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https://www.readbyqxmd.com/read/29315046/supraglottic-airway-devices-current-and-future-uses
#1
Lloyd E Kwanten, Pradeep Madhivathanan
Supraglottic airway devices have increasingly been used in anaesthesia since their invention in 1982. Now over half of general anaesthetic cases in the UK use them, and they have vital roles in difficult airway algorithms, pre-hospital use and emergency medicine. This article presents the current evidence regarding the complications of these devices, and compares these devices and endotracheal intubation. The technology of the newer generation devices has improved the safety profile, and they may be considered a better choice than endotracheal tubes in some cases...
January 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29248878/systematic-review-and-meta-analysis-of-the-effectiveness-of-pharmacist-led-medication-reconciliation-in-the-community-after-hospital-discharge
#2
Duncan McNab, Paul Bowie, Alastair Ross, Gordon MacWalter, Martin Ryan, Jill Morrison
BACKGROUND: Pharmacists' completion of medication reconciliation in the community after hospital discharge is intended to reduce harm due to prescribed or omitted medication and increase healthcare efficiency, but the effectiveness of this approach is not clear. We systematically review the literature to evaluate intervention effectiveness in terms of discrepancy identification and resolution, clinical relevance of resolved discrepancies and healthcare utilisation, including readmission rates, emergency department attendance and primary care workload...
December 16, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29241835/the-impact-of-a-statewide-mandatory-prescription-drug-monitoring-program-on-opioid-prescribing-by-emergency-medicine-providers-across-15-hospitals-in-a-single-health-system
#3
Brian Suffoletto, Michael Lynch, Charissa B Pacella, Donald M Yealy, Clifton W Callaway
Prescription drug monitoring programs (PDMP) enable registered prescribers to obtain real-time information on patients' prescription history of controlled medications. We sought to describe the impact of a state-mandated PDMP on opioid prescribing by Emergency Medicine providers. We retrospectively analyzed electronic medical records of 122,732 adult patients discharged with an opioid prescription from 15 Emergency Departments in a single health system in Pennsylvania from July 2015 to March, 2017. We used an interrupted time-series design to evaluate the percentage of patients discharged each month with an opioid prescription before and after state law mandated PDMP use on August 25th, 2016...
December 11, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29226039/an-inner-city-emergency-medicine-rotation-does-not-improve-attitudes-toward-the-homeless-among-junior-medical-learners
#4
Aaron Sibley, Kathryn A Dong, Brian H Rowe
Introduction Learners in the emergency department (ED) frequently encounter individuals who are homeless. We sought to evaluate the effect of an inner city emergency medicine rotation at the Royal Alexandra Hospital (RAH) on the attitudes of medical students and residents towards this population. Methods Data were collected both pre- and post-rotation using an electronic survey. Data collected included demographic information and as well as scores on the Health Professionals' Attitudes Towards the Homeless Inventory (HPATHI)...
October 5, 2017: Curēus
https://www.readbyqxmd.com/read/29211225/off-pump-versus-on-pump-coronary-artery-bypass-grafting-in-frail-patients-study-protocol-for-the-fragile-multicenter-randomized-controlled-trial
#5
Omar Asdrúbal Vilca Mejía, Michel Pompeu Barros Oliveira Sá, Maurilio Onofre Deininger, Luís Roberto Palma Dallan, Rodrigo Coelho Segalote, Marco Antonio Praça de Oliveira, Fernando Antibas Atik, Magaly Arrais Dos Santos, Pedro Gabriel Melo de Barros E Silva, Rodrigo Mussi Milani, Alexandre Ciappina Hueb, Rosangela Monteiro, Ricardo Carvalho Lima, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, John Puskas, Fabio Biscegli Jatene
INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29190706/elderly-emergency-patients-presenting-with-non-specific-complaints-characteristics-and-outcomes
#6
Joyce J H Wachelder, Patricia M Stassen, Laura P A M Hubens, Steffie H A Brouns, Suze L E Lambooij, Jeanne P Dieleman, Harm R Haak
BACKGROUND: Non-specific complaints (NSC) are common at the emergency department, but only a few studies have shown evidence that these complaints are associated with a poor prognosis in elderly emergency patients. OBJECTIVE: To describe patient characteristics and outcomes in a cohort of elderly emergency patients presenting with NSC. Outcomes were: patient characteristics, hospitalization, 90-day ED-return visits, and 30-day mortality. METHOD: A retrospective cohort study was conducted amongst elderly patients present to the Internal Medicine Emergency Department (ED) between 01-09-2010 and 31-08-2011...
2017: PloS One
https://www.readbyqxmd.com/read/29179271/-relationship-between-the-risk-of-emergency-cesarean-section-for-nullipara-with-the-prepregnancy-body-mass-index-or-gestational-weight-gain
#7
R F Zhao, W Y Zhang, L Zhou
Objective: To investigate the risk of emergency cesarean section during labor with the pre-pregnancy body mass index or gestational weight gain. Methods: A total of 6 908 healthy nullipara with singleton pregnancy and cephalic presentation who was in term labor in Beijing Obstetrics and Gynecology Hospital from August 1(st), 2014 to September 30(th), 2015 were recruited. They were divided into two groups, the vaginal delivery group (92.88%, 6 416/6 908) and the emergency cesarean section group (7.12%, 492/6 908)...
November 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29162440/automated-external-defibrillators-in-the-hospital-a-case-of-medical-reversal
#8
John A Stewart
Automated external defibrillators (AEDs) emerged in the 1980s as an important innovation in pre-hospital emergency cardiac care (ECC). In the years since, the American Heart Association (AHA) and the International Liaison Committee for Resuscitation (ILCOR) have promoted AED technology for use in hospitals as well, resulting in the widespread purchase and use of AED-capable defibrillators. In-hospital use of AEDs now appears to have decreased survival from cardiac arrests. This article will look at the use of AEDs in hospitals as a case of "medical reversal...
November 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29159555/use-of-a-hands-free-instantaneous-closed-loop-communication-device-improves-perception-of-communication-and-workflow-integration-in-an-academic-teaching-hospital-a-pilot-study
#9
Daniel Z Fang, Teja Patil, Ilana Belitskaya-Levy, Marianne Yeung, Keith Posley, Nazima Allaudeen
Efficient and effective communication between providers is critical to quality patient care within a hospital system. Hands free communication devices (HFCD) allow instantaneous, closed-loop communication between physicians and other members of a multidisciplinary team, providing a communication advantage over traditional pager systems. HFCD have been shown to decrease emergency room interruptions, improve nursing communication, improve speed of information flow, and eliminate health care waste. We evaluated the integration of an HFCD with an existing alphanumeric paging system on an acute inpatient medicine service...
November 17, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29115370/-febrile-syndromes-in-the-traveler-returning-from-tropical-regions-admitted-in-a-monographic-unit
#10
N Moya Notario, M Hernández-Cabrera, C Carranza-Rodríguez, E Pisos-Álamo, N Jaén-Sánchez, J L Pérez-Arellano
OBJECTIVE: The aim was to analyse those syndromes with fever in travellers who return from tropical regions evaluated at our Department of Infectology and Tropical Medicine. Clarifying these conditions intends to reach earlier diagnoses and, perhaps, to avoid the emergence and spread of imported diseases, as well as to establish appropriate preventive measures. METHODS: An observational descriptive transversal study was performed, selecting those patients who returned from tropical regions with fever, amongst all travellers evaluated in our department between 1998 and 2013...
November 8, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29113010/comparison-of-four-methods-of-endotracheal-tube-passage-in-simulated-airways-there-is-room-for-improved-techniques
#11
Kirsten Kingma, Ross Hofmeyr, Irene Suilan Zeng, Christin Coomarasamy, Andrew Brainard
OBJECTIVE: Endotracheal intubation requires laryngoscopy followed by passage of the endotracheal tube (ETT). Tube passage can be difficult, but there is little evidence to support which adjunct for tube passage is most effective. METHODS: The four tube passage adjuncts tested were the naked ETT, stylet ETT, railroaded bougie and preloaded bougie. Participants completed pre- and post-test surveys identifying demographics, experience and method preference. After instruction, participants completed eight intubations on manikins with 'easy' and 'difficult' airways...
November 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29105736/stroke-identification-by-criteria-based-dispatch-a-register-based-study
#12
E N Ellensen, H Naess, T Wisborg, S Hunskaar, E Zakariassen
BACKGROUND: Rapid and precise dispatch of resources is a key element in pre-hospital emergency medicine. Emergency medical communication centres (EMCCs) dispatch resources based on protocols and guidelines, balancing the acute need of the individual and the resource allocation of the pre-hospital emergency medical system. The aim of this study was to determine the validity of stroke identification by the Norwegian dispatch guidelines. METHOD AND MATERIAL: This was a register-based study where patients suspected for stroke were compared to those with the final diagnosis of stroke as an indicator group for the guideline validation...
January 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29074070/comparison-of-intubation-devices-in-level-c-personal-protective-equipment-a-cadaveric-study
#13
R Scott Taylor, Matthew Pitzer, Grayson Goldman, Augusta Czysz, Thomas Simunich, John Ashurst
BACKGROUND: With the advancement of chemical, biological and nuclear warfare and the reemergence of infectious diseases, the possibility of intubating in personal protective equipment has become increasingly more real to the emergency physician. Human cadaveric models have been found to simulate real world conditions better than mannequins. The aim of the study was to determine the first pass success rate and average time to successful intubation while wearing Personal Protective Equipment (PPE)...
October 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29070085/the-south-dakota-model-health-care-professions-student-disaster-preparedness-and-deployment-training
#14
Matt P Owens, Cheri Buffington, Michael P Frost, Randall J Waldner
OBJECTIVE: The Association of American Medical Colleges recommended an increase in medical education for public health emergencies, bioterrorism, and weapons of mass destruction in 2003. The University of South Dakota Sanford School of Medicine (USD SSOM) implemented a 1-day training event to provide disaster preparedness training and deployment organization for health professions students called Disaster Training Day (DTD). METHODS: Hospital staff and emergency medical services personnel provided the lecture portion of DTD using Core Disaster Life Support (CDLS; National Disaster Life Support Foundation) as the framework...
October 26, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28941075/patient-perspectives-on-priorities-for-emergency-medicine-research-the-perspex-study
#15
Stuart Vb McLay, David McCutcheon, Glenn Arendts, Stephen Pj Macdonald, Daniel M Fatovich
OBJECTIVES: To determine the priorities for emergency medicine research of patients currently in an ED and to compare their priorities with those of ACEM researchers. METHODS: A survey of current patients in the EDs of Royal Perth Hospital and Armadale Health Service. Patients gave their reason for presentation, suggested three important research priorities for emergency medicine and ranked their top 5 choices from a pre-specified list published by the ACEM researchers...
September 21, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28932302/predictive-value-of-tracheal-rapid-ultrasound-exam-performed-in-the-emergency-department-for-verification-of-tracheal-intubation
#16
Babak Masoumi, Reza Azizkhani, Gilava Hedayati Emam, Morteza Asgarzadeh, Behrouz Zargar Kharazi
BACKGROUND: Verification of the correct placement of the endotracheal tube (ETT) has been one of the most challenging issues of airway management in the field of emergency medicine. Early detection of oesophagal intubation through a reliable method is important for emergency physicians. AIM: The aim of this study was to assess the diagnostic accuracy of tracheal rapid ultrasound exam (TRUE) to assess endotracheal tube misplacement during emergency intubation. METHODS: This was an observational prospective study performed in the emergency department of the major tertiary referral hospital in the city...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28922339/incidence-and-risk-factors-of-anaesthesia-related-perioperative-cardiac-arrest-a-6-year-observational-study-from-a-tertiary-care-university-hospital
#17
Andreas Hohn, Jan-Nicolas Machatschek, Jeremy Franklin, Stephan A Padosch
BACKGROUND: In recent decades, the incidences of anaesthesia-related perioperative mortality and adverse outcomes have decreased drastically. However, to date, data on perioperative cardiac arrest and risk factors of perioperative cardiac arrest from European countries are scarce. OBJECTIVES: To determine the incidences of perioperative cardiac arrest and rates of anaesthesia-related and anaesthesia-contributory cardiac arrest. Identification of pre-existing risk factors leading to perioperative cardiac arrest...
September 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28919404/emergency-in-the-clinic-a-simulation-curriculum-to-improve-outpatient-safety
#18
Eve Espey, Gillian Baty, John Rask, Michelle Chungtuyco, Brenda Pereda, Lawrence Leeman
BACKGROUND: Emergency response skills are essential when events such as seizure, anaphylaxis, or hemorrhage occur in the outpatient setting. Because services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. OBJECTIVE: The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy...
September 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28886784/development-of-a-new-infusion-protocol-for-austere-trauma-resuscitations
#19
Stewart A Stancil
Intravenous fluid therapy for hemorrhagic shock has undergone enormous changes since it was first conducted almost 200 years ago. In the past 40 years especially, practices have dramatically changed with regards to fluid resuscitation. In pre-hospital, combat, austere, and rural emergency medicine the stakes are especially high to deliver an effective and logical resuscitation fluid strategy to a patient that is suffering from hemorrhagic shock. This article follows a prior article published in July 2014. It highlights the development of new cutting edge intravenous therapy regimens that maximize hemodynamic outcomes that can be effected by those providers that care for injured patients without the benefit of ample resources...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28874007/new-horizons-in-comprehensive-geriatric-assessment
#20
S G Parker, A McLeod, P McCue, K Phelps, M Bardsley, H C Roberts, S P Conroy
In this article, we discuss the emergence of new models for delivery of comprehensive geriatric assessment (CGA) in the acute hospital setting. CGA is the core technology of Geriatric Medicine and for hospital inpatients it improves key outcomes such as survival, time spent at home and institutionalisation. Traditionally It is delivered by specialised multidisciplinary teams, often in dedicated wards, but in recent years has begun to be taken up and developed quite early in the admission process (at the 'front door'), across traditional ward boundaries and in specialty settings such as surgical and pre-operative care, and oncology...
September 1, 2017: Age and Ageing
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