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Management of agitated

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https://www.readbyqxmd.com/read/28646587/perioperative-pain-management-after-fibular-free-flap-harvesting-for-head-and-neck-reconstruction-using-mini-catheters-to-inject-local-anesthetic-a-pilot-study
#1
Andrea Ferri, Andrea Varazzani, Adriana Valente, Giuseppe Pedrazzi, Bernardo Bianchi, Silvano Ferrari, Enrico Sesenna
BACKGROUND: Fibular donor site pain management in the early postoperative period can help minimize complications, patient discomfort, and agitation. Traditional management of postoperative pain consists of systemic administration of opioids and NSAIDS. The use of local anesthetics in addition to systemic analgesics has the potential to improve pain control. Purpose of the study is to evaluate the efficacy of mini-catheters used to inject local anesthetic into the fibular donor site after flap harvesting for reconstruction of the head-and-neck area...
June 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28638198/efficacy-of-atypical-antipsychotics-in-the-management-of-acute-agitation-and-aggression-in-hospitalized-patients-with-schizophrenia-or-bipolar-disorder-results-from-a-systematic-review
#2
REVIEW
Xin Yu, Christoph U Correll, Yu-Tao Xiang, Yifeng Xu, Jizhong Huang, Fude Yang, Gang Wang, Tianmei Si, John M Kane, Prakash Masand
Acute agitation and aggression are common symptoms in patients with bipolar disorder and schizophrenia. In this review, we discuss the prevalence, clinical assessment strategies, treatment options, and current Western and Chinese guidelines for the management of acute agitation and aggression in patients with bipolar disorder or schizophrenia. Among available approaches, we discuss in detail recent evidence supporting the use of intramuscular (IM) antipsychotics and some recently approved oral atypical antipsychotics for the management of acute aggression and agitation in hospitalized patients with bipolar disorder or schizophrenia presenting with acute agitation or aggression, highlighting some differences between individual antipsychotic agents...
October 25, 2016: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28623497/-psychiatric-emergencies
#3
F Schneider, S Weber-Papen
Psychiatric emergencies present a frequent and interdisciplinary challenge. Clinical diagnosis and management are complicated by the acuity, and the patient's compliance is often limited by the illness. Psychiatric emergencies include states of acute agitation, suicidality, delirium, stupor, and drug-induced emergencies. Sometimes interventions such as conversational contact, responding empathically to patients, or "talking down" are sufficient. If pharmacotherapy is necessary, benzodiazepines and antipsychotic drugs are the primary agents of choice...
June 16, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28614197/sedation-management-in-children-supported-on-extracorporeal-membrane-oxygenation-for-acute-respiratory-failure
#4
James B Schneider, Todd Sweberg, Lisa A Asaro, Aileen Kirby, David Wypij, Ravi R Thiagarajan, Martha A Q Curley
OBJECTIVES: To describe sedation management in children supported on extracorporeal membrane oxygenation for acute respiratory failure. DESIGN: Secondary analysis of prospectively collected data from a multicenter randomized trial of sedation (Randomized Evaluation of Sedation Titration for Respiratory Failure). SETTING: Twenty-one U.S. PICUs. PATIENTS: One thousand two hundred fifty-five children, 2 weeks to 17 years old, with moderate/severe pediatric acute respiratory distress syndrome...
June 13, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28613368/-rapid-tranquillisation-for-agitated-patients-with-psychostimulant-intoxication
#5
P Geerts, K Titeca, G M D Lemmens, J De Fruyt
Because psychostimulant intoxication can lead to serious health risks for the patient, it is often necessary to ensure that the patient receives both adequate medical surveillance and rapid tranquillisation.<br/> AIM: To find out whether there is scientific evidence that psychopharmacological intervention helps patients with psychostimulant intoxication to manage aggression and agitation.<br/> METHOD: We searched the literature systematically.<br/> RESULTS: Our study showed that intravenous droperidol worked faster and was more effective than intravenous lorazepam in inducing sedation in patients intoxicated with psychostimulants...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28595662/behavior-and-evolution-of-young-onset-dementia-part-2-beyond-ii-study-an-intervention-study-aimed-at-improvement-in-the-management-of-neuropsychiatric-symptoms-in-institutionalized-people-with-young-onset-dementia
#6
J C L van Duinen-van den IJssel, B Appelhof, S A Zwijsen, M Smalbrugge, F R J Verhey, M E de Vugt, S U Zuidema, R T C M Koopmans, C Bakker
BACKGROUND: Both neuropsychiatric symptoms (NPS) and psychotropic drug use (PDU) are common in institutionalized People with Young Onset Dementia (PwYOD) and can produce negative outcomes such as reduced quality of life and high workload. In community-dwelling PwYOD, NPS are found to be associated with unmet care needs. This emphasizes the importance of a care program for the management of NPS in institutionalized PwYOD that also addresses unmet care needs and PDU. The objectives of the Behavior and Evolution of Young ONset Dementia part 2 (BEYOND-II) study are to develop a care program for the management of NPS in institutionalized PwYOD and to evaluate its effectiveness...
June 9, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28579785/dexmedetomidine-for-the-management-of-postictal-agitation-after-electroconvulsive-therapy-with-s-ketamine-anesthesia
#7
Suna Su Aksay, Jan Malte Bumb, Dmitry Remennik, Manfred Thiel, Laura Kranaster, Alexander Sartorius, Christoph Janke
OBJECTIVES: Postictal agitation (PIA) represents one of the most common complications during a modified electroconvulsive therapy (ECT) course. Its clinical management can be challenging especially in cases with poor response to benzodiazepines. Dexmedetomidine, a highly selective alpha-2 adrenoceptor agonist acting predominantly in the locus coeruleus, exerts sedative effects without causing relevant respiratory depression. To the best of our knowledge, this is the first study that aimed to assess the impact of dexmedetomidine use with S-ketamine anesthesia on PIA reduction in ECT...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28572112/delirium-in-children-identification-prevention-and-management
#8
Amanda Bettencourt, Jodi E Mullen
Delirium in children is an often underrecognized but serious complication of hospitalization. Delirium in this age group has been described as behaviors such as refractory agitation and restlessness, visual or auditory hallucinations, children being "not themselves," and a lethargic state. Often, children with delirium are at risk for harming themselves by dislodging tubes, falling, or refusing care. Pediatric nurses must recognize and intervene to prevent and treat delirium in hospitalized children because the delirium may be an indicator of worsening clinical status and is associated with high mortality and morbidity in children of all ages and with posttraumatic stress disorder...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28572103/interprofessional-team-s-perception-of-care-delivery-after-implementation-of-a-pediatric-pain-and-sedation-protocol
#9
Sandra L Staveski, May Wu, Tiffany M Tesoro, Stephen J Roth, Michael J Cisco
BACKGROUND: Pain and agitation are common experiences of patients in pediatric cardiac intensive care units. Variability in assessments by health care providers, communication, and treatment of pain and agitation creates challenges in management of pain and sedation. OBJECTIVES: To develop guidelines for assessment and treatment of pain, agitation, and delirium in the pediatric cardiac intensive unit in an academic children's hospital and to document the effects of implementation of the guidelines on the interprofessional team's perception of care delivery and team function...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28561954/evidence-for-the-presence-of-a-bacterial-endosymbiont-in-the-pecan-scab-pathogen-venturia-effusa-basyonym-fusicladium-effusum
#10
E G Medrano, L J Grauke, R L Stanford, T Thompson
AIMS: To determine whether Venturia effusa the causative fungal agent of pecan scab harbors a bacterial symbiont. METHODS AND RESULTS: Venturia effusa isolates were maintained on potato dextrose agar amended with antibiotics (chloramphenicol 100 μg ml(-1) , and tetracycline 100 μg ml(-1) ). Genomic DNA extracted from mycelia was used to target eubacterial 16S rDNA. A 1(.) 4 kbp PCR amplified product using 16S rDNA degenerate primers was cloned, sequenced and found to have 99% identities with Actinobacteria representatives...
May 31, 2017: Journal of Applied Microbiology
https://www.readbyqxmd.com/read/28547318/a-systematic-review-of-alpha-2-agonists-for-sedation-in-mechanically-ventilated-neurocritical-care-patients
#11
Alexandre Tran, Henrietta Blinder, Brian Hutton, Shane W English
The use of sedative medications is commonplace in intensive care units (ICUs) and an invaluable clinical tool for the intensive care physician. Sedation for critically ill, mechanically ventilated patients provides an opportunity to reduce anxiety, discomfort as well as ventilator intolerance and dyssynchrony. Alpha-2 agonists in particular have become increasingly popular for use in the neurocritical care population due to their proposed effectiveness in facilitating examinations and procedures as well as reducing the need for adjunctive agents...
May 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28523268/the-sedative-effect-of-propranolol-on-critically-ill-patients-a-case-series
#12
Junji Shiotsuka, Andrew Steel, James Downar
INTRODUCTION: Recent studies have examined the effectiveness of alpha-2 adrenergic agonists for controlling delirium and agitation. Propranolol, a non-selective beta-adrenergic antagonist with good penetration of the blood-brain barrier, has not been investigated for this purpose. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all patients who were prescribed propranolol in our Medical Surgical ICU from January 1, 2010, to December 31, 2013...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28501048/systematic-review-of-evidence-underpinning-non-pharmacological-therapies-in-dementia
#13
Richard Olley, Andrea Morales
Objective Dementia is one of the most common illnesses worldwide, and is one of the most important causes of disability in older people. Currently, dementia affects over 35million people around the globe. It is expected that this number will increase to 65.7million by 2030. Early detection, diagnosis and treatment to control the principal behaviour symptoms may help reduce these numbers and delay the progression to more advanced and dangerous stages of this disorder with resultant increase quality of life for those affected...
May 15, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28500785/don-t-label-me-a-qualitative-study-of-patients-perceptions-and-experiences-of-sedation-during-behavioral-emergency-in-the-emergency-department
#14
Celene Y L Yap, Jonathan C Knott, David C M Kong, Marie Gerdtz, Kay Stewart, David McD Taylor
OBJECTIVES: Behavioral emergencies are commonly seen in emergency departments. Acutely agitated patients can be difficult to manage and sedation may be required to decrease dangerous behavior and to ensure the safety of both the patient and staff. While the experience of staff caring for this population has been reported, patients' experiences with their overall management remains unknown. We aimed to describe the perceptions and experiences of patients regarding the use of sedation during acute behavioral emergencies...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28489007/-frequency-of-symptoms-and-drug-treatment-among-dying-patients-in-the-last-24-hours-of-life-at-landspitali-the-national-university-hospital-of-iceland-and-in-nursing-homes
#15
Svandis Iris Halfdanardottir, Kristin Lara Olafsdottir, Valgerdur Sigurdardottir
INTRODUCTION: The purpose of this study was to evaluate the frequency of 5 common symptoms and drug treatments prescribed and given in the last 24 hours of life in 11 medical units at Landspitali National University Hospital of Iceland (LUH) and in 7 nursing homes (NH). MATERIAL AND METHODS: Data was collected retrospectively from 232 charts of patients who died in 2012, using documentation in the Liverpool Care Pathway (LCP) and the medication management system...
May 2017: Læknablađiđ
https://www.readbyqxmd.com/read/28485318/a-national-multicenter-survey-on-management-of-pain-agitation-and-delirium-in-intensive-care-units-in-china
#16
Jing Wang, Zhi-Yong Peng, Wen-Hai Zhou, Bo Hu, Xin Rao, Jian-Guo Li
BACKGROUND: The management of pain, agitation, and delirium (PAD) in Intensive Care Unit (ICU) is beneficial for patients and makes it widely applied in clinical practice. Previous studies showed that the clinical practice of PAD in ICU was improving; yet relatively little information is available in China. This study aimed to investigate the practice of PAD in ICUs in China. METHODS: A multicenter, nationwide survey was conducted using a clinician-directed questionnaire from September 19 to December 18, 2016...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28476252/-zero-isolation-a-care-practice-oriented-towards-recovery
#17
Laurent Defromont, Coline Groulez, Guillaume François, Bruno Dekerf
Some institutions do not have an isolation room. Agitation is managed otherwise, with the idea that restraint or isolation can only be a terrible experience. The care pathway is therefore designed to favour autonomy and to limit restrictions of freedom. In this context, professionals are in constant contact with the user. Example of a unit which advocates this concept of rehabilitation.
May 2017: Soins. Psychiatrie
https://www.readbyqxmd.com/read/28475360/patient-preferences-for-medicine-administration-for-acute-agitation-results-from-an-internet-based-survey-of-patients-diagnosed-with-bipolar-disorder-or-schizophrenia-in-two-nordic-countries
#18
Tine Rikke Jørgensen, Charlotte Emborg, Karianne Dahlen, Mette Bøgelund, Andreas Carlborg
The objective was to elicit patient preferences for medicine administration method in the management of acute agitation episodes among patients diagnosed with bipolar disorder or schizophrenia. The patients' experiences of acute agitation episodes and their management of episodes were also explored. Data were collected via an anonymous, internet-based survey of residents in Denmark or Sweden with schizophrenia or bipolar disorder (October 2014 to December 2014). Inclusion criteria were having a diagnosis of schizophrenia or bipolar disorder, and being above 18 years of age...
May 5, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28472575/beyond-anxiety-and-agitation-a-clinical-approach-to-akathisia
#19
Richardson Oghoteru Tachere, Mandana Modirrousta
BACKGROUND: When patients suddenly become restless and are unable to sit or stand still, especially in general medical settings, anxiety is often the topmost differential on every clinician's mind. However, the possibility of the very subjectively distressing condition called 'akathisia' should always be considered. OBJECTIVE: The aim of this article is to discuss a clinical approach to the management of akathisia, drawing on the presentation of a patient who was admitted to a general medical ward...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28465709/aromatherapy-and-aromatic-plants-for-the-treatment-of-behavioural-and-psychological-symptoms-of-dementia-in-patients-with-alzheimer-s-disease-clinical-evidence-and-possible-mechanisms
#20
REVIEW
Damiana Scuteri, Luigi Antonio Morrone, Laura Rombolà, Pina Rosa Avato, Anna Rita Bilia, Maria Tiziana Corasaniti, Shinobu Sakurada, Tsukasa Sakurada, Giacinto Bagetta
The treatment of agitation and aggression, typical Behavioural and Psychological Symptoms of Dementia (BPSDs) of Alzheimer's Disease (AD), is one of the most complicated aspects of handling patients suffering from dementia. Currently, the management of these symptoms often associated with an increased pain perception, which notably reduces the patients' quality of life (QoL), relies on the employment of antipsychotic drugs. Unfortunately, the use of these pharmacological agents has some limits: in the long term, they do not result in being equally effective as in the first weeks of treatment and they present important side effects...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
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