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https://www.readbyqxmd.com/read/29761867/airway-physical-examination-tests-for-detection-of-difficult-airway-management-in-apparently-normal-adult-patients
#1
REVIEW
Dominik Roth, Nathan L Pace, Anna Lee, Karen Hovhannisyan, Alexandra-Maria Warenits, Jasmin Arrich, Harald Herkner
BACKGROUND: The unanticipated difficult airway is a potentially life-threatening event during anaesthesia or acute conditions. An unsuccessfully managed upper airway is associated with serious morbidity and mortality. Several bedside screening tests are used in clinical practice to identify those at high risk of difficult airway. Their accuracy and benefit however, remains unclear. OBJECTIVES: The objective of this review was to characterize and compare the diagnostic accuracy of the Mallampati classification and other commonly used airway examination tests for assessing the physical status of the airway in adult patients with no apparent anatomical airway abnormalities...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29757892/exposures-to-single-use-detergent-sacs-reported-to-a-statewide-poison-control-system-2013-2015
#2
Rais Vohra, Serena Huntington, Yelena Fenik, Derek Phan, Nancy Ta, Richard J Geller
BACKGROUND: Single-use detergent sacs (SUDSs) represent a relatively new household hazard to children. Brand differences and packaging changes may contribute to differential risks with accidental exposure. We sought to identify high-risk features from SUDS exposures in children and to assess whether product packaging changed trends in SUDS exposures reported to poison centers. METHODS: In this institutional review board-approved, retrospective chart review of SUDS exposures from January 2013 to August 2015, deidentified case records of a large statewide poison control system were extracted and analyzed for clinical associations and trends...
May 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29757778/a-contemporary-analysis-of-medicolegal-issues-in-obstetric-anesthesia-between-2005-and-2015
#3
Vesela P Kovacheva, Ethan Y Brovman, Penny Greenberg, Ellen Song, Arvind Palanisamy, Richard D Urman
BACKGROUND: Detailed reviews of closed malpractice claims have provided insights into the most common events resulting in litigation and helped improve anesthesia care. In the past 10 years, there have been multiple safety advancements in the practice of obstetric anesthesia. We investigated the relationship among contributing factors, patient injuries, and legal outcome by analyzing a contemporary cohort of closed malpractice claims where obstetric anesthesiology was the principal defendant...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29756683/non-operative-management-of-isolated-single-abdominal-stab-wound-is-it-safe
#4
Hong Xiang Lee, Matthew Hauser, Shivangi Jog, Peter Bautz, Christopher Dobbins
BACKGROUND: This is a retrospective review of prospectively collected data on our hospital, a Level 1 trauma centre, where stable patients with single abdominal stab wounds are considered for non-operative (conservative) management if they fulfil the criteria with the aid of computed tomography. The aim is to review our current approach in managing these patients. METHODS: Patients' data were obtained from January 2005 to June 2016. All injuries classed as assault or self-harm by sharp object in Injury Severity Score body region 4 were included...
May 14, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29753518/application-of-the-canadian-computed-tomography-head-rule-to-patients-with-minimal-head-injury
#5
Kevin Davey, Turandot Saul, Geoffrey Russel, Jonathan Wassermann, Joshua Quaas
STUDY OBJECTIVE: Two clinical decision rules, the Canadian CT Head Rule and the New Orleans Criteria, set the standard to guide clinicians in determining which patients with minor head trauma need computed tomography (CT) imaging. Both rules were derived with patients with minor head injury who had had a loss of consciousness or witnessed disorientation. No evidence exists for evaluating patients and need for CT imaging with minimal head injury; that is, patients who had a head injury but no loss of consciousness or disorientation and therefore would have been excluded from the Canadian CT Head Rule and New Orleans Criteria trials...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#6
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29752776/influence-of-prehospital-airway-management-on-neurological-outcome-in-patients-transferred-to-a-heart-attack-centre-following-out-of-hospital-cardiac-arrest
#7
Timothy Edwards, Julia Williams, Michaela Cottee
OBJECTIVE: To describe the association between prehospital airway management and neurological outcomes in patients transferred by the ambulance service directly to a heart attack centre (HAC) post-return of spontaneous circulation (ROSC). METHODS: A retrospective observational cohort study in which ambulance records were reviewed to determine prehospital airway management strategy and collect physiological and demographic data. HAC notes were obtained to determine in-hospital management and quantify neurological outcome via the cerebral performance category (CPC) scale...
May 11, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29751368/rapid-systematic-review-shows-that-using-a-high-flow-nasal-cannula-is-inferior-to-nasal-continuous-positive-airway-pressure-as-first-line-support-in-preterm-neonates
#8
REVIEW
Francesca Conte, Luigi Orfeo, Camilla Gizzi, Luca Massenzi, Salvatore Fasola
AIM: We reviewed using a high-flow nasal cannula (HFNC) as first-line support for preterm neonates with, or at risk of, respiratory distress. METHODS: This rapid systematic review covered biomedical databases up to June 2017. We included randomised controlled trials (RCTs) published in English. The reference lists of the studies and relevant reviews we included were also screened. We performed the study selection, data extraction, study quality assessment, meta-analysis and quality of evidence assessment following the Grading of Recommendations Assessment, Development and Evaluation system...
May 11, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29751089/effect-of-obesity-on-patterns-and-mechanisms-of-injury-systematic-review-and-meta-analysis
#9
REVIEW
Tarn Stroud, N M Bagnall, Philip H Pucher
BACKGROUND: Trauma is one of the major causes of morbidity and mortality globally, especially in younger populations. With an increase in obesity globally, it is important to assess the potential differences in injury pattern and management of obese patients presenting with trauma compared to lean patients to try and improve patient care. This study aims to review the available literature comparing injury patterns between obese and non-obese patients. METHODS: A systematic review of articles which assessed the association between obesity and different patterns of trauma and injury were assessed...
May 8, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29744242/non-invasive-mechanical-ventilation-in-critically-ill-trauma-patients-a-systematic-review
#10
REVIEW
Annia Schreiber, Fatma Yıldırım, Giovanni Ferrari, Andrea Antonelli, Pablo Bayoumy Delis, Murat Gündüz, Marcin Karcz, Peter Papadakos, Roberto Cosentini, Yalım Dikmen, Antonio M Esquinas
There is limited literature on non-invasive mechanical ventilation (NIMV) in patients with polytrauma-related acute respiratory failure (ARF). Despite an increasing worldwide application, there is still scarce evidence of significant NIMV benefits in this specific setting, and no clear recommendations are provided. We performed a systematic review, and a search of clinical databases including MEDLINE and EMBASE was conducted from the beginning of 1990 until today. Although the benefits in reducing the intubation rate, morbidity and mortality are unclear, NIMV may be useful and does not appear to be associated with harm when applied in properly selected patients with moderate ARF at an earlier stage of injury by experienced teams and in appropriate settings under strict monitoring...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29740509/chiari-i-malformation-with-acute-neurological-deficit-after-craniocervical-trauma-case-report-imaging-and-anatomic-considerations
#11
Josha A Woodward, David E Adler
Background: In patients with Chiari I malformation (CMI), the occurrence of acute neurologic deficit after craniocervical trauma is rare. However, the pathologic potential of exacerbating anatomic overcrowding of the posterior fossa has immense clinical consequences and prompt recognition is essential. Case Description: This case study describes a 41-year-old male who sustained a single blow to the face, fell, and struck the occiput. On admission, neurological examination revealed a profound paraparesis, upper extremity diplegia, a C4 sensory level and apnea that required intubation...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29740192/safety-of-fentanyl-for-peripherally-inserted-central-catheter-in-non-intubated-infants-in-the-neonatal-intensive-care-unit
#12
Yair Kasirer, Vibhuti Shah, Eugene W Yoon, Ruben Bromiker, Carol Mcnair, Anna Taddio
OBJECTIVE: To evaluate the safety of fentanyl in non-intubated infants undergoing peripherally inserted central catheter (PICC) placement. METHODS: A retrospective chart review of PICC placements over a 3 years' period. We compared the 12h periods before and after fentanyl for clinically significant cardiorespiratory events (spells). RESULTS: Of the 998 neonates screened, 258 were eligible. The mean standard deviation gestational age was 34...
May 8, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29735230/management-of-multiple-burned-patients-with-inhalation-injuries
#13
Kouhei Ishikawa, Youichi Yanagawa, Yukino Kato, Yoko Nozawa, Hiroki Nagasawa, Ikuto Takeuchi, Kei Jitsuiki, Akihiko Kondo, Hiromichi Ohsaka, Kazuhiko Omori
The fire department in Atami received an emergency call at 6:17 am, with notification of 4 or 5 casualties because of a fire. Because there was only 1 ambulance (O) at the station, an additional ambulance (P) was also requested. Ambulance O transported 2 patients (A and B), and ambulance P transported 2 patients (C and D). These 4 patients were judged to have severe inhalation injuries at the scene and were transported to 2 local hospitals (X and Y). After patients C and D arrived at hospital Y, the medical staff decided to transfer them to the emergency medical service center...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29733098/oxycodone-is-safe-and-effective-for-general-anesthesia
#14
Stefan Wirz, Richard K Ellerkmann, Martin Soehle, Christian-Dieter Wirtz
PURPOSE: In clinical practice, using different opioid analgesics is common during the induction and maintenance of general anesthesia and for postoperative analgesia. However, if the opioid analgesic could be limited to a single drug, we hypothesized that the risk of adverse drug interactions could be reduced, with fewer adverse effects. We examined the use of oxycodone as a single opioid in a well-defined cohort of orthopedic patients undergoing general anesthesia. METHODS: In this retrolective, monocentric investigation, we reviewed data from 83 patients who underwent general anesthesia and received intravenous oxycodone as the sole analgesic (0...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29732908/airway-anomalies-in-patients-with-22q11-2-deletion-syndrome-a-5-year-review
#15
Joel W Jones, Meghan Tracy, Mollie Perryman, Jill M Arganbright
OBJECTIVES: To characterize the frequency of airway anomalies in patients with 22q11.2 deletion syndrome (22q11DS). METHODS: Retrospective review of patients with 22q11DS who had undergone microlaryngoscopy/bronchoscopy (MLB) for aerodigestive symptoms at a tertiary care children's hospital from 2011 to 2016. RESULTS: Thirty patients underwent an MLB due to the following indications: aspiration (11), stridor (10), chronic respiratory failure due to ventilator dependence (8), and difficult intubation (1)...
May 1, 2018: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29732423/predicting-critical-care-unit-level-complications-after-long-segment-fusion-procedures-for-adult-spinal-deformity
#16
Rafael De la Garza-Ramos, Jonathan Nakhla, Yaroslav Gelfand, Murray Echt, Aleka N Scoco, Merritt D Kinon, Reza Yassari
Background: To identify predictive factors for critical care unit-level complications (CCU complication) after long-segment fusion procedures for adult spinal deformity (ASD). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database [2010-2014] was reviewed. Only adult patients who underwent fusion of 7 or more spinal levels for ASD were included. CCU complications included intraoperative arrest/infarction, ventilation >48 hours, pulmonary embolism, renal failure requiring dialysis, cardiac arrest, myocardial infarction, unplanned intubation, septic shock, stroke, coma, or new neurological deficit...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29731193/thirty-years-of-submental-intubation-a-review
#17
REVIEW
D Lim, B C Ma, R Parumo, P Shanmuhasuntharam
Submental intubation has been used as an alternative to conventional intubation in the field of oral and maxillofacial surgery since its introduction by Francisco Hernández Altemir in 1986. A review of submental intubation was performed using data from all case reports, case-series, and prospective and retrospective studies published between 1986 and 2016. The indications, variations in incision length, incision sites, types of endotracheal tube used, methods of exteriorization, and complications were recorded and analyzed...
May 3, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29726931/comparable-perioperative-outcomes-and-mid-term-survival-in-prosthetic-valve-endocarditis-and-native-valve-endocarditis
#18
Makoto Mori, Kayoko Shioda, Max Jordan Nguemeni Tiako, Syed Usman Bin Mahmood, Abeel A Mangi, James J Yun, Umer Darr, Philip Yi Kit Pang, Arnar Geirsson
OBJECTIVES: Cardiac surgery for prosthetic valve endocarditis (PVE) represents one of the highest risk surgeries with in-hospital mortality of 20%. Given the complex nature of the operation, the operative outcome is likely strongly susceptible to the surgeon's experience and centre case volume, as measurements often are not apparent in large observational studies. We sought to evaluate operative outcomes and mid-term survival of patients with PVE compared with those of native valve endocarditis (NVE) at a tertiary care hospital...
May 2, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29726010/lower-versus-higher-oxygen-concentrations-titrated-to-target-oxygen-saturations-during-resuscitation-of-preterm-infants-at-birth
#19
REVIEW
Kei Lui, Lisa J Jones, Jann P Foster, Peter G Davis, See Kwee Ching, Ju Lee Oei, David A Osborn
BACKGROUND: Initial resuscitation with air is well tolerated by most infants born at term. However, the optimal fractional inspired oxygen concentration (FiO2 - proportion of the breathed air that is oxygen) targeted to oxygen saturation (SpO2 - an estimate of the amount of oxygen in the blood) for infants born preterm is unclear. OBJECTIVES: To determine whether lower or higher initial oxygen concentrations, when titrated according to oxygen saturation targets during the resuscitation of preterm infants at birth, lead to improved short- and long-term mortality and morbidity...
May 4, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29724123/evidence-supporting-clinical-use-of-proportional-assist-ventilation-a-systematic-review-and-meta-analysis-of-clinical-trials
#20
Bharath Kumar Tirupakuzhi Vijayaraghavan, Shatha Hamed, Aditi Jain, Timothy Chimunda, Irene Telias, Jan O Friedrich, Karen E A Burns
BACKGROUND: While proportional assist ventilation (PAV), generates pressure in proportion to effort without a preselected target, proportional assist ventilation plus (PAV+) measures compliance and resistance, calculates work of breathing, and adjusts support to a preset assistance level. OBJECTIVE: To summarize randomized controlled trials (RCTs) comparing invasive or noninvasive PAV or PAV+ in critically ill patients. DATA SOURCES: We searched multiple databases to April 2017 without language restrictions and conference proceedings from 5 meetings to identify randomized parallel-group and crossover RCTs that compared invasive or noninvasive PAV or PAV+ to another mode in critically ill adults or children and reported at least 1 clinically important outcome...
January 1, 2018: Journal of Intensive Care Medicine
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