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Agitated patient

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https://www.readbyqxmd.com/read/28211960/becoming-tobacco-free-changes-in-staff-and-patient-attitudes-and-incident-reports-in-a-large-academic-mental-health-and-addictions-hospital
#1
Lilian Riad-Allen, Sarah Siodmok Dermody, Yarissa Herman, Kim Bellissimo, Peter Selby, Tony Peter George
BACKGROUND AND OBJECTIVE: Complete tobacco bans in mental health facilities are thought to have the potential for adverse consequences. We evaluated staff and patient attitudes and adverse events associated with implementing Canada's largest, multi-site academic psychiatric hospital tobacco ban. METHODS: A total of 1,173 staff and 422 patients completed an anonymous attitudes survey at prior to implementation (baseline), and 4-6 months and 10-12 months post-implementation...
February 17, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28210931/serotonin-syndrome-from-5-hydroxytryptophan-supplement-ingestion-in-a-9-month-old-labrador-retriever
#2
Hopkins Jennifer, Pardo Mariana, Bischoff Karyn
INTRODUCTION: 5-Hydroxytryptophan (5-HTP) supplements are available over the counter and labeled as sleeping aids and anxiolytics for human use. 5-HTP is a serotonin precursor and overdose can lead to serotonin syndrome. CASE REPORT: A 9-month-old female Labrador retriever was evaluated after ingestion of a 5-HTP supplement. Signs of agitation developed within 1 h of ingestion, and emesis was attempted by the owner with  3% hydrogen peroxide (H2O2) orally. On presentation, the dog was obtunded, bilaterally mydriatic and salivating...
February 16, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28208928/pulsatile-clavicular-swelling-as-the-sole-presentation-of-asymptomatic-renal-cell-carcinoma-with-an-isolated-metastasis-to-the-clavicle-a-case-report
#3
Ashwani Kumar, Nitish Arora, Paras Kumar Pandove, Garima Anand, Bharti Arora
Renal Cell Carcinoma (RCC) is notorious for its unpredictable dissemination patterns involving both lymphatic and haematogenous route without a clear-cut preponderance for any. Unlike other intra-abdominal malignancies like colorectal carcinoma, renal cell carcinoma is often known to metastasize to distant sites even after a confident and unsuspecting curative resection or often as the primary presentation constantly adding and agitating our presentation patterns for this sneaky tumour. Presented below is a case of such an unsuspecting female patient...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208695/the-role-of-inhaled-loxapine-in-the-treatment-of-acute-agitation-in-patients-with-psychiatric-disorders-a-clinical-review
#4
REVIEW
Domenico de Berardis, Michele Fornaro, Laura Orsolini, Felice Iasevoli, Carmine Tomasetti, Andrea de Bartolomeis, Nicola Serroni, Alessandro Valchera, Alessandro Carano, Federica Vellante, Stefano Marini, Monica Piersanti, Giampaolo Perna, Giovanni Martinotti, Massimo Di Giannantonio
Loxapine is a first generation antipsychotic, belonging to the dibenzoxazepine class. Recently, loxapine has been reformulated at a lower dose, producing an inhaled powder that can be directly administered to the lungs to treat the agitation associated with psychiatric disorders, such as schizophrenia and bipolar disorder. Thus, the aim of this narrative and clinical mini-review was to evaluate the efficacy and tolerability of inhaled loxapine in the treatment of acute agitation in patients with psychiatric disorders...
February 8, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28205446/intramuscular-ziprasidone-dosing-for-acute-agitation-in-the-pediatric-emergency-department
#5
Tammy Nguyen, Jillian Stanton, Robin Foster
BACKGROUND: Intramuscular (IM) ziprasidone is often used to manage acute agitation. Limited data exist on the pediatric dosing of ziprasidone in the emergency department (ED). OBJECTIVE: To characterize the mg/kg dosing differences between pediatric ED patients who respond to an initial dose of ziprasidone versus patients who do not. METHODS: This was a retrospective, observational study of 5- to 18-year-old patients who were treated with IM ziprasidone in the pediatric ED from 2007 to 2015...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28203208/changes-in-heart-rate-variability-recorded-in-natural-situation-with-t-shirt-integrated-sensors-and-level-of-observed-behavioral-excitation-a-pilot-study-of-patients-with-intellectual-disabilities-and-psychiatric-disorders
#6
Julie Palix, Michel Akselrod, Charly Cungi, Fabienne Giuliani, Jérôme Favrod
BACKGROUND: The present study investigates the possibilities of using heart rate variability (HRV) parameters as physiological markers that precede increase in observed behavioral excitation of intellectually disabled individuals. The ability to recognize or predict such patterns, especially in patients showing unpredictable reactions and language deficiencies, might be a major step forward in clinical research. METHOD: Thirteen volunteers with intellectual disabilities, who had suffered of at least one event of overt aggression in the preceding 3 months, participated to the study...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28196698/-when-and-how-prescribe-antipsychotics
#7
S Tebeka, G Airagnes, F Limosin
Antipsychotics are commonly prescribed in the general population since they have many indications. They can be used in acute care such as agitation or behavior disorders, or to treat more characterized psychiatric disorders like psychotic or mood disorders. Consequently, any practitioner will have to prescribe or renew a prescription of antipsychotics. These treatments require a benefit/risk balance assessment taking into account the specific context of each patient. Indeed, antipsychotics have many side effects, mainly neurological (extrapyramidal syndrome, dyskinesia, akathisia), metabolic and cardiac...
February 10, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#8
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28190430/delirium-in-critically-ill-patients
#9
A J C Slooter, R R Van De Leur, I J Zaal
Delirium is common in critically ill patients and associated with increased length of stay in the intensive care unit (ICU) and long-term cognitive impairment. The pathophysiology of delirium has been explained by neuroinflammation, an aberrant stress response, neurotransmitter imbalances, and neuronal network alterations. Delirium develops mostly in vulnerable patients (e.g., elderly and cognitively impaired) in the throes of a critical illness. Delirium is by definition due to an underlying condition and can be identified at ICU admission using prediction models...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186850/the-use-of-dexmedetomidine-in-pediatric-palliative-care-a-preliminary-study
#10
Jamie Burns, Kevin Jackson, Kathy A Sheehy, Julia C Finkel, Zenaide M Quezado
OBJECTIVE: To evaluate the effect of dexmedetomidine infusions in patients with advanced malignancies, advanced heart disease, or after stem cell transplantation (SCT), who during end-of-life care had pain and/or agitation unresponsive to conventional therapies. BACKGROUND: Pediatric patients with intractable advanced malignancies, end-stage congenital heart diseases, or after SCT can suffer a great deal during end of life. Pain, drowsiness, fatigue, irritability, and worrying are experienced frequently, considered distressing, and are strongly associated with reductions in health-related quality-of-life scores...
February 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28184297/one-size-doesn-t-fit-all-should-we-reconsider-the-introduction-of-cold-stored-platelets-in-blood-bank-inventories
#11
REVIEW
Alessandra Berzuini, Marta Spreafico, Daniele Prati
Platelet concentrates are universally prepared with a standard method and stored for 5 days at room temperature (20-24°C) in gentle agitation. Currently, there is a renewed interest in the possibility of storing platelet concentrates below the standard temperatures. In fact, cold platelets might be more effective in bleeding patients and have a lower risk of bacterial transmission. Inventories including platelets at different temperatures may favour patient-centred strategies for prophylactic or therapeutic transfusions...
2017: F1000Research
https://www.readbyqxmd.com/read/28182021/procedural-moderate-sedation-with-ketamine-in-pediatric-critical-care-unit
#12
Tarek R Hazwani, Hala Al-Alem
OBJECTIVE: To evaluate the safety and efficacy of moderate sedation in the Pediatric Intensive Care Unit (PICU) settings according to moderate sedation protocol using ketamine and midazolam and to determine areas for the improvement in our clinical practice. SETTINGS AND DESIGN: A retrospective study was conducted in the PICU. MATERIALS AND METHODS: Retrospective chart review was performed for patients who had received moderate sedation between January and the end of December 2011 and who are eligible to inclusion criteria...
January 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28179250/impact-of-pharmacist-management-of-pain-agitation-and-delirium-in-the-intensive-care-unit-through-participation-in-multidisciplinary-bundle-rounds
#13
Patricia Louzon, Heath Jennings, Mahmood Ali, Marijo Kraisinger
PURPOSE: A two-phase program to increase pharmacist involvement in management of pain, agitation and delirium (PAD) at a large community teaching hospital is described. SUMMARY: Florida Orlando Hospital implemented a two-phase initiative to decrease intensive care unit (ICU) length of stay (LOS), ventilator use, sedative use, and hospital expenditures while advancing pharmacists' scope of practice. Phase 1 of the initiative involved a pilot project to evaluate pharmacist management of sedative therapy for mechanically ventilated patients...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28179043/measurement-of-agitation-and-aggression-in-adult-and-aged-neuropsychiatric-patients-review-of-definitions-and-frequently-used-measurement-scales
#14
Ladislav Volicer, Leslie Citrome, Jan Volavka
Agitation and aggression in adult psychiatric patients with psychoses and in persons with dementia increase the burden of disease and frequently cause hospitalization. The implementation of currently available management strategies and the development of new ones is hindered by inconsistent terminology that confuses agitation with aggression. This confusion is maintained by many rating scales that fail to distinguish between these two syndromes. We review the frequently used rating scales with a particular focus on their ability to separate agitation from aggression...
February 9, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28178037/benefits-of-dexmedetomidine-in-management-of-post-ect-agitation
#15
Puneet Narang, Francesca Ianovich, Simrat Kaur Sarai, Steven Lippmann
Electroconvulsive therapy (ECT) is an intervention for patients with a variety of psychiatric conditions. Occasionally, people exhibit dangerous degrees of agitation after this treatment, and some do not respond well to conventional pharmacotherapies. Dexmedetomidine is a central α-2 agonist that can induce significantly calmative effects in persons with post-ECT agitation. The indication for it is in calming individuals with acute and/or recurrent posttreatment agitation. Dexmedetomidine is safe and effective when infused just before, or postictally, at ECT sessions...
February 8, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28177178/association-of-premorbid-personality-with-behavioral-and-psychological-symptoms-in-dementia-with-lewy-bodies-comparison-with-alzheimer-s-disease-patients
#16
Kazuki Tabata, Yasuaki Saijo, Fumiyoshi Morikawa, Juichiro Naoe, Eiji Yoshioka, Yasuyuki Kawanishi, Yoshihiko Nakagi, Takahiko Yoshida
AIM: The aim of this study was to elucidate the relationship between premorbid personality traits and behavioral and psychological symptoms in dementia (BPSD) in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) patients. METHODS: Forty-one DLB patients and 98 AD patients were assessed for BPSD using the Neuropsychiatric Inventory (NPI). Each patient's midlife personality traits were rated by a family member using the NEO Five-Factor Inventory (NEO-FFI) questionnaire...
February 8, 2017: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28173768/-bowel-prep-hyponatremia-a-state-of-acute-water-intoxication-facilitated-by-low-dietary-solute-intake-case-report-and-literature-review
#17
Martin Windpessl, Christoph Schwarz, Manfred Wallner
BACKGROUND: Symptomatic hyponatremia is considered a rare complication of oral bowel preparation for colonoscopy. The pathophysiology underlying this phenomenon has been widely regarded as a mere sequela of excessive arginine vasopressin (AVP) release. CASE PRESENTATION: This case describes a 61-year old woman who developed acute hyponatremic encephalopathy when preparing for elective outpatient lower endoscopy. She had had negligible oral solute intake for two days and ingested four liters of clear fluid within two hours...
February 7, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28169824/-agitation-in-people-with-dementia-160-scoping-review-and-putting-the-phenomenon-into-perspective-using-the-comfort-theory-and-the-concept-of-attachment
#18
Corinne Schaub, Diane Morin, Armin von Gunten
<ce:para>Agitation in hospitalized demented patients is troublesome and disruptive for both patients and caregivers. The literature indicates that agitation is strongly related to physical or psychological discomfort and its recent definition includes the additional relation to emotional distress. Hospitalization associated with major cognitive difficulties further activates the need for attachment and security to which caregivers must pay attention. This synthesis review first deals with the evidence related to agitation in people with dementia and its relationship with discomfort...
July 5, 2016: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28169814/examen-de-la-port%C3%A3-e-des-connaissances-sur-les-concepts-du-toucher-et-du-massage-et-de-leurs-effets-sur-l%C3%A2-agitation-et-le-stress-des-personnes-%C3%A3-g%C3%A3-es-hospitalis%C3%A3-es-atteintes-de-d%C3%A3-mence
#19
Corinne Schaub, Armin von Gunten, Diane Morin
<ce:para>This scoping review examines the effects of touch/massage on agitation and stress in aged hospitalized patients suffering from dementia. This intervention is multidimensional, at the edges of medical neurosciences, nursing sciences, and social sciences. This review is primarily supported by a biological model of social relations, describing the interconnection between cognition, affect, and endocrine aspects of attachment modes. It is also guided by nursing sciences conceptualizations which anchors touch/massage in the heart of nursing practice...
October 27, 2016: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28160834/-observational-study-of-delirium-in-palliative-care
#20
REVIEW
Maryse Mailly, Jean-Pierre Bénézech, Josyane Chevallier-Michaud
Caregivers know that the agitation and movements to reject sheets and clothes is found in some patients with cancer in the palliative phase. An observational study was carried out with the aim of refining the short-term prognosis clinical approach and to organise more suitably adapted care.
February 2017: Revue de L'infirmière
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