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https://www.readbyqxmd.com/read/27923115/a-comparison-of-the-universal-tor-guideline-to-the-absence-of-prehospital-rosc-and-duration-of-resuscitation-in-predicting-futility-from-out-of-hospital-cardiac-arrest
#1
Ian R Drennan, Erin Case, P Richard Verbeek, Joshua C Reynolds, Zachary D Goldberger, Jamie Jasti, Mark Charleston, Heather Herren, Ahamed H Idris, Paul R Leslie, Michael A Austin, Yan Xiong, Robert H Schmicker, Laurie J Morrison
INTRODUCTION: The Universal Termination of Resuscitation (TOR) Guideline accurately identifies potential out-of-hospital cardiac arrest (OHCA) survivors. However, implementation is inconsistent with some Emergency Medical Service (EMS) agencies using absence of return of spontaneous circulation (ROSC) as sole criterion for termination. OBJECTIVE: To compare the performance of the Universal TOR Guideline with the single criterion of no prehospital ROSC. Second, to determine factors associated with survival for patients transported without a ROSC...
December 3, 2016: Resuscitation
https://www.readbyqxmd.com/read/27918869/paramedic-initiated-cms-sepsis-core-measure-bundle-prior-to-hospital-arrival-a-stepwise-approach
#2
Jason G Walchok, Ronald G Pirrallo, Douglas Furmanek, Martin Lutz, Colt Shope, Brandi Giles, Greta Gue, Aaron Dix
BACKGROUND: To improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) implemented core measures that outline the initial treatment of the septic patient. These measures include initial blood culture collection prior to antibiotics, adequate intravenous fluid resuscitation, and early administration of broad spectrum antibiotics. We sought to determine if Paramedics can initiate the CMS sepsis core measure bundle in the prehospital field reliably. METHODS: This is a retrospective, case series from a 3rd service EMS system model in Greenville, South Carolina between November 17, 2014 and February 20, 2016...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27915124/a-literature-review-examining-the-barriers-to-the-implementation-of-family-witnessed-resuscitation-in-the-emergency-department
#3
REVIEW
Catherine Johnson
BACKGROUND: Caring for people near death in the Emergency Department (ED) is challenging for professionals, duty bound to respond to the needs of the dying. Family witnessed resuscitation (FWR) is practiced internationally, allowing relatives to be present at the time of a patient's death, offering comfort to the dying and aiding the bereaved along a healthy grief trajectory. AIM: The literature review elicits barriers to the implementation of FWR in the ED, examining why practice is sporadic despite numerous professional bodies calling for implementation...
November 30, 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#4
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27908910/hospital-variation-in-time-to-epinephrine-for-non-shockable-in-hospital-cardiac-arrest
#5
Rohan Khera, Paul S Chan, Michael W Donnino, Saket Girotra
BACKGROUND: -For patients with in-hospital cardiac arrests due to non-shockable rhythms, delays in epinephrine administration beyond 5 minutes is associated with worse survival. However, the extent of hospital variation in delayed epinephrine administration and its impact on hospital-level outcomes is unknown. METHODS: -Within Get with the Guidelines-Resuscitation, we identified 103,932 adult patients (≥18 years) at 548 hospitals with an in-hospital cardiac arrest due to a non-shockable rhythm who received at least 1 dose of epinephrine between 2000 to 2014...
December 1, 2016: Circulation
https://www.readbyqxmd.com/read/27908331/sepsis-resuscitation-in-resource-limited-settings
#6
REVIEW
Brian Meier, Catherine Staton
Our evolving understanding of the physiologic processes that lead to sepsis has led to updated consensus guidelines outlining priorities in the recognition and treatment of septic patients. However, an enormous question remains when considering how to best implement these guidelines in settings with limited resources, which include rural US emergency departments and low- and middle-income countries. The core principles of sepsis management should be a priority in community emergency departments. Similarly, cost-effective interventions are key priorities in low- and middle-income countries; however, consideration must be given to the unique challenges associated with such settings...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906192/thematic-analysis-of-barriers-and-facilitators-to-implementation-of-neonatal-resuscitation-guideline-changes
#7
H C Lee, V Arora, T Brown, A Lyndon
OBJECTIVE: To evaluate experiences regarding implementation of Neonatal Resuscitation Program (NRP) guideline changes in the context of a collaborative quality improvement (QI) project. STUDY DESIGN: Focus groups were conducted with local QI leaders and providers from nine sites that participated in a QI collaborative. Thematic analysis identified facilitators and barriers to implementation of NRP guideline changes and QI in general. RESULTS: Facilitators for QI included comparative process measurement and data tracking...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27903037/resuscitation-update-for-general-practitioners
#8
Hugh Grantham Asm, Rowena Christiansen
BACKGROUND: The latest changes to resuscitation guidelines in Australia were released in 2016. Few of the changes will have an impact on general practitioners (GPs) but there are some additional issues that they, as health professionals and leaders in the community, should be informed about. OBJECTIVE: The objective of this article is to provide an update for GPs on the current resuscitation guidelines. DISCUSSION: This article describes the latest changes in resuscitation recommendations in the fields of first aid, basic life support, advanced life support and paediatric resuscitation, with an emphasis on issues of particular relevance to GPs...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27897754/in-hospital-resuscitation
#9
Abby Morrow-Barnes
What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? This CPD article explored the Resuscitation Council UK guidelines for in-hospital resuscitation and considered their application to practice.
November 16, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27888429/inappropriateness-of-diagnostic-imaging-examinations-in-the-inpatient-setting-a-case-study-research
#10
Ettore Squillaci, Francesca Bolacchi, Jacopo Scaggiante, Francesca Ricci, Luca Pugliese, Alberto Bergamini, Francesco Garaci, Roberto Floris
OBJECTIVE: The purpose of our study was to audit the clinical appropriateness of the prescriptions of whole body CT (WB-CT), PET-CT and chest X-rays (CXRs) performed at Tor Vergata University Hospital in the inpatient setting. MATERIALS AND METHODS: WB-CT, PET-CT and CXRs examinations were retrospectively analysed in the period between January and December 2014. CXR examinations were divided into bedside CXRs and traditional CXRs. The appropriateness of the examinations was defined according the American College of Radiology Appropriateness Criteria...
November 25, 2016: La Radiologia Medica
https://www.readbyqxmd.com/read/27882326/ventricular-fibrillation-induced-cardiac-arrest-results-in-regional-cardiac-injury-preferentially-in-left-anterior-descending-coronary-artery-territory-in-piglet-model
#11
Giridhar Kaliki Venkata, John R Forder, Dan Clark, Andre Shih, Sharda Udassi, Srinivasarao Badugu, Melissa A Lamb, Stacy L Porvasnik, Renata S Shih, Dalia Colon-Lopez, Arno L Zaritsky, Ikram U Haque, Jai P Udassi
Objective. Decreased cardiac function after resuscitation from cardiac arrest (CA) results from global ischemia of the myocardium. In the evolution of postarrest myocardial dysfunction, preferential involvement of any coronary arterial territory is not known. We hypothesized that there is no preferential involvement of any coronary artery during electrical induced ventricular fibrillation (VF) in piglet model. Design. Prospective, randomized controlled study. Methods. 12 piglets were randomized to baseline and electrical induced VF...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27878801/strength-training-effects-on-quality-of-prolonged-basic-cardiopulmonary-resuscitation
#12
Cristian Abelairas-Gómez, Roberto Barcala-Furelos, Łukasz Szarpak, Óscar García-García, Álvaro Paz-Domínguez, Sergio López-García, Antonio Rodríguez-Núñez
BACKGROUND: Providing high-quality chest compressions and rescue breaths are a key elements affecting the effectiveness of cardiopulmonary resuscitation (CPR). AIM: To investigate the effects of a strength training program on the quality of prolonged in time basic cardiopulmonary resuscitation on a manikin. METHODS: This was a quasi-experimental.trial. Thirty-nine participants with prior basic life support knowledge were randomized to an experimental or control group...
November 23, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27876325/does-early-goal-directed-therapy-decrease-mortality-compared-with-standard-care-in-patients-with-septic-shock
#13
Michael E Winters, Robert Sherwin, Gary M Vilke, Gabriel Wardi
BACKGROUND: Current international guidelines for the treatment of patients with severe sepsis and septic shock recommend that patients receive targeted care to various physiologic endpoints, thereby optimizing tissue perfusion and oxygenation. These recommendations are primarily derived from a protocol published >15 years ago, which was viewed by many as complex and was therefore not widely adopted. Instead, many emergency physicians focused on the administration of early antibiotics, source control, aggressive fluid resuscitation, vasoactive medications as needed to maintain mean arterial blood pressure, and careful monitoring of these patients...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27876084/a-trial-to-determine-whether-septic-shock-reversal-is-quicker-in-pediatric-patients-randomized-to-an-early-goal-directed-fluid-sparing-strategy-versus-usual-care-squeeze-study-protocol-for-a-pilot-randomized-controlled-trial
#14
Melissa J Parker, Lehana Thabane, Alison Fox-Robichaud, Patricia Liaw, Karen Choong
BACKGROUND: Current pediatric septic shock resuscitation guidelines from the American College of Critical Care Medicine focus on the early and goal-directed administration of intravascular fluid followed by vasoactive medication infusions for persistent and fluid-refractory shock. However, accumulating adult and pediatric data suggest that excessive fluid administration is associated with worse patient outcomes and even increased risk of death. The optimal amount of intravascular fluid required in early pediatric septic shock resuscitation prior to the initiation of vasoactive support remains unanswered...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27873263/effects-of-volume-resuscitation-on-the-microcirculation-in-animal-models-of-lipopolysaccharide-sepsis-a-systematic-review
#15
REVIEW
Nchafatso G Obonyo, Jonathon P Fanning, Angela S Y Ng, Leticia P Pimenta, Kiran Shekar, David G Platts, Kathryn Maitland, John F Fraser
BACKGROUND: Recent research has identified an increased rate of mortality associated with fluid bolus therapy for severe sepsis and septic shock, but the mechanisms are still not well understood. Fluid resuscitation therapy administered for sepsis and septic shock targets restoration of the macro-circulation, but the pathogenesis of sepsis is complex and includes microcirculatory dysfunction. OBJECTIVE: The objective of the study is to systematically review data comparing the effects of different types of fluid resuscitation on the microcirculation in clinically relevant animal models of lipopolysaccharide-induced sepsis...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27866109/magnitude-of-temperature-elevation-is-associated-with-neurologic-and-survival-outcomes-in-resuscitated-cardiac-arrest-patients-with-postrewarming-pyrexia
#16
Anne V Grossestreuer, David F Gaieski, Michael W Donnino, Douglas J Wiebe, Benjamin S Abella
PURPOSE: Avoidance of pyrexia is recommended in resuscitation guidelines, including after treatment with targeted temperature management (TTM). Which aspects of postresuscitation pyrexia are harmful and modifiable have not been conclusively determined. MATERIALS AND METHODS: This retrospective multicenter registry study collected serial temperatures during 72 hours postrewarming to assess the relationship between 3 aspects of pyrexia (maximum temperature, pyrexia duration, timing of first pyrexia) and neurologic outcome (primary) and survival (secondary) at hospital discharge...
November 9, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27865553/the-need-for-personalized-resuscitation-guidelines-in-children-with-congenital-heart-disease
#17
EDITORIAL
Aditya K Kaza
No abstract text is available yet for this article.
October 24, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27858578/severe-cerebral-edema-following-nivolumab-treatment-for-pediatric-glioblastoma-case-report
#18
Xiao Zhu, Michael M McDowell, William C Newman, Gary E Mason, Stephanie Greene, Mandeep S Tamber
Nivolumab is an immune checkpoint inhibitor (ICI) currently undergoing Phase III clinical trials for the treatment of glioblastoma. The authors present the case of a 10-year-old girl with glioblastoma treated with nivolumab under compassionate-use guidelines. After the first dose of nivolumab the patient developed hemiparesis, cerebral edema, and significant midline shift due to severe tumor necrosis. She was managed using intravenous dexamethasone and discharged on a dexamethasone taper. The patient's condition rapidly deteriorated after the second dose of nivolumab, demonstrating hemiplegia, seizures, and eventually unresponsiveness with a fixed and dilated left pupil...
November 18, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27847811/effect-of-erythropoietin-on-postresuscitation-renal-function-in-a-swine-model-of-ventricular-fibrillation
#19
Charalampos Pantazopoulos, Nicoletta Iacovidou, Evangelia Kouskouni, Paraskevi Pliatsika, Apostolos Papalois, Georgios Kaparos, Dimitrios Barouxis, Panagiotis Vasileiou, Pavlos Lelovas, Olympia Kotsilianou, Ioannis Pantazopoulos, Georgios Gkiokas, Clara Garosa, Gavino Faa, Theodoros Xanthos
Purpose. To investigate the effect of EPO administration on postresuscitation renal function. Methods. Twenty-four female Landrace/Large-White piglets aged 10-15 weeks with average weight of 19 ± 2 kg were randomly assigned to 2 different groups of 12 subjects each. After the end of an 8-minute ventricular fibrillation, the control group (Group C) received saline as placebo, whereas the EPO group (Group E) received EPO 5000 U/kg. The animals were resuscitated according to the 2010 European Resuscitation Council Guidelines for Resuscitation...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27843049/acute-hospital-administration-of-amiodarone-and-or-lidocaine-in-shockable-patients-presenting-with-out-of-hospital-cardiac-arrest-a-nationwide-cohort-study
#20
Chien-Hua Huang, Ping-Hsun Yu, Min-Shan Tsai, Po-Ya Chuang, Tzung-Dau Wang, Chih-Yen Chiang, Wei-Tien Chang, Matthew Huei-Ming Ma, Chao-Hsiun Tang, Wen-Jone Chen
BACKGROUND: Terminating ventricular fibrillation (VF) or pulseless ventricular tachyarrhythmia (VT) is critical for successful resuscitation of patients with shockable cardiac arrest. In the event of shock-refractory VF, applicable guidelines suggest use of anti-arrhythmic agents. However, subsequent long-term outcomes remain unclear. A nationwide cohort study was therefore launched, examining 1-year survival rates in patients given amiodarone and/or lidocaine for cardiac arrest. METHODS: Medical records accruing between years 2004 and 2011 were retrieved from the Taiwan National Health Insurance Research Database (NHIRD) for review...
November 9, 2016: International Journal of Cardiology
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