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https://www.readbyqxmd.com/read/28430068/caring-for-patients-or-organs-new-therapies-raise-new-dilemmas-in-the-emergency-department
#1
Arjun Prabhu, Lisa S Parker, Michael A DeVita
Two potentially lifesaving protocols, emergency preservation and resuscitation (EPR) and uncontrolled donation after circulatory determination of death (uDCDD), currently implemented in some U.S. emergency departments (EDs), have similar eligibility criteria and initial technical procedures, but critically different goals. Both follow unsuccessful cardiopulmonary resuscitation and induce hypothermia to "buy time": one in trauma patients suffering cardiac arrest, to enable surgical repair, and the other in patients who unexpectedly die in the ED, to enable organ donation...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28429475/common-carotid-artery-sonography-versus-transthoracic-echocardiography-for-cardiac-output-measurements-in-intensive-care-unit-patients
#2
Qian-Yi Peng, Li-Na Zhang, Mei-Lin Ai, Li Li, Cheng-Huan Hu, Yan-Xin Zhang, Wei Liu, Qing Feng, Yu Zou, Yu-Hang Ai
OBJECTIVES: This study was designed to test the effectiveness of common carotid artery sonography in comparison with transthoracic echocardiography (TTE) for cardiac output measurements to provide an easier alternative for cardiac output monitoring in the intensive care unit. METHODS: This study included 148 patients who had common carotid artery Doppler examinations and TTE performed within 8 hours of each other, and the cardiac output measurement results were compared with each other...
April 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28427372/protocol-for-evaluation-of-the-continuum-of-primary-care-in-the-case-of-a-miscarriage-in-the-emergency-room-a-mixed-method-study
#3
Francine de Montigny, Chantal Verdon, Diane Dubeau, Annie Devault, Martin St-André, Éric Tchouaket Nguemeleu, Carl Lacharité
BACKGROUND: In Quebec (Canada), nearly 20,000 pregnancies end in miscarriage, and the majority of the miscarriages are dealt with in an emergency unit. Although there are studies documenting the effects of this type of grief on mental health, men's experiences are much less discussed than those of women. Similarly, no study has evaluated best practices in terms of service continuity, from emergency care to community resources. The aim of this study is to better understand the relationships that exist between the organization of emergency room and primary care health services for women presenting with miscarriage, on the one hand, and the positions and experiences of women and men within these services, on the other...
April 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28424835/-future-of-emergency-medicine-in-germany-2-0
#4
REVIEW
A Gries, M Bernhard, M Helm, J Brokmann, J-T Gräsner
In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment...
April 19, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28424799/role-of-psychological-resilience-on-health-outcomes-in-hospitalized-patients-with-acute-illness-a-scoping-review
#5
Elen Marged Bradley-Roberts, Christian P Subbe
Recovery from Acute Illness is dependent on severity of illness. We aimed to investigate whether resilience as the 'ability to bounce back' might also affect recovery. We conducted a scoping review to identify gaps in the existing literature. We used emergency care, intensive care, critical care and trauma as surrogates for acute illness. We mapped synonyms for resilience and selected 'resilience' and 'robustness'. The search was limited to adult patients admitted to hospitals. We found strong evidence for psychological sequelae of acute illness but no research focusing specifically on the concepts of resilience or robustness and no interventional studies in the acute hospital setting...
2017: Acute Medicine
https://www.readbyqxmd.com/read/28422779/the-utility-of-high-fidelity-simulation-for-training-critical-care-fellows-in-the-management-of-extracorporeal-membrane-oxygenation-emergencies-a-randomized-controlled-trial
#6
Bishoy M Zakhary, Lily M Kam, Brian S Kaufman, Kevin J Felner
OBJECTIVE: Although extracorporeal membrane oxygenation volume has increased, proficiency in the technology requires extensive training. We compared traditional water-drill-based extracorporeal membrane oxygenation training with simulation-based extracorporeal membrane oxygenation training with the hypothesis that simulation-based training is superior. DESIGN: Randomized controlled trial. SETTING: Academic medical center. SUBJECTS: Pulmonary/critical care fellows...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28421900/the-magnitude-and-factors-related-to-facility-based-maternal-mortality-in-mozambique
#7
Leonardo Chavane, Martinho Dgedge, Olivier Degomme, Osvaldo Loquiha, Marc Aerts, Marleen Temmerman
Facility-based maternal mortality remains an important public health problem in Mozambique. A number of factors associated with health system functioning can be described behind the occurrence of these deaths. This paper aimed to evaluate the magnitude of the health facility-based maternal mortality, its geographical distribution and to assess the health facility factors implicated in the occurrence of these deaths. A secondary analysis was done on data from the survey on maternal health needs performed by the Ministry of Health of Mozambique in 2008...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28421836/analytical-confirmation-of-synthetic-cannabinoids-in-a-cohort-of-179-presentations-with-acute-recreational-drug-toxicity-to-an-emergency-department-in-london-uk-in-the-first-half-of-2015
#8
Rachelle Abouchedid, Simon Hudson, Natalie Thurtle, Takahiro Yamamoto, James H Ho, George Bailey, Michelle Wood, Nele Sadones, Christophe P Stove, Alison Dines, John R H Archer, David M Wood, Paul I Dargan
CONTEXT: Synthetic cannabinoid receptor agonists are the largest group of new psychoactive substances reported in the last decade; in this study we investigated how commonly these drugs are found in patients presenting to the Emergency Department with acute recreational drug toxicity. METHODS: We conducted an observational cohort study enrolling consecutive adult patients presenting to an Emergency Department (ED) in London (UK) January-July 2015 (6 months) with acute recreational drug toxicity...
June 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28421650/keeping-up-with-the-kids-diffusion-of-innovation-in-pediatric-emergency-medicine-among-emergency-physicians
#9
Robert L Cloutier, Rakesh D Mistry, Stephen Cico, Chris Merritt, Samuel H F Lam, Marc Auerbach, L Melissa Skaugset, Jean Klig, Meg Wolff, Myto Duong, Jennifer Walthall
With 30,000,000 emergency department (ED) visits annually, children account for nearly one fourth of all ED visits in the United States. Despite these statistics, EDs across the country remain underprepared to care for pediatric patients [1, 2]. Based on published data, only 45% of EDs report having a pediatric quality improvement plan in place, one third of hospitals do not weigh children in kilograms, less than half have disaster plans in place for pediatric patients and more than 15% are missing critical pediatric emergency equipment [1]...
April 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28420474/-value-of-apacheiifor-predicting-the-nursing-workload-in-eicu
#10
Yongli Gao, Xingyu Zhu, Yan Ma, Na He, Dayan Li, Hai Hu
OBJECTIVE: To investigate the predictive value of acute physiology and chronic health evaluationII(APACHEII) for nursing workload in emergency intensive care unit (EICU). METHODS: A retrospective cohort study was conducted. Critical patients except for trauma admitted to EICU of West China Hospital of Sichuan University from June 2012 to July 2016 were enrolled. APACHEII score and therapeutic intervention scoring system (TISS-28) score were calculated in each case...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#11
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28418524/evaluating-testing-strategies-for-identifying-youths-with-hiv-infection-and-linking-youths-to-biomedical-and-other-prevention-services
#12
Robin Lin Miller, Cherrie B Boyer, Danielle Chiaramonte, Peter Lindeman, Kate Chutuape, Bendu Cooper-Walker, Bill G Kapogiannis, Craig M Wilson, J Dennis Fortenberry
Importance: Most human immunodeficiency virus (HIV)-infected youths are unaware of their serostatus (approximately 60%) and therefore not linked to HIV medical or prevention services. The need to identify promising and scalable approaches to promote uptake of HIV testing among youths at risk is critical. Objective: To evaluate a multisite HIV testing program designed to encourage localized HIV testing programs focused on self-identified sexual minority males and to link youths to appropriate prevention services after receipt of their test results...
April 17, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28417645/the-early-chain-of-care-and-risk-of-death-in-acute-stroke-in-relation-to-the-priority-given-at-the-dispatch-centre-a-multicentre-observational-study
#13
Birgitta Wireklint Sundström, Magnus Andersson Hagiwara, Peter Brink, Johan Herlitz, Per Olof Hansson
BACKGROUND: The early chain of care is critical for stroke patients. The most important part is the so-called 'system delay' i.e. the delay time from call to the emergency medical services until a diagnosis is established (computer tomography). AIM: The purpose of this study was to relate the initial priority level given by the dispatch centre to the early chain of care in acute stroke and to short-term and long-term mortality. METHODS: All patients hospitalised with the first and the final diagnosis of acute stroke, 15 December 2010-15 April 2011, were recruited across nine hospitals, each hospital with a stroke care unit...
April 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28416042/earthquakes-fuel-crisis-power-outages-and-health-care-in-nepal-implications-for-the-future
#14
Bipin Adhikari, Shiva Raj Mishra, Sujan Babu Marahatta, Nils Kaehler, Kumar Paudel, Janak Adhikari, Shristi Raut
Earthquakes are a major natural calamity with pervasive effects on human life and nature. Similar effects are mimicked by man-made disasters such as fuel crises and power outages in developing countries. Natural and man-made disasters can cause intangible human suffering and often leave scars of lifelong psychosocial damage. Lessons from these disasters are frequently not implemented. The main objective of this study was to review the effects of the 2015 earthquakes, fuel crisis, and power outages on the health services of Nepal and formulate recommendations for the future...
April 18, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28414165/recognising-out-of-hospital-cardiac-arrest-during-emergency-calls-increases-bystander-cardiopulmonary-resuscitation-and-survival
#15
Søren Viereck, Thea Palsgaard Møller, Annette Kjær Ersbøll, Josefine Stokholm Bækgaard, Andreas Claesson, Jacob Hollenberg, Fredrik Folke, Freddy K Lippert
BACKGROUND: Initiation of early bystander cardiopulmonary resuscitation (CPR) depends on bystanders' or medical dispatchers' recognition of out-of-hospital cardiac arrest (OHCA). The primary aim of our study was to investigate if OHCA recognition during the emergency call was associated with bystander CPR, return of spontaneous circulation (ROSC), and 30-day survival. Our secondary aim was to identify patient-, setting-, and dispatcher-related predictors of OHCA recognition. METHODS: We performed an observational study of all OHCA patients' emergency calls in the Capital Region of Denmark from 01/01/2013-31/12/2013...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28413938/psychiatric-service-users-experiences-of-emergency-departments-a-cerqual-review-of-qualitative-studies
#16
Kathrine Carstensen, Stina Lou, Lotte Groth Jensen, Nina Konstantin Nissen, Lisbeth Ortenblad, Margarete Pfau, Pia Vedel Ankersen
BACKGROUND: There is increased clinical and political attention towards integrating general and psychiatric emergency departments (ED). However, research into psychiatric service users' experiences regarding general EDs is limited. AIM: To identify and summarize current, qualitative evidence regarding service users' experiences attending EDs. A secondary aim is to apply and test the newly developed CERQual approach to summarizing qualitative review findings. METHODS: A systematic literature review of five databases based on PRISMA guidelines yielded 3334 unique entries...
May 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28413269/localization-of-epidural-space-a-review-of-available-technologies
#17
REVIEW
Hesham Elsharkawy, Abraham Sonny, Ki Jinn Chin
Although epidural analgesia is widely used for pain relief, it is associated with a significant failure rate. Loss of resistance technique, tactile feedback from the needle, and surface landmarks are traditionally used to guide the epidural needle tip into the epidural space (EDS). The aim of this narrative review is to critically appraise new and emerging technologies for identification of EDS and their potential role in the future. The PubMed, Cochrane Central Register of Controlled Clinical Studies, and Web of Science databases were searched using predecided search strategies, yielding 1048 results...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412917/is-there-a-teratogenicity-risk-associated-with-cannabis-and-synthetic-cannabimimetics-spice-intake
#18
Laura Orsolini, Duccio Papanti, John Corkery, Maria Antonietta De Luca, Cristina Cadoni, Gaetano Di Chiara, Fabrizio Schifano
BACKGROUND: Substance use, including cannabis, has been documented amongst women both in the pre-conception period and during pregnancy, particularly during the 1st trimester, which is clearly the most critical period in the organogenesis. The recent emergence on the drug market of synthetic cannabimimetics/SC ('spice') may represent a new challenge for clinicians. OBJECTIVE: A literature overview on the teratogenicity profile of both cannabis and synthetic cannabimimetics was here carried out...
April 13, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28409655/9-1-1-triage-of-non-traumatic-chest-pain-association-with-hospital-diagnosis
#19
Greg Scott, Jeff J Clawson, Isabel Gardett, Meghan Broadbent, Nathan Williams, Conrad Fivaz, Gigi Marshall, Tracey Barron, Christopher Olola
OBJECTIVE: Chest pain is one of the most common reasons people seek emergency care-and one of the most critical. In the United States, chest pain is the second most common reason for emergency department (ED) visits. A patient's primary complaint of "chest pain" may reflect a broad range of underlying causes; therefore, it is important that emergency medical service (EMS) agencies gain a thorough understanding of these cases, beginning with the initial management of chest pain in the 9-1-1 center...
April 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28409518/colon-epithelial-injury-in-critically-ill-colectomized-patients-aberration-of-tight-junction-proteins-and-toll-like-receptors
#20
Seija Sipola, Tero I Ala-Kokko, Jouko J Laurila, Juha Saarnio, Pasi Ohtonen, Hannu Syrjälä, Tuomo J Karttunen
BACKGROUND: Abnormal permeability and extensive epithelial injury are characteristic of colon wall damage complicating critical illness, such as sepsis, and associated with mortality. To assess mechanisms of such colon epithelial disruption, we studied expression of markers of innate immunity and intercellular junctions in patients with critical illness. METHODS: Emergency colectomy samples from 38 intensive care unit patients with sepsis, fulminant C. difficile colitis, or colon ischemia were studied...
April 13, 2017: Minerva Anestesiologica
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