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https://www.readbyqxmd.com/read/28807986/a-turbine-driven-ventilator-improves-adherence-to-advanced-cardiac-life-support-guidelines-during-a-cardiopulmonary-resuscitation-simulation
#1
Scott G Allen, Lara Brewer, Erik S Gillis, Nathan L Pace, Derek J Sakata, Joseph A Orr
BACKGROUND: Research has shown that increased breathing frequency during cardiopulmonary resuscitation is inversely correlated with systolic blood pressure. Rescuers often hyperventilate during cardiopulmonary resuscitation (CPR). Current American Heart Association advanced cardiac life support recommends a ventilation rate of 8 -10 breaths/min. We hypothesized that a small, turbine-driven ventilator would allow rescuers to adhere more closely to advanced cardiac life support (ACLS) guidelines...
August 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28802983/systemic-and-local-management-of-burn-wounds
#2
REVIEW
Alessio Vigani, Christine A Culler
Management of severe burn injury (SBI) requires prompt, complex, and aggressive care. Despite major advances in the management of SBI-including patient-targeted resuscitation, management of inhalation injuries, specific nutritional support, enhanced wound therapy, and infection control-the consequences of SBI often result in complex, multiorgan metabolic changes. Consensus guidelines and clinical evidence regarding specific management of small animal burn patients are lacking. This article aims to review updated therapeutic consideration for the systemic and local management of SBI that are proven effective to optimize outcomes in human burn patients and may translate to small animal patients...
August 9, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28802261/how-do-different-brands-of-size-1-laryngeal-mask-airway-compare-with-face-mask-ventilation-in-a-dedicated-laryngeal-mask-airway-teaching-manikin
#3
Mark Brian Tracy, Archana Priyadarshi, Dimple Goel, Krista Lowe, Jacqueline Huvanandana, Murray Hinder
BACKGROUND: International neonatal resuscitation guidelines recommend the use of laryngeal mask airway (LMA) with newborn infants (≥34 weeks' gestation or >2 kg weight) when bag-mask ventilation (BMV) or tracheal intubation is unsuccessful. Previous publications do not allow broad LMA device comparison. OBJECTIVE: To compare delivered ventilation of seven brands of size 1 LMA devices with two brands of face mask using self-inflating bag (SIB). DESIGN: 40 experienced neonatal staff provided inflation cycles using SIB with positive end expiratory pressure (PEEP) (5 cmH2O) to a specialised newborn/infant training manikin randomised for each LMA and face mask...
August 11, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28793138/temporal-changes-in-the-racial-gap-in-survival-after-in-hospital-cardiac-arrest
#4
Lee Joseph, Paul S Chan, Steven M Bradley, Yunshu Zhou, Garth Graham, Philip G Jones, Mary Vaughan-Sarrazin, Saket Girotra
Importance: Previous studies have found marked differences in survival after in-hospital cardiac arrest by race. Whether racial differences in survival have narrowed as overall survival has improved remains unknown. Objectives: To examine whether racial differences in survival after in-hospital cardiac arrest have narrowed over time and if such differences could be explained by acute resuscitation survival, postresuscitation survival, and/or greater temporal improvement in survival at hospitals with higher proportions of black patients...
August 9, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28793002/laryngeal-tube-suction-for-airway-management-during-in-hospital-emergencies
#5
Haitham Mutlak, Christian Friedrich Weber, Dirk Meininger, Colleen Cuca, Kai Zacharowski, Christian Byhahn, Richard Schalk
OBJECTIVE: The role of supraglottic airway devices in emergency airway management is highlighted in international airway management guidelines. We evaluated the application of the new generation laryngeal tube suction (LTS-II/LTS-D) in the management of in-hospital unexpected difficult airway and cardiopulmonary resuscitation. METHODS: During a seven-year period, patients treated with a laryngeal tube who received routine anesthesia and had an unexpected difficult airway (Cormack Lehane Grade 3-4), who underwent cardiopulmonary resuscitation, or who underwent cardiopulmonary resuscitation outside the operating room and had a difficult airway were evaluated...
July 2017: Clinics
https://www.readbyqxmd.com/read/28792628/a-review-of-international-clinical-practice-guidelines-for-the-use-of-oxygen-in-the-delivery-room-resuscitation-of-preterm-infants
#6
A Wilson, M Vento, P Shah, O Saugstad, N Finer, W Rich, R Morton, Y Rabi, W Tarnow-Mordi, K Suzuki, I M Wright, J Oei
AIM: To collate and assess international clinical practice guidelines (CPG) to determine current recommendations guiding oxygen management for respiratory stablisation of preterm infants at delivery. METHODS: A search of public databases using the terms "clinical practice guidelines", "preterm", "oxygen" and "resuscitation" was made and complemented by direct query to consensus groups, resuscitation expert committees and clinicians. Data were extracted to include the three criteria for assessment: country of origin, gestation and initial FiO2 and target SpO2 for the first 10 minutes of life...
August 9, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28790011/management-of-septic-shock-in-an-intermediate-care-unit
#7
Eric Meaudre, Cédric Nguyen, Claire Contargyris, Ambroise Montcriol, Erwan d'Aranda, Pierre Esnault, Mourad Bensalah, Bertrand Prunet, Julien Bordes, Philippe Goutorbe
BACKGROUND: While guidelines advocate goal-directed resuscitation based on timed bundles, the management of SS outside an ICU setting has been poorly studied in intermediate care units (IMCU). PATIENTS AND METHOD: We reviewed all cases of septic shock patients admitted to our IMCU between January 2013 and June 2014. The characteristics of sepsis, compliance of bundles, and outcomes were collected. The IMCU population was compared with the SS patients admitted to the ICU during the same period...
August 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28789766/-post-resuscitation-care-after-out-of-hospital-cardiac-arrest
#8
Johannes Grand, Christian Hassager, Jesper Kjærgaard
Survival from out-of-hospital cardiac arrest in Denmark has increased significantly since 2001, and important improvements have been made in the post-resuscitation care. The aim of this article is to summarize the most recent international guidelines for post-resuscitation care in a Danish perspective. The main aspects concern securing haemodynamic and respiratory functions and performing urgent coronary catheterization and targeted temperature management in selected patients. In prognostication a multi-modal approach should be applied...
July 24, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28777268/pediatric-life-support-update-2015-american-heart-association-highlights
#9
Carson Gill, Niranjan Kissoon
Despite improving survival rates for pediatric cardiac arrest victims, they remain strikingly low. Evidence for pediatric cardiopulmonary resuscitation is limited with many areas of ongoing controversy. The American Heart Association provides updated guidelines for life support based on comprehensive reviews of evidence-based recommendations and expert opinions. This facilitates the translation of scientific discoveries into daily patient care, and familiarization with these guidelines by health care providers and educators will facilitate the widespread, consistent, and effective care for patients...
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28774567/minnesota-heart-safe-communities-are-community-based-initiatives-increasing-pre-ambulance-cpr-and-aed-use
#10
Lori L Boland, Michelle B Formanek, Kim K Harkins, Carol L Frazee, Jonathan W Kamrud, Andrew C Stevens, Charles J Lick, Demetris Yannopoulos
AIM: Implementation research that describes how successfully resuscitation guidelines are translated into practice are lacking. We examined whether recent community-based initiatives being conducted as part of the Minnesota Heart Safe (HS) Communities program increase the delivery of CPR and use of automated external defibrillators (AED) by bystanders and first responders prior to ambulance arrival. METHODS: Non-EMS witnessed out-of-hospital cardiac arrests (OHCA) with presumed cardiac etiology treated by a single ambulance service in 2013-2015 were studied...
July 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/28766924/factors-associated-with-performing-urgent-coronary-angiography-in-out-of-hospital-cardiac-arrest-patients
#11
David H Lam, Lauren M Glassmoyer, Jordan B Strom, Roger B Davis, James M McCabe, Donald E Cutlip, Michael W Donnino, Michael N Cocchi, Duane S Pinto
OBJECTIVES: Factors associated with performing urgent coronary angiography (UCA) in patients with out-of-hospital cardiac arrest (OHCA) were identified. BACKGROUND: Current guidelines for resuscitated OHCA patients recommend UCA if there is ST-elevation on post-arrest electrocardiogram or high suspicion of acute myocardial infarction. Some have advocated for UCA in all OHCA regardless of suspected etiology. The reasons for variations in performing UCA are not well understood...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28763260/patterns-of-resuscitation-care-and-survival-after-in-hospital-cardiac-arrest-in-patients-with-advanced-cancer
#12
Jeffrey T Bruckel, Sandra L Wong, Paul S Chan, Steven M Bradley, Brahmajee K Nallamothu
PURPOSE: Little is known regarding patterns of resuscitation care in patients with advanced cancer who suffer in-hospital cardiac arrest (IHCA). METHODS: In the Get With The Guidelines - Resuscitation registry, 47,157 adults with IHCA with and without advanced cancer (defined as the presence of metastatic or hematologic malignancy) were identified at 369 hospitals from April 2006 through June 2010. We compared rates of return of spontaneous circulation (ROSC) and survival to discharge between groups using multivariable models...
August 1, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28759509/update-on-sepsis-treatment-in-the-emergency-department
#13
Kyle A Weant, Abby M Bailey
Sepsis continues to be a devastating, costly, and challenging syndrome to manage in emergency departments (ED) across the nation, and its impact seems to be only increasing. Recently, consensus recommendations have made some profound changes in the way we approach, classify, and treat sepsis. The ED serves as an important initial screening and intervention point for sepsis, and ED care can have a profound impact on overall morbidity and mortality. The provision of early fluid resuscitation, antimicrobial therapy, and vasopressor therapy, if appropriate, is essential in early care...
July 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28756074/-european-guidelines-on-cardiac-arrest-what-s-new
#14
Pascal Cassan
The European recommendations on cardiac arrest are based on the evidence gathered and reviewed by the International Resuscitation Liaison Committee (ILCOR) and were published in October 2015. These recommendations without representing a revolution, constitute an evolution centered on a primary goal to increase survival following cardiac arrest. This improvement in survival depends on four main factors: early identification of cardiac arrest, early access to rescue, early and quality CPR, and access to early defibrillation...
July 26, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28754527/ultrasound-use-during-cardiopulmonary-resuscitation-is-associated-with-delays-in-chest-compressions
#15
Maite A Huis In 't Veld, Michael G Allison, David S Bostick, Kiondra R Fisher, Olga G Goloubeva, Michael D Witting, Michael E Winters
AIM: High-quality chest compressions are a critical component of the resuscitation of patients in cardiopulmonary arrest. Point-of-care ultrasound (POCUS) is used frequently during emergency department (ED) resuscitations, but there has been limited research assessing its benefits and harms during the delivery of cardiopulmonary resuscitation (CPR). We hypothesized that use of POCUS during cardiac arrest resuscitation adversely affects high-quality CPR by lengthening the duration of pulse checks beyond the current cardiopulmonary resuscitation guidelines recommendation of 10s...
July 25, 2017: Resuscitation
https://www.readbyqxmd.com/read/28751533/fifteen-minute-consultation-stabilisation-of-the-high-risk-newborn-infant-beside-the-mother
#16
Natalie Batey, Charles W Yoxall, Joe A Fawke, Lelia Duley, Jon Dorling
Paediatric and adult resuscitation is often performed with family present. Current guidelines recommend deferred umbilical cord clamping as part of immediate neonatal care, requiring neonatal assessment next to the mother. This paper describes strategies for providing care beside the mother using both standard resuscitation equipment and a trolley designed for this purpose.
July 27, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28750883/delayed-return-of-spontaneous-circulation-the-lazarus-phenomenon-after-cessation-of-out-of-hospital-cardiopulmonary-resuscitation
#17
Markku Kuisma, Ari Salo, Jyrki Puolakka, Jouni Nurmi, Hetti Kirves, Taneli Väyrynen, James Boyd
INTRODUCTION: The delayed return of spontaneous circulation (ROSC) after cessation of cardiopulmonary resuscitation (CPR), also known as the Lazarus phenomenon, is a rare event described in several case reports. This study aims to determine the incidence and the time of occurrence of the Lazarus phenomenon after cessation of out-of-hospital CPR. METHODS: This prospective observational cohort study was conducted in the Helsinki Emergency Medical Service in Finland from 1 January 2011 through 31 December 2016...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28743232/emergency-medical-service-provider-decision-making-in-out-of-hospital-cardiac-arrest-an-exploratory-study
#18
J Brandling, K Kirby, S Black, S Voss, J Benger
BACKGROUND: There are approximately 60,000 out-of-hospital cardiac arrests (OHCA) in the United Kingdom (UK) each year. Within the UK there are well-established clinical practice guidelines that define when resuscitation should be commenced in OHCA, and when resuscitation should cease. Background literature indicates that decision-making in the commencement and cessation of resuscitation efforts in OHCA is complex, and not comprehensively understood. No relevant research from the UK has been published to date and this research study seeks to explore the influences on UK Emergency Medical Service (EMS) provider decision-making when commencing and ceasing resuscitation attempts in OHCA...
July 25, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28742911/targeted-temperature-management-for-48-vs-24-hours-and-neurologic-outcome-after-out-of-hospital-cardiac-arrest-a-randomized-clinical-trial
#19
RANDOMIZED CONTROLLED TRIAL
Hans Kirkegaard, Eldar Søreide, Inge de Haas, Ville Pettilä, Fabio Silvio Taccone, Urmet Arus, Christian Storm, Christian Hassager, Jørgen Feldbæk Nielsen, Christina Ankjær Sørensen, Susanne Ilkjær, Anni Nørgaard Jeppesen, Anders Morten Grejs, Christophe Henri Valdemar Duez, Jakob Hjort, Alf Inge Larsen, Valdo Toome, Marjaana Tiainen, Johanna Hästbacka, Timo Laitio, Markus B Skrifvars
Importance: International resuscitation guidelines recommend targeted temperature management (TTM) at 33°C to 36°C in unconscious patients with out-of-hospital cardiac arrest for at least 24 hours, but the optimal duration of TTM is uncertain. Objective: To determine whether TTM at 33°C for 48 hours results in better neurologic outcomes compared with currently recommended, standard, 24-hour TTM. Design, Setting, and Participants: This was an international, investigator-initiated, blinded-outcome-assessor, parallel, pragmatic, multicenter, randomized clinical superiority trial in 10 intensive care units (ICUs) at 10 university hospitals in 6 European countries...
July 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28742548/association-between-survival-and-time-of-day-for-rapid-response-team-calls-in-a-national-registry
#20
Matthew Michael Churpek, Dana P Edelson, Ji Yeon Lee, Kyle Carey, Ashley Snyder
OBJECTIVES: Decreased staffing at nighttime is associated with worse outcomes in hospitalized patients. Rapid response teams were developed to decrease preventable harm by providing additional critical care resources to patients with clinical deterioration. We sought to determine whether rapid response team call frequency suffers from decreased utilization at night and how this is associated with patient outcomes. DESIGN: Retrospective analysis of a prospectively collected registry database...
July 22, 2017: Critical Care Medicine
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