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https://www.readbyqxmd.com/read/28430697/abusive-head-trauma-and-mortality-an-analysis-from-an-international-comparative-effectiveness-study-of-children-with-severe-traumatic-brain-injury
#1
Nikki Miller Ferguson, Ajit Sarnaik, Darryl Miles, Nadeem Shafi, Mark J Peters, Edward Truemper, Monica S Vavilala, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Patrick M Kochanek
OBJECTIVES: Small series have suggested that outcomes after abusive head trauma are less favorable than after other injury mechanisms. We sought to determine the impact of abusive head trauma on mortality and identify factors that differentiate children with abusive head trauma from those with traumatic brain injury from other mechanisms. DESIGN: First 200 subjects from the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial-a comparative effectiveness study using an observational, cohort study design...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422910/incremental-balloon-deflation-following-complete-reboa-results-in-steep-inflection-of-flow-and-rapid-reperfusion-in-a-large-animal-model-of-hemorrhagic-shock
#2
Anders J Davidson, Rachel M Russo, Sarah-Ashley E Ferencz, Jeremy W Cannon, Todd E Rasmussen, Lucas P Neff, M Austin Johnson, Timothy K Williams
INTRODUCTION: To avoid potential cardiovascular collapse after Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), current guidelines recommend methodically deflating the balloon over 5 minutes to gradually reperfuse distal tissue beds. However, anecdotal evidence suggests that this approach may still result in unpredictable aortic flow rates and hemodynamic instability. We sought to characterize aortic flow dynamics following REBOA as the balloon is deflated in accordance with current practice guidelines...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28419753/systematic-review-of-gender-differences-in-sepsis-management-and-outcomes
#3
Kim Reina Failla, Cynthia D Connelly
PURPOSE: Contributors to disparities in sepsis management have been attributed to genetic susceptibility, differences in clinical presentation, and healthcare delivery. The influence of gender on survival or mortality of patients with sepsis-related diagnoses is unclear. The purpose of the current study was to systematically review published research to identify factors and outcomes associated with sepsis management and outcomes based on gender differences. METHODS: Covering a period from 2006 to 2016, a literature search was conducted on four electronic data bases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCO, MedlinePlus, and PubMed...
April 18, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28419016/an-evaluation-of-a-new-debriefing-framework-reflect
#4
Lauren E Zinns, Paul C Mullan, Karen J OʼConnell, Leticia M Ryan, Angela T Wratney
BACKGROUND: Postresuscitation debriefing (PRD) is recommended by the American Heart Association guidelines but is infrequently performed. Prior studies have identified barriers for pediatric emergency medicine (PEM) fellows including lack of a standardized curriculum. OBJECTIVE: Our objective was to create and assess the feasibility of a time-limited, structured PRD framework entitled REFLECT: Review the event, Encourage team participation, Focused feedback, Listen to each other, Emphasize key points, Communicate clearly, and Transform the future...
April 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28413267/vasopressors-do-they-have-any-role-in-hemorrhagic-shock
#5
REVIEW
Babita Gupta, Neha Garg, Rashmi Ramachandran
The priority in the management of patients with traumatic hemorrhagic shock is to control the bleeding with simultaneous volume resuscitation to maintain adequate tissue perfusion. Fluid replacement remains the mainstay of initial resuscitation in hemorrhagic shock. Traditionally, vasopressors are contraindicated in the early management of hemorrhagic shock due to their deleterious consequences, although vasopressors may have a role in resuscitation when vasoplegic shock ensues and blood pressure cannot be maintained by fluids alone...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28411062/incidence-and-characteristics-of-positive-pressure-ventilation-delivered-to-newborns-in-a-us-tertiary-academic-hospital
#6
Dana E Niles, Courtney Cines, Elena Insley, Elizabeth E Foglia, Okan U Elci, Christiane Skåre, Theresa Olasveengen, Anne Ades, Michael Posencheg, Vinay M Nadkarni, Jo Kramer-Johansen
INTRODUCTION: The Neonatal Resuscitation Program (NRP) guidelines recommend positive pressure ventilation (PPV) in the first 60s of life to support perinatal transition in non-breathing newborns. Our aim was to describe the incidence and characteristics of newborn PPV using real-time observation in the delivery unit. METHODS: Prospective, observational, quality improvement study conducted at a tertiary academic hospital. Deliveries during randomized weekday/evening 8-h shifts were attended by a trained observer...
April 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28408236/unintentional-pediatric-cocaine-exposures-result-in-worse-outcomes-than-other-unintentional-pediatric-poisonings
#7
Patil Armenian, Michelle Fleurat, George Mittendorf, Kent R Olson
BACKGROUND: Unintentional pediatric cocaine exposures are rare but concerning due to potentially serious complications such as seizures, dysrhythmias, and death. OBJECTIVES: The objectives were to assess the demographic and clinical characteristics of pediatric cocaine exposures reported to the California Poison Control System. METHODS: This is a retrospective study of all confirmed pediatric (< 6 years of age) cocaine exposures reported to the California Poison Control System from January 1, 1997-September 30, 2010...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28404450/does-lying-in-the-recovery-position-increase-the-likelihood-of-not-delivering-cardiopulmonary-resuscitation
#8
Miguel Freire-Tellado, Rubén Navarro-Patón, Maria Del Pilar Pavón-Prieto, Marta Fernández-López, Javier Mateos-Lorenzo, Ivan López-Fórneas
BACKGROUND: Resuscitation guidelines endorse unconscious and normally breathing out-of-hospital victims to be placed in the recovery position to secure airway patency, but recently a debate has been opened as to whether the recovery position threatens the cardiac arrest victim's safety assessment and delays the start of cardiopulmonary resuscitation. AIM: To compare the assessment of the victim's breathing arrest while placed in the recovery position versus maintaining an open airway with the continuous head tilt and chin lift technique to know whether the recovery position delays the cardiac arrest victim's assessment and the start of cardiopulmonary resuscitation...
April 9, 2017: Resuscitation
https://www.readbyqxmd.com/read/28402986/no-small-matter-pediatric-resuscitation
#9
Taylor McCormick, Kevin McVaney, Paul E Pepe
PURPOSE OF REVIEW: To present advancements in pediatric cardiac arrest research, highlighting articles most relevant to clinical practice published since the latest international guidelines for cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Clinical trials examining targeted temperature management in children support avoidance of hyperthermia for both pediatric in-hospital cardiac arrest (PIHCA) and out-of-hospital cardiac arrest (POHCA), but no statistically significant outcome differences were confirmed comparing 33 and 36 °C in the limited populations studied...
April 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28402985/the-past-present-and-future-of-ventilation-during-cardiopulmonary-resuscitation
#10
Mary P Chang, Ahamed H Idris
PURPOSE OF REVIEW: To evaluate the past and present literature on ventilation during out of hospital cardiac arrest, highlighting research that has informed current guidelines. RECENT FINDINGS: Previous studies have studied what are optimal compression-to-ventilation ratios, ventilation rates, and methods of ventilation. Continuous chest compression cardiopulmonary resuscitation (CPR) has not shown to provide a significant survival benefit over the traditional 30 : 2 CPR...
April 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28398910/ebm-vs-ebm-combining-evidence-based-and-experienced-based-medicine-in-resuscitation-research
#11
Paul E Pepe, Tom P Aufderheide
PURPOSE OF REVIEW: To discuss the clear rationale for evidence-based medicine (EvBM) in the challenging realms of resuscitation research, yet also provide case examples in which even the well designed, multicentered randomized clinical trial may have had unrecognized limitations, and thus misleading results. This is where experienced-based medicine (ExBM) helps to resolve the issue. RECENT FINDINGS: Recent publications have brought to task the conclusions drawn from various clinical trials of resuscitative interventions...
April 8, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28398908/evolution-and-revolution-in-cardiopulmonary-resuscitation
#12
Ray Fowler, Mary Chang, Ahamed H Idris
PURPOSE OF REVIEW: To discuss the evolution of the technique of cardiopulmonary resuscitation (CPR), including presenting important research that has made substantial improvements in patient outcome. RECENT FINDINGS: The last half century has seen the arising of guidelines for performing CPR increasingly based on good scientific evidence. Improvements in the technique, including teaching citizens 'compressions only CPR', have simplified the process of rescue while improving survival...
April 8, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28391604/health-care-professionals-concerns-regarding-in-hospital-family-witnessed-cardiopulmonary-resuscitation-implementation-into-clinical-practice
#13
Natalia Sak-Dankosky, Paweł Andruszkiewicz, Paula R Sherwood, Tarja Kvist
BACKGROUND: In-hospital, family-witnessed cardiopulmonary resuscitation of adults has been found to help patients' family members deal with the short- and long-term emotional consequences of resuscitation. Because of its benefits, many national and international nursing and medical organizations officially recommend this practice. Research, however, shows that family-witnessed resuscitation is not widely implemented in clinical practice, and health care professionals generally do not favour this recommendation...
April 9, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28388951/implementing-the-emergency-triage-assessment-and-treatment-plus-admission-care-etat-clinical-practice-guidelines-to-improve-quality-of-hospital-care-in-rwandan-district-hospitals-healthcare-workers-perspectives-on-relevance-and-challenges
#14
Celestin Hategeka, Leah Mwai, Lisine Tuyisenge
BACKGROUND: An emergency triage, assessment and treatment plus admission care (ETAT+) intervention was implemented in Rwandan district hospitals to improve hospital care for severely ill infants and children. Many interventions are rarely implemented with perfect fidelity under real-world conditions. Thus, evaluations of the real-world experiences of implementing ETAT+ are important in terms of identifying potential barriers to successful implementation. This study explored the perspectives of Rwandan healthcare workers (HCWs) on the relevance of ETAT+ and documented potential barriers to its successful implementation...
April 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28385640/bystander-capability-to-activate-speaker-function-for-continuous-dispatcher-assisted-cpr-in-case-of-suspected-cardiac-arrest
#15
Alvilda T Steensberg, Mette M Eriksen, Lars B Andersen, Ole M Hendriksen, Heinrich D Larsen, Gunnar H Laier, Thomas Thougaard
BACKGROUND: The European Resuscitation Council Guidelines 2015 recommend bystanders to activate their mobile phone speaker function, if possible, in case of suspected cardiac arrest. This is to facilitate continuous dialogue with the dispatcher including (if required) cardiopulmonary resuscitation instructions. The aim of this study was to measure the bystander capability to activate speaker function in case of suspected cardiac arrest. METHOD: In 87days, a systematic prospective registration of bystander capability to activate the speaker function, when cardiac arrest was suspected, was performed...
April 4, 2017: Resuscitation
https://www.readbyqxmd.com/read/28385449/centhaquin-effects-in-a-swine-model-of-ventricular-fibrillation-centhaquin-and-cardiac-arrest
#16
Konstantina Papalexopoulou, Athanasios Chalkias, Paraskevi Pliatsika, Apostolos Papalois, Panagiotis Papapanagiotou, Georgios Papadopoulos, Eleni Arnaoutoglou, Anastasios Petrou, Anil Gulati, Theodoros Xanthos
BACKGROUND: Centhaquin citrate is a novel agent being developed for use in the treatment of haemorrhagic shock. The aim of our study was to assess whether the administration of centhaquin would improve initial resuscitation success, 24-hour survival, and neurologic outcome compared with adrenaline alone in a porcine model of ventricular fibrillation. METHODS: Ventricular fibrillation was induced in 20 healthy Landrace/Large White piglets. The animals were randomised to receive placebo plus adrenaline 0...
December 19, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28383471/clinical-practice-guideline-adherence-during-operation-inherent-resolve
#17
Timothy P Plackett, Darren C Cherry, Gerald Delk, Steven Satterly, Jared Theler, Derek McVay, Jacqueline Moore, Stacy A Shackelford
BACKGROUND: The Joint Trauma System (JTS) Clinical Practice Guidelines (CPGs) contributed to the decrease in battlefield morality over the past 15 years. However, it is unknown to what degree the guidelines are being followed in current military operations. METHODS: A retrospective review was performed of all patients treated at three separate US Army Role II facilities during the first ten months of Operation Inherent Resolve in Iraq. Charts were reviewed for patient demographics, clinical care, and outcomes...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28383397/evaluation-of-a-newly-developed-infant-chest-compression-technique-a-randomized-crossover-manikin-trial
#18
Jacek Smereka, Karol Bielski, Jerzy R Ladny, Kurt Ruetzler, Lukasz Szarpak
BACKGROUND: Providing adequate chest compression is essential during infant cardio-pulmonary-resuscitation (CPR) but was reported to be performed poor. The "new 2-thumb technique" (nTTT), which consists in using 2 thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist, was recently introduced. Therefore, the aim of this study was to compare 3 chest compression techniques, namely, the 2-finger-technique (TFT), the 2-thumb-technique (TTHT), and the nTTT in an randomized infant-CPR manikin setting...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28380495/risk-factors-for-severe-reactions-during-double-blind-placebo-controlled-food-challenges
#19
Noriyuki Yanagida, Sakura Sato, Tomoyuki Asaumi, Kiyotake Ogura, Motohiro Ebisawa
BACKGROUND: Severe anaphylactic symptoms can occur during oral food challenges (OFCs). Thus, high-risk patients (e.g., patients with a history of anaphylaxis or high antigen-specific immunoglobulin E [IgE] levels) must carefully undergo OFCs in hospitals. We attempted to identify the risk factors for severe symptoms during OFC testing among high-risk patients. METHODS: We retrospectively evaluated patients' characteristics and severe symptoms that were experienced during a double-blind placebo-controlled food challenge test performed before the patients underwent oral immunotherapy between June 2008 and June 2012...
April 6, 2017: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/28377295/frequency-of-medical-emergency-team-activation-prior-to-pediatric-cardiopulmonary-resuscitation
#20
Natalie Jayaram, Maya L Chan, Fengming Tang, Christopher S Parshuram, Paul S Chan
BACKGROUND: Medical Emergency Teams (METs) are designed to respond to signs of clinical decline in order to prevent cardiopulmonary arrest and reduce mortality. The frequency of MET activation prior to pediatric cardiopulmonary resuscitation (CPR) is unknown. METHODS: Within the Get With The Guidelines-Resuscitation Registry (GWTG-R), we identified children with bradycardia or cardiac arrest requiring CPR on the general inpatient or telemetry floors from 2007 to 2013...
April 1, 2017: Resuscitation
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