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https://www.readbyqxmd.com/read/29220603/evaluating-dispatch-assisted-cpr-using-the-cares-registry
#1
Manali Shah, Cherie Bartram, Kevin Irwin, Kimberly Vellano, Bryan McNally, Timothy Gallagher, Robert Swor
OBJECTIVES: Dispatch-assisted cardiopulmonary resuscitation (DA-CPR) has been shown to improve cardiac arrest survival. Recent literature has proposed dispatch metrics for provision of this intervention. Our objectives are to: use the Cardiac Arrest Registry to Enhance Survival (CARES) to compare current practice to proposed DA-CPR guidelines; describe barriers to DA-CPR; and assess the association of DA-CPR with out-of-hospital cardiac arrest (OHCA) survival. METHODS: We reviewed data from structured dispatch reviews of 911 OHCA calls from 1/1/14-12/31/15...
December 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29206786/same-day-discharge-compared-with-inpatient-hospitalization-following-hip-and-knee-arthroplasty
#2
COMPARATIVE STUDY
Bryce A Basques, Matthew W Tetreault, Craig J Della Valle
BACKGROUND: Discharge from the hospital on the day of (same-day) hip and knee arthroplasties has become more common; however, to our knowledge, few studies have compared morbidity between same-day and inpatient surgical procedures. The aims of this study were to compare matched cohorts of patients who underwent same-day and inpatient hip or knee arthroplasty in terms of postoperative complications and 30-day readmission rates. METHODS: Patients who underwent primary elective total hip arthroplasty, total knee arthroplasty, or unicompartmental knee arthroplasty from 2005 to 2014 were identified from the National Surgical Quality Improvement Program registry...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29200678/radiofrequency-ablation-of-osteoid-osteoma-in-common-and-technically-challenging-locations-in-pediatric-population
#3
Shaileshkumar Garge, Shyamkumar Nidugala Keshava, Vinu Moses, George Koshy, Munawwar Ahmed, Suraj Mammen, Vrisha Madhuri
Context: Percutaneous radiofrequency ablation (RFA) of osteoid osteoma has a high technical and clinical success rate. However, there is limited data on its use in the pediatric population, especially in technically challenging locations. Objective: The objective of this study was to assess the safety and efficacy of CT-guided percutaneous RFA of osteoid osteoma in pediatric population. Subjects and Methods: From June 2009 to May 2014, thirty patients with osteoid osteoma were treated with CT-guided RFA in common (25 cases) and technically challenging (five cases: four near articular surface and one in sacrum) locations...
July 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29189367/oxycodone-ingestion-patterns-in-acute-fracture-pain-with-digital-pills
#4
Peter R Chai, Stephanie Carreiro, Brendan J Innes, Brittany Chapman, Kristin L Schreiber, Robert R Edwards, Adam W Carrico, Edward W Boyer
BACKGROUND: Opioid analgesics are commonly prescribed on an as-needed (PRN) basis for acute painful conditions. Uncertainty of how patients actually take PRN opioids, coupled with a desire to completely cover pain, leads to variable and overly generous opioid prescribing practices, resulting in a surplus of opioids. This opioid surplus becomes a source for diversion and nonmedical opioid use. Understanding patterns of actual opioid ingestion after acute painful conditions can help clinicians counsel patients on safe opioid use, and allow timely recognition and intervention when escalating opioid self-dosing occurs, to prevent tolerance and addiction...
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29179369/monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#5
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
September 15, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/29170321/24%C3%A2-an-audit-into-the-number-of-patients-suffering-out-of-hospital-cardiac-arrest-that-are-resuscitated-despite-a-high-likelihood-of-futility
#6
Mia Cokljat, Gareth Clegg, Scott Clarke
BACKGROUND: For a significant number of patients suffering out-of-hospital cardiac arrest (OHCA) cardiopulmonary resuscitation (CPR) is likely to be futile and attempting it may be the wrong thing to do. Anticipatory care plans with do-not-attempt cardiopulmonary resuscitation (DNACPR) instructions exist to prevent this. Anecdotally we felt that many patients present to our Emergency Department (ED) with ongoing resuscitation which was not in their best interests. The aim of this study was to establish the proportion of patients arriving in our ED with ongoing CPR who had low, intermediate or high risk of futility...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29135664/pain-relief-after-operative-treatment-of-an-extremity-fracture-a-noninferiority-randomized-controlled-trial
#7
RANDOMIZED CONTROLLED TRIAL
Gijs T T Helmerhorst, Ruben Zwiers, David Ring, Peter Kloen
BACKGROUND: Opioid pain medication is frequently given to patients recovering from a surgical procedure for an extremity fracture in spite of evidence that acetaminophen may be adequate. The aim of this study was to determine whether prescription of step 1 pain medication (acetaminophen) is noninferior to step 2 pain medication (acetaminophen and tramadol) after operative treatment of an extremity fracture. METHODS: Fifty-two patients with a single extremity fracture were randomized from July 2012 to March 2015 in this 2-week follow-up, noninferiority trial in a level-I trauma center in the Netherlands...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29132255/selected-radiation-safety-aspects-including-transportation-and-lodging-after-outpatient-sup-131-sup-i-therapy-for-differentiated-thyroid-cancer
#8
Cristiane Jeyce Gomes-Lima, Di Wu, Pejman H Kharazi, Gauri Khorjekar, Matthew D Ringel, Richard J Vetter, Gary Bloom, Kenneth D Burman, Leonard Wartofsky, Douglas Van Nostrand
BACKGROUND: Whether <sup>131</sup>I treatments for differentiated thyroid cancer (DTC) should be performed as an outpatient or inpatient remains controversial. The objective of this study was to survey selected aspects of radiation safety of patients treated with <sup>131</sup>I for DTC as an outpatient. METHODS: An e-mail invitation was sent to over 15,000 members of ThyCa: Thyroid Cancer Survivors' Association, Inc. to complete a web-based survey on selected aspects of radiation safety regarding their last outpatient <sup>131</sup>I treatment...
November 13, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29117293/patient-satisfaction-with-an-early-smartphone-based-cosmetic-surgery-postoperative-follow-up
#9
Edoardo Dalla Pozza, Gehaan F D'Souza, Anthony DeLeonibus, Brianna Fabiani, Bahar Bassiri Gharb, James E Zins
Background: While prevalent in everyday life, smartphones are also finding increasing use as a medical care adjunct. The use of smartphone technology as a postoperative cosmetic surgery adjunct for care has received little attention in the literature. Objectives: The purpose of this effort was to assess the potential efficacy of a smartphone-based cosmetic surgery early postoperative follow-up program. Specifically, could smartphone photography provided by the patient to the plastic surgeon in the first few days after surgery allay patient's concerns, improve the postoperative experience and, possibly, detect early complications? Methods: From August 2015 to March 2016 a smartphone-based postoperative protocol was established for patients undergoing cosmetic procedures...
June 1, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29114106/designing-and-implementation-of-a-heart-failure-telemonitoring-system
#10
Reza Safdari, Maryam Jafarpour, Mehrshad Mokhtaran, Nasim Naderi
Introduction: The aim of this study was to identify patients at-risk, enhancing self-care management of HF patients at home and reduce the disease exacerbations and readmissions. Method: In this research according to standard heart failure guidelines and Semi-structured interviews with 10 heart failure Specialists, a draft heart failure rule set for alerts and patient instructions was developed. Eventually, the clinical champion of the project vetted the rule set...
September 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/29114003/pediatric-patient-centered-transitions-from-hospital-to-home-improving-the-discharge-medication-process
#11
Leah A Mallory, Noah P Diminick, Jonathan P Bourque, Meredith R Bryden, Jessica L Miller, Nancy M Nystrom, Melanie R Lord, Lorraine L McElwain
OBJECTIVES: Medications prescribed at hospital discharge can lead to patient harm if there are access barriers or misunderstanding of instructions. Filling prescriptions before discharge can decrease these risks. We aimed to increase the percentage of patients leaving the hospital with new discharge medications in hand to 70% by 18 months. METHODS: We used sequential plan-do-study-act cycles from January 2015 to September 2016. We used statistical process control charts to track process measures, new medications filled before discharge, and rates of bedside delivery with pharmacist teaching to the inpatient pediatric unit...
November 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29112107/a-scoping-review-of-emergency-department-discharge-instructions-for-children-and-adolescents-with-mental-disorders
#12
Andrea L Murphy, Janet Curran, Amanda S Newton, Debbie Emberly, Cecilia McRae, Shannon MacPhee
BACKGROUND: Although most young people under the age of 25 years with mental health presentations to the emergency department (ED) are discharged home, several studies suggest discharge instructions are inadequate. We conducted a scoping review to characterize and map the literature, identify research gaps, and prioritize targeted areas for future reviews for ED discharge instructions for young people with mental disorders. METHODS: Our review was conducted in an iterative approach with 6 stages including identifying the research question, identifying relevant studies, study selection, data extraction, collaring and summarizing, and stakeholder engagement...
July 3, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29110557/post-discharge-issues-identified-by-a-call-back-program-identifying-improvement-opportunities
#13
Patty Ines Ojeda, Areeba Kara
OBJECTIVES: The period following discharge from the hospital is one of heightened vulnerability. Discharge instructions serve as a guide during this transition. Yet, clinicians receive little feedback on the quality of this document that ties into the patients' experience. We reviewed the issues voiced by discharged patients via a call-back program and compared them to the discharge instructions they had received. METHODS: At our institution, patients receive an automated call forty-eight hours following discharge inquiring about progress...
November 7, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29106868/the-use-of-ct-scan-in-foreign-body-aspiration-in-children-a-6-years-experience
#14
Vincent Pitiot, Margaux Grall, Dominique Ploin, Eric Truy, Sonia Ayari Khalfallah
INTRODUCTION: A foreign body aspiration is a risky situation, common in pediatric emergency. The "gold standard" to rule out a foreign body or proceed to its extraction, is rigid bronchoscopy (RB) under general anesthesia. However, RB is an intrusive exam with possible complications. Depending on authors, RB in emergency is a procedure at risk of complications in 4-17% of cases. Advances in radiology allow CT-scanners of fast acquisition and high definition, which could be used as an alternative to RB...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29081584/evaluation-of-a-welfare-assessment-tool-to-examine-practices-for-preventing-recognizing-and-managing-pain-at-companion-animal-veterinary-clinics
#15
Lauren C Dawson, Cate E Dewey, Elizabeth A Stone, Cornelia I Mosley, Michele T Guerin, Lee Niel
Successful prevention, recognition, and treatment of pain are integral to ensuring veterinary patient welfare. A canine and feline welfare assessment tool, incorporating verbal interviews with veterinarians using open-ended questions, was developed to assess pain management practices that safeguard and improve patient welfare. The tool was evaluated in 30 companion- and mixed-animal veterinary clinics in Ontario in order to assess its reliability, feasibility, and validity, while also benchmarking current practices...
October 2017: Canadian Journal of Veterinary Research, Revue Canadienne de Recherche Vétérinaire
https://www.readbyqxmd.com/read/29075986/a-practical-method-for-prevention-of-readmission-for-symptomatic-hyponatremia-following-transsphenoidal-surgery
#16
William T Burke, David J Cote, Sherry I Iuliano, Hasan A Zaidi, Edward R Laws
INTRODUCTION: Patients undergoing transsphenoidal pituitary surgery (TSS) are at risk for several serious complications, including the syndrome of inappropriate antidiuretic hormone and subsequent hyponatremia. OBJECTIVE: In this study, we examined the effect of 1 week of post-discharge fluid restriction to 1.0 L daily on rates of post-operative readmission for hyponatremia. METHODS: We retrospectively analyzed all patients undergoing TSS from 2008 to 2014 and prospectively recorded patient data from 2015 to 2017...
October 26, 2017: Pituitary
https://www.readbyqxmd.com/read/29056437/texting-to-increase-contraceptive-initiation-among-adolescents-in-the-emergency-department
#17
Lauren S Chernick, Melissa S Stockwell, Mengfei Wu, Paula M Castaño, Rebecca Schnall, Carolyn L Westhoff, John Santelli, Peter S Dayan
PURPOSE: To evaluate the feasibility and acceptability of a text messaging intervention to increase contraception among adolescent emergency department patients. METHODS: A pilot randomized controlled trial of sexually active females aged 14-19 receiving 3 months of theory-based, unidirectional educational and motivational texts providing reproductive health information versus standardized discharge instructions. Blinded assessors measured contraception initiation via telephone follow-up and health record review at 3 months...
October 19, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29050058/-ambulant-anesthesia-limits-and-possibilities
#18
Harald Hofer, Frank Vescia
The number of operations carried out on an outpatient basis is increasing in Germany. This trend has been observed for years. The prerequisite is an infrastructure that is in line with guidelines. The competence of the anesthetist must not be restricted to that of a standard specialist anesthetist, but the physician should have experience in ambulatory anesthesia. Well-adjusted comorbidities of the patient are generally not a contraindication for an outpatient procedure. The heavily overweight patient can also be operated on an outpatient basis if he is compliant, comorbidities are well adjusted and intensive postoperative care is ensured...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29039377/a-case-study-of-the-technology-use-and-information-flow-at-a-hospital-driven-telemedicine-service
#19
Berglind Smaradottir, Rune Fensli
Health care services face the challenge of providing individualised treatment to a growing ageing population prone to chronic conditions and multi-morbidities. The research project Patients and Professionals in Productive Teams aims to study health care services that are run with a patient-centred teamwork approach. In this context, a case study was made of a hospital-driven telemedicine service for chronic obstructive pulmonary disease patients after hospital discharge, with a focus on information flow and technology use...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29026957/autologous-buccal-micro-mucosa-free-graft-combined-with-posterior-scrotal-flap-transfer-for-vaginoplasty-in-male-to-female-transsexuals-a-pilot-study
#20
Shu-Yi Wei, Feng-Yong Li, Qiang Li, Sen-Kai Li, Chuan-De Zhou, Yu Zhou, Yu-Jiao Cao, Si-Ya Zhang, Yang Zhao
BACKGROUND: The inverted peno-scrotal flap method is considered the standard method of vaginoplasty in male-to-female genital reassignment surgery. Though with numerous advantages, the method has its limitations regarding skin texture, lack of inherent lubrication, and that the tissues for creating the labia depend on the amount of tissues remaining after vaginoplasty. Our purpose was to describe the procedure and outcome of vaginoplasty applying a new technique: autologous buccal micro-mucosa free graft combined with posterior scrotal flap transfer, which could solve some of the problems the previous methods had...
October 12, 2017: Aesthetic Plastic Surgery
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