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Bedside report

Anna-Maria Kuivalainen, Freja Ebeling, Eira Poikonen, Per H Rosenberg
Background and aims Bone marrow aspiration and/or biopsy (BMAB), performed under local anaesthesia in adults, is a common and often painful procedure. Anxiety is known to intensify pain during the procedure. Nitrous oxide (N2O), known for its sedative and analgesic benefit in various short medical procedures and labour pain, could be advantageous also for pain relief during bone marrow examination. N2O acts rapidly and is eliminated in a couple of minutes once the inhalation is stopped, and occasional side effects (e...
December 29, 2017: Scandinavian Journal of Pain
Thomas G Poder, Serge Maltais
OBJECTIVE: Medication administration omission errors (MAOEs) occur frequently in hospitals and can significantly affect patient health. An interdisciplinary committee was formed in summer 2012 to analyse incident/accident reports (AH-223-1 forms) of MAOEs for the 2011-2012 fiscal year in order to identify contributing factors and to propose preventive solutions. Special attention was paid to events with consequences for patients. METHOD: An aggregate data analysis involving four major steps was conducted: sampling, categorisation, identification of contributing factors, and seeking preventive solutions...
January 1, 2018: Health Information Management: Journal of the Health Information Management Association of Australia
Carlijn D J M Borm, Florian Krismer, Gregor K Wenning, Klaus Seppi, Werner Poewe, Maria Teresa Pellecchia, Paolo Barone, Erik L Johnsen, Karen Østergaard, Tanya Gurevich, Ruth Djaldetti, Luisa Sambati, Pietro Cortelli, Igor Petrović, Vladimir S Kostić, Hana Brožová, Evžen Růžička, Maria Jose Marti, Eduardo Tolosa, Margherita Canesi, Bart Post, Jorik Nonnekes, Bastiaan R Bloem
OBJECTIVE: Differentiating Parkinson's disease (PD) from atypical parkinsonian disorders (APD) such as Multiple System Atrophy, parkinsonian type (MSA-p) or Progressive Supranuclear Palsy (PSP-RS) can be challenging. Early signs of postural Instability and gait disability (PIGD) are considered clues that may signal presence of APD. However, it remains unknown which PIGD test - or combination of tests - can best distinguish PD from APD. We evaluated the discriminative value of several widely-used PIGD tests, and aimed to develop a short PIGD evaluation that can discriminate parkinsonian disorders...
June 8, 2018: Parkinsonism & related Disorders
Nicola Magnavita, Carlo Chiorri
BACKGROUND: The active role of nursing students is particularly important in the delivery of health care, since playing an active role at the bedside and the use of active and collaborative engagement of students in the nursing activities has been associated with improved student learning. This is consistent with Karasek's learning hypothesis, but it has never been tested on nursing students. This study aimed at investigating whether nursing students in high control conditions reported lower levels of work impairment than students in the conditions with low control, compared them with a group of healthcare workers (HCWs), and tested the moderating role of social support at work...
June 8, 2018: Nurse Education Today
Mayadhar Barik, Pravash R Mishra, Ashok Kumar Mohapatra
Aim: Split cord malformation (SCM) is associated with extensive vertebral fusions (Klippel-Feil anomaly). In light of previous embryological theories and recent research findings, we attempt to document the origin of split cord, and vertebral fusions involvement of spectrum of genes is necessary to know better the etiopathogenesis of SCM and its associated diseases. Materials and Methods: We used the various databases such as PubMed/MEDLINE, Cochrane Review, Hinari, and Google Scholar for the recently published medical literature...
January 2018: Journal of Pediatric Neurosciences
Jane Ferguson, Liz Seston, Darren M Ashcroft
BACKGROUND: Transition between care settings is a time of high risk for preventable medication errors. Poor communication about medication changes on discharge from hospital can result in adverse drug events and medicines-related readmissions. Refer-to-Pharmacy is a novel electronic referral system that allows hospital pharmacy staff to refer patients from their bedside to their community pharmacist for post-hospital discharge medication support. The aim of this study was to examine factors that promoted or inhibited the implementation of Refer-to-Pharmacy in hospital and community settings...
June 7, 2018: BMC Health Services Research
Seok Jeong Lee, Yong Sung Cha, Yoonsuk Lee, Hyun Kim
The risk of thromboembolism is higher in those with carbon monoxide (CO) poisoning than in the general population. Pulmonary embolisms (PE) usually develop during admission for acute CO poisoning. We report the first case of a life-threatening PE that occurred immediately after acute CO poisoning and was treated with a thrombolytic agent. A 38-year-old woman presented at the emergency department with a stuporous mental status immediately after acute CO poisoning. She was started on hyperbaric oxygen therapy (HBOT), which maintained her hemodynamic stability...
May 30, 2018: American Journal of Emergency Medicine
Karen White-Trevino, Valorie Dearmon
The emergency department is a complex environment in which reliable communication is vital for safe patient care. Communication during nurse shift report can be risky without an effective report process in practice. Reliability improves with the use of a standardized, patient-centered nurse handoff process. Quality improvement methods were used to promote reliable information exchange during nurse shift handoff through the implementation of a standardized, patient-centric bedside report process. Forty-six hospital-based emergency nurses participated in the project...
July 2018: Nursing Administration Quarterly
Dimple Goel, Pankaj Gupta, Stephen Cooper, Jan Klimek
AIM: Cardiorespiratory physiology plays an important role in neonatal care with increasing utility of point of care ultrasound. This review is to bring to light the importance of systemic to pulmonary collaterals (SPCs) in the preterm population without congenital heart disease (CHD) and provide a useful diagnostic tool to the neonatologist performing a cardiac ultrasound. METHODS: Medline, PubMed, EMBASE, and the internet were searched up to November 2017 for papers in English which included SPCs in preterm infants without CHD...
June 5, 2018: Acta Paediatrica
Daniel Pinggera, Ondra Petr, Gabriel Putzer, Claudius Thomé
Multimodal neuromonitoring has become a fundamental part of management for many neurosurgical disorders such as subarachnoid hemorrhage and severe traumatic brain injury. Obviously, brain tissue oxygen tension monitoring requires insertion of a probe into the brain parenchyma through a single multiple lumen bolt, or in a subcutaneously tunneled fashion. As those patients often require early magnetic resonance imaging(MRI), typically used bolts are disadvantageous due to massive metal artifact. Similarly, subcutaneous tunneling is often problematic as suture fixation can loosen over time...
May 30, 2018: World Neurosurgery
Maxim A Moroz, Pat Zanzonico, Jason T Lee, Vladimir Ponomarev
Recent advances in T cell-based immunotherapies from bench to bedside have highlighted the need for improved diagnostic imaging of T cell trafficking in vivo and the means to noninvasively investigate failures in treatment response. T cells expressing tumor-associated T cell receptors (TCRs) or engineered with chimeric antigen receptors (CARs) face multiple challenges, including possible influence of genetic engineering on T cell efficacy, inhibitory effects of the tumor microenvironment, tumor checkpoint proteins and on-target, off-tissue toxicities (Kershaw et al...
2018: Methods in Molecular Biology
Caroline Phillips, Clare Harris, Nathaniel Broughton, Thomas Pulimood, Liam Ring
We present the case of a 68-year-old gentleman who presented with breathlessness and was found to have NSTEMI, pulmonary oedema, and hypoxia. He remained hypoxic despite appropriate treatment and was found to have preserved LV function and raised cardiac output. CT pulmonary angiogram was negative but a cirrhotic liver was incidentally noted and later confirmed via ultrasound. Bedside examination was positive for orthodeoxia, suggesting a diagnosis of hepatopulmonary syndrome (HPS). The finding of significant intrapulmonary shunting on "bubble" echocardiography confirmed the diagnosis...
2018: Case Reports in Critical Care
Vigil James, Jade Seguin, Charisse W Kwan
Irreducible umbilical swelling in infants is considered a surgical emergency because a delay in surgical intervention for an incarcerated umbilical hernia can lead to bowel ischemia and necrosis. We report two patients who presented to a pediatric emergency department with history and symptoms of irreducible umbilical mass suggestive of umbilical hernia. Point-of-care ultrasound was used at the bedside to demonstrate the presence of urachal cyst remnants and accurately guided the care of these children.
November 2017: Clinical practice and cases in emergency medicine
Koichiro Shinozaki, Michael J Capilupi, Kota Saeki, Hideaki Hirahara, Katsuyuki Horie, Naoki Kobayashi, Steve Weisner, Junhwan Kim, Joshua W Lampe, Lance B Becker
Capillary refill time has been accepted as a method to manually assess a patient's peripheral blood perfusion. Recently, temperature has been reported to affect capillary refill time and therefore temperature may interfere with accurate bedside peripheral blood perfusion evaluation. We applied a new method of analysis that uses standard hospital pulse oximetry equipment and measured blood refill time in order to test whether lowered fingertip temperature alters peripheral blood perfusion. Thirty adult healthy volunteers of differing races (skin colors) and age (young: 18-49 years and old: ≥ 50 years) groups were recruited...
May 30, 2018: Journal of Clinical Monitoring and Computing
José Augusto Santos Pellegrini, Ricardo Luiz Cordioli, Ana Cristina Burigo Grumann, Patrícia Klarmann Ziegelmann, Leandro Utino Taniguchi
BACKGROUND: Point-of-care ultrasonography (POCUS) has recently become a useful tool that intensivists are incorporating into clinical practice. However, the incorporation of ultrasonography in critical care in developing countries is not straightforward. METHODS: Our objective was to investigate current practice and education regarding POCUS among Brazilian intensivists. A national survey was administered to Brazilian intensivists using an electronic questionnaire...
April 20, 2018: Annals of Intensive Care
Heather A Heaton, Rona Wang, Kyle J Farrell, Octavia S Ruelas, Deepi G Goyal, Christine M Lohse, Annie T Sadosty, David M Nestler
BACKGROUND: Scribes are unlicensed professionals trained in medical data entry. Limited data exist on the impact of scribes on provider time management in the emergency department (ED). Time-motion analysis is a tool utilized in business to capture detailed movements and durations to task completion. It offers a means to categorize how providers allocate their time during a clinical shift. OBJECTIVE: Evaluate the impact of scribes on how ED providers spend their time...
May 25, 2018: Journal of Emergency Medicine
Abhishek A Mangaonkar, Mrinal M Patnaik
Short telomere syndromes (STSs) are accelerated aging syndromes often caused by inheritable gene mutations resulting in decreased telomere lengths. Consequently, organ systems with increased cell turnover, such as the skin, bone marrow, lungs, and gastrointestinal tract, are commonly affected. Owing to diverse clinical presentations, STSs pose a diagnostic challenge, with bone marrow failure and idiopathic pulmonary fibrosis being frequent manifestations, occurring in association with gene mutations involving DKC1 (for expansion of gene symbols, use search tool at www...
May 24, 2018: Mayo Clinic Proceedings
Bianca LoVerde, Alison Falck, Pamela Donohue, Brenda Hussey-Gardener
BACKGROUND: Mother's own milk (MOM) provides significant health benefits to very low birth-weight infants (VLBW, ≤1500 g). However, 60% of African American (AA) women initiate lactation, and less than 35% provide MOM 6 months following the birth of their infant. Previous research focuses on term infants and is not specific to AA mothers of VLBW infants. PURPOSE: To qualitatively describe supports and barriers experienced by AA mothers while providing MOM for their VLBW infants...
June 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Emma L Munro, Donna F Hickling, Damian M Williams, Jack J Bell
Skin tears cause pain, increased length of stay, increased costs, and reduced quality of life. Minimal research reports the association between skin tears, and malnutrition using robust measures of nutritional status. This study aimed to articulate the association between malnutrition and skin tears in hospital inpatients using a yearly point prevalence of inpatients included in the Queensland Patient Safety Bedside Audit, malnutrition audits and skin tear audits conducted at a metropolitan tertiary hospital between 2010 and 2015...
May 24, 2018: International Wound Journal
Donna M Prentice, Carrie Sona, Brian T Wessman, Enyo A Ablordeppey, Warren Isakow, Cassandra Arroyo, Marilyn Schallom
Objective: Intensive care unit patients are at risk for catheter-associated urinary tract infection. Earlier removal of catheters may be possible with accurate measurement of bladder volume. The purpose was to compare measured bladder volumes with bedside ultrasound, bladder scanner, and urine volume. Design: Prospective correlational descriptive study. Setting: Surgical/trauma intensive care unit and medical intensive care unit. Patients: Renal dialysis patients with less than 100 ml of urine in 24 h prior to urinary catheter removal and patients with suspected catheter obstruction...
May 2018: Journal of the Intensive Care Society
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