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https://www.readbyqxmd.com/read/29350383/which-position-should-we-take-during-newborn-resuscitation-a-prospective-randomized-multicentre-simulation-trial
#1
Jacek Smereka, Halla Kaminska, Wojciech Wieczorek, Marek Dabrowski, Jerzy Robert Ladny, Kurt Ruetzler, Lukasz Szarpak, Oliver Robak, Michael Frass
BACKGROUND: Early bystander cardiopulmonary resuscitation (CPR) for cardiac arrest is crucial in the chain of survival. Cardiac arrest in infants is rare but CPR is also performed in severe bradycardia. The European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines recommend starting CPR and continuing it until the heart muscle is sufficiently oxygenated and regains sufficient contractility and function. Among the techniques of CPR that can be applied in newborns, the most common and therefore recommended by the ERC and AHA are the two-finger technique and two-thumb technique...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29347956/what-should-be-included-in-the-assessment-of-laypersons-paediatric-basic-life-support-skills-results-from-a-delphi-consensus-study
#2
Asbjørn Børch Hasselager, Torsten Lauritsen, Tim Kristensen, Cathrine Bohnstedt, Claus Sønderskov, Doris Østergaard, Martin Grønnebæk Tolsgaard
BACKGROUND: Assessment of laypersons' Paediatric Basic Life Support (PBLS) skills is important to ensure acquisition of effective PBLS competencies. However limited evidence exists on which PBLS skills are essential for laypersons. The same challenges exist with respect to the assessment of foreign body airway obstruction management (FBAOM) skills. We aimed to establish international consensus on how to assess laypersons' PBLS and FBAOM skills. METHODS: A Delphi consensus survey was conducted...
January 18, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29346233/video-recordings-to-analyze-preventable-management-errors-in-pediatric-resuscitation-bay
#3
Julia Borns, Jörg Ersch, Milana Dobrovoljac, Georg Staubli, Barbara Brotschi
OBJECTIVE: In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. METHODS: Video recording of all patients admitted to the pediatric resuscitation bay at University Children's Hospital Zurich during a 13-month period was performed...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29340725/decision-making-in-management-of-the-complex-trauma-patient-changing-the-mindset-of-the-non-trauma-surgeon
#4
Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark, Klas Karlgren
BACKGROUND: European surgeons are frequently subspecialized and trained primarily in elective surgical techniques. As trauma leaders, they may occasionally have to deal with complex polytrauma, advanced management techniques, differing priorities, and the need for multidisciplinary care. There is a lack of expertise, experience, and a low trauma volume, as well as a lack of research, with limited support as to the decision-making and teaching challenges present. We studied what experienced trauma experts describe as the challenges that are specific to the advanced surgical decision-making required, whether civilian, humanitarian, or military...
January 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29338148/novel-applications-of-bedside-monitoring-to-plumb-patient-hemodynamic-state-and-response-to-therapy
#5
Fabio Guarracino, Pietro Bertini, Michael R Pinsky
Hemodynamic monitoring is essential during the treatment of the critically ill in order to address the hemodynamic alterations and assess the response to treatment. Traditionally classified causes of shock and underlying pathophysiological mechanisms are often neglected by resuscitative strategies included in the guidelines. Most of hemodynamic management focuses on the ability to early recognise patients susceptible to increase cardiac output (CO) and mean arterial pressure (MAP) after a defined fluid challenge by eliciting Starling's law of the heart, and less is known of the ones presenting in shock and not volume responsive...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29336239/early-prognosis-and-predictor-analysis-for-positive-coronary-angiography-after-out-of-hospital-cardiac-arrest-ohca
#6
Julien Higny, Antoine Guédès, Jacques Jamart, Claude Hanet, Laurence Gabriel, Vincent Dangoisse, Christophe de Meester de Ravenstein, Erwin Schroeder
BACKGROUND: Key predictors of survival after OHCA have been described in the literature. Current guidelines recommend emergency angiography in patients without an obvious extra-cardiac cause of arrest. However, the value of this strategy is debated. Moreover, diagnosis of acute coronary ischaemia after OHCA remains challenging, especially in patients without ST-segment elevation. OBJECTIVES: The primary objective was to identify qualitative variables associated with an increased chance of 30-d survival after OHCA...
January 16, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#7
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29325592/magnesium-sulphate-for-fetal-neuroprotection-to-prevent-cerebral-palsy-mag-cp-implementation-of-a-national-guideline-in-canada
#8
Dane A De Silva, Anne R Synnes, Peter von Dadelszen, Tang Lee, Jeffrey N Bone, Laura A Magee
BACKGROUND: Evidence supports magnesium sulphate (MgSO4) for women at risk of imminent birth at < 32-34 weeks to reduce the likelihood of cerebral palsy in the child. MAGnesium sulphate for fetal neuroprotection to prevent Cerebral Palsy (MAG-CP) was a multifaceted knowledge translation (KT) strategy for this practice. METHODS: The KT strategy included national clinical practice guidelines, a national online e-learning module and, at MAG-CP sites, educational rounds, focus group discussions and surveys of barriers and facilitators...
January 11, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29321048/danish-first-aid-books-compliance-with-the-new-evidence-based-non-resuscitative-first-aid-guidelines
#9
Theo Walther Jensen, Thea Palsgaard Møller, Søren Viereck, Jens Roland, Thomas Egesborg Pedersen, Freddy K Lippert
BACKGROUND: The European Resuscitation Council (ERC) released new guidelines on resuscitation in 2015. For the first time, the guidelines included a separate chapter on first aid for laypersons. We analysed the current major Danish national first aid books to identify potential inconsistencies between the current books and the new evidence-based first aid guidelines. METHODS: We identified first aid books from all the first aid courses offered by major Danish suppliers...
January 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29320801/fatigue-during-chest-compression-using-a-neonatal-patient-simulator
#10
Diego Enriquez, Javier Meritano, Birju A Shah, Clara Song, Edgardo Szyld
OBJECTIVE:  The objective of this study was to evaluate chest compression (CC) quality and operator fatigue during CC, with coordinated ventilation, on a neonatal simulator and to explore its association with provider aerobic activity and body mass index. METHODS:  This was a prospective observational experimental study on pediatricians, neonatologists, and neonatal nurses who frequently deliver newborns and who have signed the informed consent. Subjects performed CC coordinated with ventilations at a ratio of 3:1 for 10 minutes on a neonatal mannequin...
January 10, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29317455/improving-temporal-trends-in-survival-and-neurological-outcomes-after-out-of-hospital-cardiac-arrest
#11
Jason E Buick, Ian R Drennan, Damon C Scales, Steven C Brooks, Adams Byers, Sheldon Cheskes, Katie N Dainty, Michael Feldman, P Richard Verbeek, Cathy Zhan, Alex Kiss, Laurie J Morrison, Steve Lin
BACKGROUND: Considerable effort has gone into improving outcomes from out-of-hospital cardiac arrest (OHCA). Studies suggest that survival is improving; however, prior studies had insufficient data to pursue the relationship between markers of guideline compliance and temporal trends. The objective of the study was to evaluate trends in OHCA survival over an 8-year period that included the implementation of the 2005 and 2010 international cardiopulmonary resuscitation (CPR) guidelines...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29315469/changes-in-colloid-solution-sales-in-nordic-countries
#12
U E Kongsgaard, A Holtan, A Perner
BACKGROUND: Administration of resuscitation fluid is a common intervention in the treatment of critically ill patients, but the right choice of fluid is still a matter of debate. Changes in medical practice are based on new evidence and guidelines as well as traditions and personal preferences. Official warnings against the use of hydroxyl-ethyl-starch (HES) solutions have been issued. Nordic guidelines have issued several strong recommendations favouring crystalloids over colloids in all patient groups...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29315458/implementation-and-effectiveness-of-a-video-based-debriefing-programme-for-neonatal-resuscitation
#13
C Skåre, T E Calisch, E Saeter, T Rajka, A M Boldingh, B Nakstad, D E Niles, J Kramer-Johansen, T M Olasveengen
BACKGROUND: Approximately 5%-10% of newly born babies need intervention to assist transition from intra- to extrauterine life. All providers in the delivery ward are trained in neonatal resuscitation, but without clinical experience or exposure, training competency is transient with a decline in skills within a few months. The aim of this study was to evaluate whether neonatal resuscitations skills and team performance would improve after implementation of video-assisted, performance-focused debriefings...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29313566/factors-influencing-high-quality-chest-compressions-during-cardiopulmonary-resuscitation-scenario-according-to-2015-american-heart-association-guidelines
#14
Halla Kaminska, Wojciech Wieczorek, Pawel Matysiuk, Lukasz Czyzewski, Jerzy Robert Ladny, Jacek Smereka, Krzysztof J Filipiak, Lukasz Szarpak
BACKGROUND AND AIM: Recent American Heart Association Guidelines from 2010 and 2015 year stressed the importance of high quality chest compression and define standards for compression rate, depth, recoil and maximal acceptable time for interruptions. High - quality cardiopulmonary resuscitation (CPR) is the "cornerstone" of a system of care that can optimize outcomes beyond return of spontaneous circulation Methods: 100 medical students were enrolled to the study. Study participants after Basic Life Support Course according to American Heart Association 2015 guidelines performed 2-min cardiopulmonary resuscitation on Resusci Anne® QCPR Manikin...
January 9, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29310974/sepsis-in-tropical-regions-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#15
Steven McGloughlin, Guy A Richards, Mohd Basri Mat Nor, Shirish Prayag, Tim Baker, Pravin Amin
Sepsis and septic shock in the tropics are caused by a wide array of organisms. These infections are encountered mainly in low and middle-income countries (LMIC) where a lack of infrastructure and medical facilities contribute to the high morbidity and mortality. Published sepsis guidelines are based on studies primarily performed in high income countries and as such recommendations may or may not be relevant to practice in the tropics. Failure to adhere to guidelines, particularly among non-intensive care specialists even in high-income countries, is an area of concern for sepsis management...
December 30, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29304308/acute-kidney-injury-and-sepsis
#16
Steven J Skube, Stephen A Katz, Jeffrey G Chipman, Christopher J Tignanelli
BACKGROUND: Worldwide, both acute kidney injury (AKI) and sepsis are significant clinical complications, particularly in critical care patients. Sepsis is an important cause of AKI, and AKI is a common complication of sepsis. METHODS: We reviewed the literature, including current practice guidelines, on sepsis-associated AKI. RESULTS: We assessed causes of renal failure, potential mechanisms of sepsis-associated acute kidney injury, current practice guidelines, diagnostic criteria and methods, prevention strategies, treatment options, and outcomes...
January 5, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29300273/self-confidence-and-level-of-knowledge-after-cardiopulmonary-resuscitation-training-in-14-to-18-year-old-schoolchildren-a-randomised-interventional-controlled-prospective-study-in-secondary-schools-in-germany
#17
Sabine Wingen, Daniel C Schroeder, Hannes Ecker, Susanne Steinhauser, Sibel Altin, Stephanie Stock, Alex Lechleuthner, Andreas Hohn, Bernd W Böttiger
BACKGROUND: Education of schoolchildren in cardiopulmonary resuscitation (CPR) is a strategic goal for improvement of bystander CPR in society. OBJECTIVE(S): The primary objective was to analyse the impact of CPR training on the resuscitation knowledge and self-confidence of secondary schoolchildren. In addition, independent predictors of improved CPR knowledge and self-confidence were investigated. DESIGN: Prospective, randomised-interventional controlled study...
January 2, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29295800/point-of-care-ultrasound-guided-percutaneous-cannulation-of-extracorporeal-membrane-oxygenation-make-it-simple
#18
Hong Joon Ahn, Jun Wan Lee, Ki Hyuk Joo, Yeon Ho You, Seung Ryu, Jin Woong Lee, Seung Whan Kim
BACKGROUND: Cannulation of the great vessels is required for extracorporeal membrane oxygenation (ECMO). Currently, there is no guideline for optimal imaging modalities during percutaneous cannulation of ECMO. OBJECTIVE: The purpose of this study was to describe percutaneous cannulation guided by point-of-care ultrasound (POCUS) for ECMO and compare it with fluoroscopy and landmark guidance. METHODS: Three groups (POCUS-, fluoroscopy-, and landmark-guided) of percutaneous cannulation for ECMO were analyzed retrospectively in a tertiary academic hospital...
December 30, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29289490/positive-end-expiratory-pressure-during-resuscitation-at-birth-in-very-low-birth-weight-infants-a-randomized-controlled-pilot-trial
#19
Ratchada Kitsommart, Kittaya Nakornchai, Buranee Yangthara, Ratchada Jiraprasertwong, Bosco Paes
BACKGROUND: There is limited evidence of the effect of positive end-expiratory pressure (PEEP) during resuscitation soon after birth. Premature neonates may experience respiratory distress from surfactant insufficiency and providing PEEP after the very first breath, may improve outcomes following appropriate resuscitation. The objective of this study was to evaluate the short term respiratory outcomes after positive pressure ventilation (PPV) with PEEP in preterm infants at birth. METHODS: A prospective randomized-controlled, pilot trial was conducted...
December 9, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29284892/resuscitation-of-a-newborn-with-right-hypoplastic-heart-syndrome-a-rare-confrontation-for-an-anesthesiologist
#20
Prachi Gaurang Kadam, Veena R Shah, Kishori Saikia, Rujal R Patel
According to newborn resuscitation guidelines, all referrals for neonates with suspected or confirmed duct-dependent congenital heart disease are to be discussed with pediatric cardiologist beforehand and are to be transferred immediately under their care for optimal management. However, in case of emergency, when there is not adequate time for preoperative consultations or a multidisciplinary approach, we should be able to manage these patients in the immediate perioperative period to decrease the likelihood of adverse outcome...
October 2017: Anesthesia, Essays and Researches
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