycotics, and Mycoplasma infection...
March 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28248127/a-pediatric-intensive-care-unit-bedside-computer-clinical-decision-support-protocol-for-hyperglycemia-is-feasible-safe-and-offers-advantages
#7
Eliotte L Hirshberg, Michael J Lanspa, Emily L Wilson, Katherine A Sward, Al Jephson, Gitte Y Larsen, Alan H Morris
BACKGROUND: Computer clinical decision support (CDS) systems are uncommon in the pediatric intensive care unit (PICU), despite evidence suggesting they improve outcomes in adult ICUs. We reasoned that a bedside CDS protocol for intravenous insulin titration, eProtocol-insulin, would be feasible and safe in critically ill children. METHODS: We retrospectively reviewed data from non-diabetic children admitted to the PICU with blood glucose (BG) ≥140 mg/dL who were managed with intravenous insulin by either unaided clinician titration or eProtocol-insulin...
March 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28246618/effect-of-intravenous-ketorolac-on-postoperative-pain-in-mandibular-fracture-surgery-a-randomized-double-blind-placebo-controlled-trial
#8
Hamid Reza Eftekharian, Homa Ilkhani Pak
OBJECTIVE: To evaluate the effects of intravenous ketorolac on early postoperative pain in patients with mandibular fractures, who underwent surgical repair. METHODS: This prospective, randomized, placebo-controlled clinical trial was conducted in Shahid Rajaei Hospital, affiliated with Shiraz University of Medical Sciences during a 1-year period from 2015 to 2016. We included a total number of 50 patients with traumatic mandibular fractures who underwent surgical repair...
January 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28216284/new-risk-and-protective-factors-for-severe-hypoglycaemia-in-people-with-type-1-diabetes
#9
T Wohland, J D Holstein, O M Patzer, M Mende, T Tiemann, C Koch-Tessarek, P Kovacs, A Holstein
AIMS: To evaluate risk factors for severe hypoglycaemia (SH) in patients with type 1 diabetes (T1DM). METHODS AND RESULTS: Retrospective observational and comparative study. All SH occurring between 2007 and 2014 in a German population (Lippe-Detmold) were captured. Characteristics of patients with T1DM and SH were compared with a control group being equivalent concerning age, diabetes duration, HbA1c, comorbidity, and β-blocker treatment. SH was defined as a symptomatic event requiring treatment with intravenous glucose or glucagon administration and being confirmed by a blood glucose measurement of <2...
December 24, 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/28215922/early-postdischarge-stop-hf-clinic-reduces-30-day-readmissions-in-old-and-frail-patients-with-heart-failure
#10
Cristina Pacho, Mar Domingo, Raquel Núñez, Josep Lupón, Pedro Moliner, Marta de Antonio, Beatriz González, Javier Santesmases, Emili Vela, Jordi Tor, Antoni Bayes-Genis
INTRODUCTION AND OBJECTIVES: Heart failure (HF) is associated with a high rate of readmissions within 30 days postdischarge. Strategies to lower readmission rates generally show modest results. To reduce readmission rates, we developed a STructured multidisciplinary outpatient clinic for Old and frail Postdischarge patients hospitalized for HF (STOP-HF-Clinic). METHODS: This prospective all-comers study enrolled patients discharged from internal medicine or geriatric wards after HF hospitalization...
February 16, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28214194/orthogeriatric-activity-in-a-general-hospital-of-castilla-la-mancha-spain
#11
J M Fernández-Ibáñez, M C Morales-Ballesteros, E Crespo-Romero, S Gómez-Gómez, M D Fraga-Fuentes, J Cruz-Tejado, P A Hernández-Zegarra, Á Arias-Arias, M M García-Baltasar
AIM: To describe the orthogeriatric activity in the elderly with hip fractures in the Hospital Mancha Centro, based on the recommendations of the main guidelines. MATERIAL AND METHOD: Observational prospective study, comprising all patients over 65 years of age admitted to the Traumatology Unit with a hip fracture between April 2015 and December 2015. Patients were admitted under the care of the Traumatology Unit with cross-consultation carried out with the Geriatrics Department, which then carried out a pre-operative geriatric assessment and the post-operative follow-ups...
February 14, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28210707/assessing-the-safety-of-physician-directed-nurse-administered-propofol-sedation-in-low-risk-patients-undergoing-endoscopy-and-colonoscopy
#12
Dharshan Sathananthan, Edward Young, Garry Nind, Biju George, Angelie Ashby, Sharon Drummond, Kasia Redel, Neville Green, Rajvinder Singh
Background and study aims Physician-directed nurse-administered balanced propofol sedation (PhD NAPS) in patients undergoing endoscopy and/or colonoscopy is being increasingly utilized worldwide. However, this method of sedation is not universally employed in Australian hospitals due to concerns surrounding its safety. The aim of this study was to assess the safety of PhD NAPS in low-risk patients undergoing endoscopy and/or colonoscopy. Patients and methods This study was conducted at a single tertiary teaching hospital in Adelaide, Australia...
February 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28169811/-improve-the-extravasation-assessment-of-peripheral-venous-catheter-by-nurses-with-the-establishment-of-a-standardized-instrument-and-suitable-for-children
#13
Nathalie Bochaton, Anne Sylvie Ramelet, Peter Rimensberger, Jean-Marie Januel
In pediatric and neonatal intensive care units, severity assessment of extravasation is difficult, considering the specificity of this population. The purpose of this study was to demonstrate the ability to improve the measurement of extravasation by nurses with the establishment of a standardized instrument and suitable for children. 66 nurses, randomly assigned to two groups, assessed the severity of extravasations using 15 clinical vignettes.The intervention group with the Pediatric Peripheral Intravenous Infiltration Scale (PIV Scale) (n=33) and the control group based on clinical judgment only (n=33)...
2016: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28157790/physical-design-factors-contributing-to-patient-falls
#14
Debajyoti Pati, Shabboo Valipoor, Aimee Cloutier, James Yang, Patricia Freier, Thomas E Harvey, Jaehoon Lee
OBJECTIVES: The aim of this study was to identify physical design elements that contribute to potential falls in patient rooms. METHODS: An exploratory, physical simulation-based approach was adopted for the study. Twenty-seven subjects, older than 70 years (11 male and 16 female subjects), conducted scripted tasks in a mockup of a patient bathroom and clinician zone. Activities were captured using motion-capture technology and video recording. After biomechanical data processing, video clips associated with potential fall moments were extracted and then examined and coded by a group of registered nurses and health care designers...
February 3, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28157394/how-well-prepared-are-medical-and-nursing-students-to-identify-common-hazards-in-the-icu
#15
Alison S Clay, Saumil M Chudgar, Kathleen M Turner, Jacqueline Vaughn, Nancy W Knudsen, Jeanne M Farnan, Vineet M Arora, Margory A Molloy
RATIONALE: Care in the hospital is hazardous. Harm in the hospital may prolong hospitalization, increase suffering, result in death, and increase costs of care. While the interprofessional team is critical to eliminating hazards that may result in adverse events to patients, professional students' formal education may not prepare students adequately for this role. OBJECTIVES: To determine if medical and nursing students can identify hazards of hospitalization that could result in harm to patients and to detect differences between professions in the types of hazards identified...
February 3, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28152927/reducing-wait-time-wt-in-the-infusion-center-ic
#16
Lianne Lopez, Angela Aschian, Betty Chan, Martha Inofuentes, Zoraida Truax, Sally Golingay, Gwendoyn Lynch, Peggy Matsuura, Afsaneh Barzi
249 Background: Lengthy WT is the primary source of dis-satisfaction with IC services. We created a patient (PT) flow diagram outlining each step beginning from PT check-in to discharge and plotted the impact of multiple disciplines on the WT. A team of nurses, pharmacists, physicians, and administrators, analyzed the flow and identified ways to improve efficiencies. METHODS: First attempt was to improve communications between pharmacy and nursing, coordinating the preparation of medications with patient's check-in time; use of a simple clipboard facilitated this task and improved the efficiency of the system...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28148611/reducing-acute-kidney-injury-due-to-contrast-material-how-nurses-can-improve-patient-safety
#17
Peggy Lambert, Kristine Chaisson, Susan Horton, Carmen Petrin, Emily Marshall, Sue Bowden, Lynn Scott, Sheila Conley, Janette Stender, Gertrude Kent, Ellen Hopkins, Brian Smith, Anita Nicholson, Nancy Roy, Brenda Homsted, Cindy Downs, Cathy S Ross, Jeremiah Brown
BACKGROUND: Acute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year. OBJECTIVE: To reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. METHODS: Nurse leaders in the Northern New England Cardiovascular Disease Study Group, a 10-center quality improvement consortium in Maine, New Hampshire, and Vermont, formed a nursing task force to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28141899/intravenous-midazolam-infusion-for-sedation-of-infants-in-the-neonatal-intensive-care-unit
#18
REVIEW
Eugene Ng, Anna Taddio, Arne Ohlsson
BACKGROUND: Proper sedation for neonates undergoing uncomfortable procedures may reduce stress and avoid complications. Midazolam is a short-acting benzodiazepine that is used increasingly in neonatal intensive care units (NICUs). However, its effectiveness as a sedative in neonates has not been systematically evaluated. OBJECTIVES: Primary objeciveTo assess the effectiveness of intravenous midazolam infusion for sedation, as evaluated by behavioural and/or physiological measurements of sedation levels, in critically ill neonates in the NICU...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28132552/service-development-of-a-nurse-led-community-based-picc-insertion-service
#19
Eva Bedford, Dee Waterhouse
Patients receiving intravenous therapy require reliable venous access. Typically patients with poor peripheral access or requiring long-term treatment from an outpatient antibiotic therapy (OPAT) service need to receive secondary care input for safe central line placement, and radiological confirmation of the correct line tip placement where necessary, if treatment is to proceed as planned. Technological developments that enable accurate ultrasound-guided vein selection and electrocardiograph (ECG)-guided central line tip placement have eliminated the need for radiological or fluoroscopic confirmation of correct tip placement for peripherally placed central catheters (PICCs)...
January 26, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28121978/a-vibrating-cold-device-to-reduce-pain-in-the-pediatric-emergency-department-a-randomized-clinical-trial
#20
Debra Ann Potts, Katherine Finn Davis, Okan U Elci, Joel A Fein
OBJECTIVE: Pain of intravenous (IV) catheter insertion can be mitigated with appropriate analgesia, thereby avoiding unnecessary distress. Our objective was to compare the self-reported pain of IV catheter insertion in children when using a vibrating cold device (VCD) versus standard of care 4% topical lidocaine cream (TL). METHODS: This was a 2-arm randomized controlled noninferiority trial with a convenience sample of 4- to 18-year-olds requiring nonemergent IV catheter insertion...
January 24, 2017: Pediatric Emergency Care
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