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https://www.readbyqxmd.com/read/29146420/extracorporeal-membrane-oxygenation-used-successfully-in-a-near-fatal-case-of-opioid-induced-acute-respiratory-distress-syndrome
#1
Karen Greenberg, Benjamin Kohl
Acute Respiratory Distress Syndrome (ARDS) was first recognized during the 1960s. It is a distinct type of hypoxemic respiratory failure characterized by acute abnormality of both lungs. Extracorporeal membrane oxygenation (ECMO) is being increasingly used for patients with severe ARDS refractory to otherwise conventional management. A 29year old male arrived with Emergency Medical Services (EMS) status post presumed heroin overdose. He was administered Naloxone 2mg intravenously prior to arrival in the emergency department...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29136272/are-you-ready-crisis-leadership-in-a-hyper-vuca-environment
#2
Khaldoon H Alkhaldi, Meredith L Austin, Boris A Cura, Darrell Dantzler, Leslie Holland, David L Maples, Jamie C Quarrelles, Robert K Weinkle, Leonard J Marcus
The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes...
April 2017: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/29122001/development-of-a-peer-supported-self-management-intervention-for-people-following-mental-health-crisis
#3
Alyssa Milton, Brynmor Lloyd-Evans, Kate Fullarton, Nicola Morant, Bethan Paterson, David Hindle, Kathleen Kelly, Oliver Mason, Marissa Lambert, Sonia Johnson
BACKGROUND: A documented gap in support exists for service users following discharge from acute mental health services, and structured interventions to reduce relapse are rarely provided. Peer-facilitated self-management interventions have potential to meet this need, but evidence for their effectiveness is limited. This paper describes the development of a peer-provided self-management intervention for mental health service users following discharge from crisis resolution teams (CRTs)...
November 9, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29121299/gender-power-and-leadership-the-effect-of-a-superior-s-gender-on-respiratory-therapists-ability-to-challenge-leadership-during-a-life-threatening-emergency
#4
N Pattni, M D Bould, M A Hayter, D McLuckie, L M K Noble, A Malavade, Z Friedman
Background: Effective communication within teams is crucial, especially in crisis situations. Hierarchy gradients between team members can contribute to communication failures and are influenced by many factors. The effect of gender on team performance has not been well studied. The objective of this study was to examine the effect of the physician's gender on respiratory therapists' ability to effectively challenge clearly incorrect clinical decisions during a life-threatening crisis...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29119085/pediatric-care-during-a-short-term-medical-mission-to-a-syrian-refugee-camp-in-northern-jordan
#5
Kenneth L Abbott, Catherine A Woods, Dahlia A Halim, Henna A Qureshi
Introduction: The Syrian refugee crisis, now in its 6(th) year, has displaced millions. Refugees depend on support from host nation governments and humanitarian organizations like the Syrian American Medical Society (SAMS). We describe the delivery of pediatric care during a SAMS short-term medical mission to a refugee camp in Northern Jordan. Methods: The medical mission team encompassed dozens of specialties. Teams visited many sites, including the Zaatari refugee camp near the Syrian border...
October 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/29106923/impact-of-objective-echocardiographic-criteria-for-timing-of-congenital-diaphragmatic-hernia-repair
#6
Scott Deeney, Lisa W Howley, Maggie Hodges, Kenneth W Liechty, Ahmed I Marwan, Jason Gien, John P Kinsella, Timothy M Crombleholme
OBJECTIVE: To assess the impact of specific echocardiographic criteria for timing of congenital diaphragmatic hernia repair on the incidence of acute postoperative clinical decompensation from pulmonary hypertensive crisis and/or acute respiratory decompensation, with secondary outcomes including survival to discharge, duration of ventilator support, and length of hospitalization. STUDY DESIGN: The multidisciplinary congenital diaphragmatic hernia management team instituted a protocol in 2012 requiring the specific criterion of echocardiogram-estimated pulmonary artery pressure ≤80% systemic blood pressure before repairing congenital diaphragmatic hernias...
October 26, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29079602/randomised-controlled-trial-of-the-clinical-and-cost-effectiveness-of-a-peer-delivered-self-management-intervention-to-prevent-relapse-in-crisis-resolution-team-users-study-protocol
#7
Sonia Johnson, Oliver Mason, David Osborn, Alyssa Milton, Claire Henderson, Louise Marston, Gareth Ambler, Rachael Hunter, Stephen Pilling, Nicola Morant, Richard Gray, Tim Weaver, Fiona Nolan, Brynmor Lloyd-Evans
INTRODUCTION: Crisis resolution teams (CRTs) provide assessment and intensive home treatment in a crisis, aiming to offer an alternative for people who would otherwise require a psychiatric inpatient admission. They are available in most areas in England. Despite some evidence for their clinical and cost-effectiveness, recurrent concerns are expressed regarding discontinuity with other services and lack of focus on preventing future relapse and readmission to acute care. Currently evidence on how to prevent readmissions to acute care is limited...
October 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/29073687/-interdisciplinary-simulation-of-emergency-caesarean-section-to-improve-subjective-competence
#8
Markus Flentje, Martin Schott, Anna-Lena Woltemate, Jan-Peter Jantzen
The emergency caesaran section is a gynecological emergency situation which is potentially life-threatening for mother and child. In the management of these time-critical situations human factors as well as the competence of the crisis resource management team have been shown to be important factors for success. The concept "simulation" has not been validated as a training tool for professional competence of multidisciplinary teams in the delivery suite. The aim of this study was, to assess the competence gain by subjective evaluation of the team members after taking part in an emergency caesarian section training which is integrable into the daily clinic setting...
October 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29042760/a-scoping-review-of-crisis-teams-managing-dementia-in-older-people
#9
Amy Streater, Donna Maria Coleston-Shields, Jennifer Yates, Miriam Stanyon, Martin Orrell
BACKGROUND: Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. METHODS: For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28974071/impact-of-sleep-deprivation-on-anaesthesia-residents-non-technical-skills-a-pilot-simulation-based-prospective-randomized-trial
#10
A Neuschwander, A Job, A Younes, A Mignon, C Delgoulet, P Cabon, J Mantz, A Tesniere
Background: Sleep deprivation is common in anaesthesia residents, but its impact on performance remains uncertain. Non-technical skills (team working, situation awareness, decision making, and task management) are key components of quality of care in anaesthesia, particularly in crisis situations occurring in the operating room. The impact of sleep deprivation on non-technical skills is unknown. We tested the hypothesis that in anaesthesia residents sleep deprivation is associated with impaired non-technical skills...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28959508/autonomic-dysreflexia-in-the-peripartum-patient-a-multidisciplinary-and-interprofessional-simulation-scenario
#11
Purnima M Rao, Adam Garber, Chandrew Rajakumar, Genevieve Rousseau, George Dumitrascu, Glenn D Posner
This case is one of an eight-case multidisciplinary curriculum designed and implemented at the University of Ottawa by simulation educators with specialty training in obstetrics and gynecology (ob/gyn) and anesthesiology. Consultation with a nurse educator maintained quality and relevance of objectives for nursing participants. The curriculum was prepared to train ob/gyn and anesthesiology residents and nurses to hone crisis resource management skills and to recognize and manage rare/critical medical events in an obstetrical setting...
July 25, 2017: Curēus
https://www.readbyqxmd.com/read/28959139/a-case-study-on-building-capacity-to-improve-clinical-mentoring-and-maternal-child-health-in-rural-tanzania-the-path-to-implementation
#12
Melissa T Ojemeni, Paulomi Niles, Salum Mfaume, Ntuli A Kapologwe, Linda Deng, Renae Stafford, Marie Jose Voeten, Kokusiima Theonestina, Wendy Budin, Nok Chhun, Allison Squires
BACKGROUND: Tanzania is a low income, East African country with a severe shortage of human resources for health or health workers. This shortage threatens any gains the country is making in improving maternal health outcomes. This paper describes a partnership between Touch Foundation and NYU Rory Meyers College of Nursing - Global, aimed at improving clinical mentorship and capacity among nurses and midwives at two rural hospitals in the Tanzanian Lake Zone Region. Clinical mentoring capacity building and supportive supervision of staff has been shown to be a facilitator of retaining nurses and would be possible to acquire and implement quickly, even in a context of low resources and limited technology...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28949838/the-interactions-of-canadian-ethics-consultants-with-health-care-managers-and-governing-boards-during-times-of-crisis
#13
Chris Kaposy, Victor Maddalena, Fern Brunger, Daryl Pullman, Richard Singleton
BACKGROUND: Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations...
April 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/28943140/hospital-to-home-a-quality-improvement-initiative-to-implement-high-fidelity-simulation-training-for-caregivers-of-children-requiring-long-term-mechanical-ventilation
#14
Jodi Thrasher, Joyce Baker, Kathleen M Ventre, Sara E Martin, Jessica Dawson, Roberta Cox, Heather M Moore, Sarah Brethouwer, Sharon Sables-Baus, Christopher D Baker
BACKGROUND: Preparing families of children requiring long-term mechanical ventilation (LTMV) to manage medical emergencies at home is challenging. Opportunities for family caregivers to rehearse crisis management in a controlled setting before discharge are limited. OBJECTIVE: We aimed to create a multimodal discharge preparedness curriculum, incorporating high-fidelity simulation training, to prepare family caregivers of children with complex medical conditions requiring long-term mechanical ventilation...
September 21, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28915950/improving-team-performance-through-simulation-based-learning
#15
REVIEW
Mark S Volk
American health care is facing an epidemic of medical errors. A major cause of these errors is poor teamwork. Crisis resource management (CRM) is a set of teamwork principles derived from the airline industry. Medical simulation is an educational tool that affords health care providers a means of improving teamwork by learning and practicing CRM. This article (1) discusses the case for teaching team training, (2) reviews the principles of medical simulation as they pertain to team training, (3) provides practical guidelines for using medical simulation in otolaryngology education, (4) discusses current evidence for the efficacy of medical simulation...
October 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28887348/population-health-management-in-a-small-health-system-impact-of-controlled-substance-stewardship-in-a-patient-centered-medical-home
#16
Felicity A E Homsted, Chelsea E Magee, Noah Nesin
PURPOSE: The success of a patient-centered medical home in providing population health management (PHM) services through controlled substance stewardship is described. SUMMARY: In 2013, Penobscot Community Health Care (PCHC), in Bangor, Maine, was fully engulfed in the prescription opioid crisis. At PCHC, patients' opioid doses were startlingly high. Within the organization, measures to ensure that prescriptions were being used as prescribed, and not diverted, were underutilized...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28882740/effect-of-sleep-deprivation-after-a-night-shift-duty-on-simulated-crisis-management-by-residents-in-anaesthesia-a-randomised-crossover-study
#17
Ségolène Arzalier-Daret, Clément Buléon, Marie-Laure Bocca, Pierre Denise, Jean-Louis Gérard, Jean-Luc Hanouz
BACKGROUND: Sleep deprivation has been associated with an increased incidence of medical errors and can jeopardise patients' safety during medical crisis management. The aim of the study was to assess the effect of sleep deprivation on the management of simulated anaesthesia crisis by residents in anaesthesiology. METHODS: A randomised, comparative, monocentric crossover study involving 48 residents in anaesthesia was performed on a high fidelity patient simulator...
September 4, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28869934/typical-hemodialysis-in-india-a-case-report
#18
Georgi Abraham, Madhusudan Vijayan, Milly Mathew
We report here a typical case of a patient on hemodialysis (HD) for end-stage renal disease (ESRD) in India that highlights some of the management issues encountered in a country with an enormous burden of ESRD and major challenges of underdialysis and management of comorbidities. The patient, a 42-year-old multiparous woman with chronic kidney disease (CKD) stage V, type 2 diabetes mellitus, and hypertension is a homemaker from a middle-class family, living in a large city, with no family history of CKD. From May 2013 to December 2016, she has been receiving twice-weekly maintenance HD for 4 h (intermittent HD); access was via an internal jugular line initially and then via a left brachiocephalic arteriovenous fistula (AVF) from late June 2013...
2017: Blood Purification
https://www.readbyqxmd.com/read/28829528/are-you-ready-crisis-leadership-in-a-hyper-vuca-environment
#19
Khaldoon H Alkhaldi, Meredith L Austin, Boris A Cura, Darrell Dantzler, Leslie Holland, David L Maples, Jamie C Quarrelles, Robert K Weinkle, Leonard J Marcus
The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes...
May 2017: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/28820230/are-you-ready-crisis-leadership-in-a-hyper-vuca-environment
#20
Khaldoon H Alkhaldi, Meredith L Austin, Boris A Cura, Darrell Dantzler, Leslie Holland, David L Maples, Jamie C Quarrelles, Robert K Weinkle, Leonard J Marcus
The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes...
March 2017: Journal of Emergency Management: JEM
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