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https://www.readbyqxmd.com/read/29207895/nonpharmacological-management-of-neonatal-abstinence-syndrome-a-review-of-the-literature
#1
Gareth Ryan, Anishnaabe Bimaadiziwin, Joe Dooley, Lianne Gerber Finn, Len Kelly
BACKGROUND: Infants with neonatal abstinence syndrome (NAS) experience withdrawal that occurs as a result of termination of placental opioid supply following delivery. Common symptoms include restlessness, tremors, agitation and gastrointestinal disturbances. Severe NAS is often treated using opioids and/or sedatives. Although commonly employed effectively in neonatal care, there is a lack of published information regarding nonpharmacological management of the NAS infant. OBJECTIVE: The purpose of this review was to summarize the current literature on nonpharmacological management of NAS...
December 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29203336/spontaneous-recovery-of-traumatic-brain-injury-induced-functional-deficits-is-not-hindered-by-daily-administration-of-lorazepam
#2
Jeffrey P Cheng, Jacob B Leary, Darik A O'Neil, Elizabeth A Meyer, Kristin E Free, Corina O Bondi, Anthony E Kline
Agitation and aggression are common sequelae of traumatic brain injury (TBI) and pose a challenge to physicians and other health providers during acute patient care and subsequent neurorehabilitation. Antipsychotic drugs (APDs) are routinely administered to manage TBI patients displaying such maladaptive behaviors despite several clinical and preclinical studies demonstrating that they hinder recovery. A potentially viable alternative to APDs may be the benzodiazepines, which have differing mechanisms of action...
February 26, 2018: Behavioural Brain Research
https://www.readbyqxmd.com/read/29196585/feasibility-of-a-nurse-managed-pain-agitation-and-delirium-protocol-in-the-surgical-intensive-care-unit
#3
Alan Rozycki, Andrew S Jarrell, Rachel M Kruer, Samantha Young, Pedro A Mendez-Tellez
BACKGROUND: Society of Critical Care Medicine guidelines recommend the use of pain, agitation, and delirium protocols in the intensive care unit. The feasibility of nurse management of such protocols in the surgical intensive care unit has not been well assessed. OBJECTIVES: To evaluate the percentage of adherent medication interventions for patients assessed by using a pain, sedation, and delirium protocol. METHODS: Data on all adult patients admitted to a surgical intensive care unit from January 2013 through September 2013 who were assessed at least once by using a pain, sedation, and delirium protocol were retrospectively reviewed...
December 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/29181532/management-of-suspected-opioid-overdose-with-naloxone-in-out-of-hospital-settings-a-systematic-review
#4
Roger Chou, P Todd Korthuis, Dennis McCarty, Phillip O Coffin, Jessica C Griffin, Cynthia Davis-O'Reilly, Sara Grusing, Mohamud Daya
Background: Naloxone is effective for reversing opioid overdose, but optimal strategies for out-of-hospital use are uncertain. Purpose: To synthesize evidence on 1) the effects of naloxone route of administration and dosing for suspected opioid overdose in out-of-hospital settings on mortality, reversal of overdose, and harms, and 2) the need for transport to a health care facility after reversal of overdose with naloxone. Data Sources: Ovid MEDLINE (1946 through September 2017), PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, U...
November 28, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29174963/diagnosis-pathophysiology-and-management-of-cluster-headache
#5
REVIEW
Jan Hoffmann, Arne May
Cluster headache is a trigeminal autonomic cephalalgia characterised by extremely painful, strictly unilateral, short-lasting headache attacks accompanied by ipsilateral autonomic symptoms or the sense of restlessness and agitation, or both. The severity of the disorder has major effects on the patient's quality of life and, in some cases, might lead to suicidal ideation. Cluster headache is now thought to involve a synchronised abnormal activity in the hypothalamus, the trigeminovascular system, and the autonomic nervous system...
November 23, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/29171275/single-use-polyetheretherketone-peek-solid-phase-microextraction-transmission-mode-spme-tm-devices-for-rapid-screening-and-quantitation-of-drugs-of-abuse-in-oral-fluid-and-urine-via-direct-analysis-in-real-time-tandem-mass-spectrometry-dart-ms-ms
#6
Tijana Vasiljevic, German Augusto Gómez-Riós, Janusz Pawliszyn
The analysis of oral fluid (OF) and urine samples to detect recent drug consumption has garnered considerable attention as alternative and less invasive biological matrices. Indeed, several groups have demonstrated that efficiently combining microex-traction and ambient ionization technologies can facilitate the rapid determination of target compounds in such biofluids at trace levels (low or sub ng mL-1). However, there is still a need for biocompatible devices that can both be implemented for in-vivo sampling and easily interfaced with mass-spectrometry (MS) analyzers...
November 24, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/29165558/-she-had-a-smile-on-her-face-as-wide-as-the-great-australian-bite-a-qualitative-examination-of-family-perceptions-of-a-therapeutic-robot-and-a-plush-toy
#7
Wendy Moyle, Marguerite Bramble, Cindy J Jones, Jenny E Murfield, Barbara J Bowers
Background and Objectives: Recent years have seen social robotic pets introduced as a means of treating behavioral and psychological symptoms of dementia, and many show promising potential. In this study, we sought to explore family members' perceptions of the Japanese-developed baby harp seal, Paro (version 9), and a look-alike, nonrobotic Plush Toy, when used by their relative with dementia for 15 min, 3 afternoons per week for 10 weeks. Research Design and Method: The study employed a descriptive qualitative approach, which was nested within a larger cluster randomized controlled trial...
November 19, 2017: Gerontologist
https://www.readbyqxmd.com/read/29153907/-violent-outburst-from-teenagers-in-the-pediatric-emergency-room-complex-cases
#8
L Cohen, C Gras-Le Guenb, J Fleury, E Caldagues, L Dreno, G Picherot, N Vabres
INTRODUCTION: Teenagers admitted to the emergency room for a violent attacks episode are increasingly numerous. The source of agitation is multifactorial for these teenagers, often with a complex course. They jeopardize hospital wards, which are often ill-suited for and overwhelmed during these outbursts. This study aims to identify and describe all the teenagers admitted to the hospital over 1 year for a violent outburst and discuss their management. METHODS AND EQUIPMENT: Retrospective and descriptive study of teenagers admitted to the pediatric emergency department of the Nantes University Hospital for a violent outburst in 2015...
November 16, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29146222/nursing-staff-distress-associated-with-neuropsychiatric-symptoms-in-young-onset-dementia-and-late-onset-dementia
#9
Jeannette C L van Duinen-van den IJssel, Ans J M J Mulders, Martin Smalbrugge, Sandra A Zwijsen, Britt Appelhof, Syste U Zuidema, Marjolein E de Vugt, Frans R J Verhey, Christian Bakker, Raymond T C M Koopmans
OBJECTIVE: The aims of this study were (1) to investigate the relationship between different neuropsychiatric symptoms (NPS) and the level of distress experienced by nurses caring for residents with young-onset dementia (YOD) and (2) to compare these findings with those for nurses caring for residents with late-onset dementia (LOD). DESIGN/SETTING: This is a retrospective study conducted in Dutch long-term care facilities. Data were used from the Behavior and Evolution of Young-ONset Dementia studies (BEYOND) Parts I and II and the WAAL Behavior in Dementia-II (Waalbed-II) study...
November 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29140615/operator-exposure-to-hydrogen-sulfide-from-dairy-manure-storages-containing-gypsum-bedding
#10
Eileen E Fabian-Wheeler, Michael L Hile, Dennis J Murphy, Davis E Hill, Robert Meinen, Robin C Brandt, Hershel A Elliott, Daniel Hofstetter
Dairy manure storages containing gypsum-based bedding have been linked anecdotally with injury and death due to presumed dangerous levels of gases released. Recycled gypsum products are used as a cost-effective bedding alternative to improve animal welfare and provide agronomic benefits to manure recycled back to the land. Sulfur contained in gypsum (calcium sulfate) can contribute to hydrogen sulfide (H2S) gas formation under the anaerobic storage conditions typical of dairy manure slurry. Disturbance of stored manure during agitation releases a burst of volatile gases...
January 26, 2017: Journal of Agricultural Safety and Health
https://www.readbyqxmd.com/read/29136301/ketamine-for-the-acute-management-of-excited-delirium-and-agitation-in-the-prehospital-setting
#11
Kyle A Weant, Lauren M Linder, Clint A Ross
BACKGROUND: Traditional first-line therapy in the prehospital setting for the acutely agitated patient includes an antipsychotic in combination with a benzodiazepine. Recently, interest has grown regarding the use of ketamine in the prehospital setting as an attempt to overcome the limitations of the traditional medications and provide a more safe and effective therapy. This review provides an overview of the pharmacology of ketamine, evaluates the literature regarding ketamine use for prehospital agitation, and proposes an algorithm that may be used within the prehospital setting...
November 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29136228/opioid-prescription-use-in-nursing-home-residents-with-advanced-dementia
#12
Charlotte Griffioen, Bettina S Husebo, Elisabeth Flo, Monique A A Caljouw, Wilco P Achterberg
Background: Although proper pain treatment may require opioids, discussion continues about possible undertreatment or overtreatment in persons with advanced dementia. Objective: To investigate the prevalence of pain, frequency of opioid prescription use, and factors associated with strong opioid prescription use in nursing homes. Design: Cross-sectional study. Setting and Subjects: Eighteen Norwegian nursing homes; 327 persons with advanced dementia and behavioral disturbances participated...
November 9, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29132582/airway-management-in-trauma
#13
REVIEW
George Kovacs, Nicholas Sowers
Airway management in the trauma patient presents numerous unique challenges beyond placement of an endotracheal tube and outcomes are dependent on the provider's ability to anticipate difficulty. Airway management strategies for the care of the polytrauma patient are reviewed, with specific considerations for those presenting with traumatic brain injury, suspected c-spine injury, the contaminated airway, the agitated trauma patient, maxillofacial trauma, and the traumatized airway. An approach to airway management that considers the potential anatomic and physiologic challenges in caring for these complicated trauma patients is presented...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29109752/management-of-exaggerated-gag-reflex-in-dental-patients-using-intravenous-sedation-with-dexmedetomidine
#14
Aleksei P Reshetnikov, Anton A Kasatkin, Aleksandr L Urakov, Dmitrii Y Baimurzin
Pharmacological sedation is one of the effective ways of prevention of gag reflex development in patients experiencing anxiety and fright before dental treatment. We are reporting a case where we could successfully eliminate exaggerated gag reflex (intravenous [IV] Gagging Severity Index) in a dental patient using IV sedation with dexmedetomidine. IV administration of dexmedetomidine provided elimination of gag reflex at a depth of sedation for the patient with the Richmond Agitation-Sedation Scale score of -2 and -1...
September 2017: Dental Research Journal
https://www.readbyqxmd.com/read/29100197/using-simulated-family-presence-to-decrease-agitation-in-older-hospitalized-delirious-patients-a-randomized-controlled-trial
#15
Christine M Waszynski, Kerry A Milner, Ilene Staff, Sheila L Molony
BACKGROUND: Simulated family presence has been shown to be an effective nonpharmacological intervention to reduce agitation in persons with dementia in nursing homes. Hyperactive or mixed delirium is a common and serious complication experienced by hospitalized patients, a key feature of which is agitation. Effective nonpharmacological interventions to manage delirium are needed. OBJECTIVES: To examine the effect of simulated family presence through pre-recorded video messages on the agitation level of hospitalized, delirious, acutely agitated patients...
October 7, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29095327/cerebral-venous-sinus-thrombosis-due-to-low-molecular-weight-heparin-induced-thrombocytopenia
#16
Ezequiel Gleichgerrcht, Ming Y Lim, Tanya N Turan
INTRODUCTION: Heparin-induced thrombocytopenia (HIT) is an immune-mediated complication of heparin exposure. A limited number of studies have reported cerebral venous sinus thrombosis (CVST) as the presenting thrombotic event induced by HIT, only one of which occurred with exposure to low-molecular-weight heparin (LMWH), with death as outcome. Here, we present a unique case of LMWH-induced HIT leading to CVST but resulting in good clinical outcome. CASE REPORT: A 52-year-old woman received subcutaneous LMWH for deep vein thrombosis prophylaxis while in rehabilitation following kyphoplasty for spinal fracture related to recent trauma...
November 2017: Neurologist
https://www.readbyqxmd.com/read/29076979/the-impact-of-intraoperative-magnetic-resonance-imaging-on-patient-safety-management-during-awake-craniotomy
#17
Kotoe Kamata, Takashi Maruyama, Hiroshi Iseki, Minoru Nomura, Yoshihiro Muragaki, Makoto Ozaki
BACKGROUND: Awake craniotomy paired with intraoperative magnetic resonance imaging (iMRI) is now the established technique for maximizing surgical resection, while preserving neurological function. However, leaving an unsecured airway patient in the iMRI gantry represents considerable risk. Our study aimed at identifying the incidence of critical adverse events in unsecured airway patients during iMRI as part of awake craniotomy. MATERIALS AND METHODS: We conducted a clinical chart review of consecutive awake craniotomies performed between November 1999 and December 2015...
October 25, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29068771/investigation-of-a-worker-death-while-agitating-manure-in-a-non-enclosed-storage
#18
John M Shutske, Daniel Schaefer, Rebecca Larson, Kevin Erb, Cheryl Skjolaas, Stephanie Leonard, Jeff Nelson, Elizabeth Binversie, Scott Rifleman
An in-depth investigation of an unusual, non-enclosed manure storage hydrogen sulfide fatality on a Holstein beef production operation is presented. The case involved several factors that likely played a role in the young farmer's death. These included zero wind movement, a reported temperature inversion in the area, relatively cool late summer outdoor temperatures on the morning of the incident, higher outdoor temperatures the week prior, and a high by-product steer ration containing ingredients that contributed significant sulfur content to the stored manure...
October 25, 2017: Journal of Agromedicine
https://www.readbyqxmd.com/read/29051871/bilateral-divergent-shoulder-s-fracture-dislocation-case-in-an-ischemic-stroke-patient
#19
Atchi Walla, Faré Gnandi-Piou, Pilakimwé Egbohou, Komi Assogba, Mawuko Quacoe
INTRODUCTION: The literature review revealed that nowadays only about 15 cases of bilateral shoulder dislocation associated with the fracture of the upper end of the humerus have been published. The triad of lesional mechanism designated by the triple syndrome E composed of epilepsy, electrocution, and external trauma was the circumstances noted in which these fractures dislocations occur with migration of the two humeral heads either forward or backward. CASE REPORT: An architect of 36-year-old, right-handed, was admitted in emergency department for loss of knowledge of progressive installation...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29045280/sedation-practice-in-extracorporeal-membrane-oxygenation-treated-patients-with-acute-respiratory-distress-syndrome-a-retrospective-study
#20
Julian deBacker, Erik Tamberg, Laveena Munshi, Lisa Burry, Eddy Fan, Sangeeta Mehta
Our objective was to characterize sedation management in adult patients with severe respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We conducted a retrospective chart review of these patients treated at Toronto General Hospital between January 2012 and October 2015. Medications administered (sedative, analgesic, paralytic, and antipsychotic), sedation depth (Sedation Agitation Scale [SAS] score) delirium assessments, and mobilization were recorded daily...
October 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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