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https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#1
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29769006/role-of-cardiac-catheterization-lab-post-resuscitation-in-patients-with-st-elevation-myocardial-infarction
#2
Sridhar Reddy, Kwan S Lee, Karl Kern, Kapildeo Lotun
BACKGROUND: Cardiac arrest remains a common and lethal condition associated with high morbidity and mortality. Even with improving survival rates, the successfully resuscitated post cardiac arrest patient is also at risk for poor neurological outcomes, functional status and long- term survival if not managed appropriately. Given that acute coronary occlusion has been found to be the leading cause of cardiac arrest, long-term prognosis is good in selected patients after successful out-of-hospital resuscitation and ST elevation myocardial infarction who are taken for immediate coronary angiography, treated with primary percutaneous coronary intervention and hypothermia when indicated...
May 16, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29764556/-extra-longtime-continuous-chest-compression-to-rescue-cardiopulmonary-arrest-a-case-report-and-the-literature-review
#3
Yan Zhang, Tianxue Yue, Kexin Sun, Jiang Wang, Ruiwu Zhu
The new cardiopulmonary resuscitation (CPR) guideline emphasize the importance of chest compression, which was considered as the first step to CPR. The duration for CPR is usually limited to 30 minutes. With the development of new technology and evidence-based medicine, the success of extra longtime CPR has become possible, which is of great significance to some patients with cardiac arrest (CA), but the time limit has not been determined. On February 23rd in 2016, a 76-year-old female patient with respiratory and cardiac arrest who was on the third day after transurethral resection of bladder tumor (TUR-BT) was admitted to the intensive care unit of the General Hospital of Fushun Mining Bureau...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29764540/-2018-national-consensus-on-cardiopulmonary-resuscitation-training-in-china
#4
Lixiang Wang, Qingyi Meng, Tao Yu
To promote the technical training and scientific popularization of cardiopulmonary resuscitation (CPR) in China, the Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association combined with the Science Popularization Branch of the Chinese Medical Association wrote "2018 National consensus on cardiopulmonary resuscitation training in China". The formation was based on the general outline about "2016 National consensus on cardiopulmonary resuscitation in China", and to implement the important strategies included the "three pre" policy, prevention, precognition, and pre-warning, before the cardiac arrest (CA); the "three modernization" methods, standardized, diversified and individualized, during the CA; and the "three life" strategies, the rebirth, the extra and the extended, after the CA; and also combined with the concrete National conditions and clinical practice of China area...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29763391/should-trauma-physicians-treat-a-severely-injured-patient-for-the-sake-of-elucidating-preferences-about-organ-donation
#5
Sandra R DiBrito, Macey L Henderson
Organ donation potential is not a motivator of care in the trauma bay, and it is ethically problematic to consider organ donor potential during the active resuscitation of a trauma patient. Despite organ donation being a public good, the role of the trauma physician is to maintain focus on the patient as an individual and to respect a patient's right to life and autonomy. This tenet of medicine is the foundation of the trust that a community and individuals must have in order for the health care system to function...
May 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29755795/double-bolus-alteplase-therapy-during-cardiopulmonary-resuscitation-for-cardiac-arrest-due-to-massive-pulmonary-embolism-guided-by-focused-bedside-echocardiography
#6
Hafiz B Mahboob, Bruce W Denney
Massive pulmonary embolism (PE) frequently leads to cardiac arrest (CA) which carries an extremely high mortality rate. Although available, randomized trials have not shown survival benefits from thrombolytic use. Thrombolytics however have been used successfully during resuscitation in clinical practice in multiple case reports and in retrospective studies. Recent resuscitation guidelines recommend using alteplase for PE related CA; however they do not offer a standardized treatment regimen. The most consistently applied approach is an intravenous bolus of 50 mg tissue plasminogen activator (t-PA) early during cardiopulmonary resuscitation (CPR)...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29754417/teaching-paediatric-basic-life-support-in-medical-schools-using-peer-teaching-or-video-demonstration-a-prospective-randomised-trial
#7
Frederik Stephan, Hanjo Groetschel, Anja K Büscher, Deniz Serdar, Kjell A Groes, Rainer Büscher
AIM: The outcome of children with an out-of-hospital cardiac arrest is still poor, but bystander cardiopulmonary resuscitation can increase survival and minimise severe neurological sequelae. While teaching basic life support is standardised in emergency medicine classes, paediatric basic life support (PBLS) in neonates and toddlers is under-represented in paediatric curricula during university education. The appropriate mixture of E-learning and peer teaching lessons remains controversial in teaching paediatric basic skills...
May 13, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29753856/analysis-of-bystander-cpr-quality-during-out-of-hospital-cardiac-arrest-using-data-derived-from-automated-external-defibrillators
#8
Shannon M Fernando, Christian Vaillancourt, Stanley Morrow, Ian G Stiell
BACKGROUND: Little is known regarding the quality of cardiopulmonary resuscitation (CPR) performed by bystanders in out-of-hospital cardiac arrest (OHCA). We sought to determine quality of bystander CPR provided during OHCA using CPR quality data stored by Automated External Defibrillators (AEDs). METHODS: We used the Resuscitation Outcomes Consortium database to identify OHCA cases of presumed cardiac etiology where an AED was utilized. We then matched AED data to each case identified...
May 10, 2018: Resuscitation
https://www.readbyqxmd.com/read/29746985/theoretical-personalized-optimum-chest-compression-point-can-be-determined-using-posteroanterior-chest-radiography
#9
Sunho Cho, Won Sup Oh, Sung-Bin Chon, Shinwoo Kim, Keunha Hwang
AIM: Cardiopulmonary resuscitation guidelines suggest the lower sternal half be compressed. However, stroke volume has been assumed to be maximized by compressing the 'point' (P_max.LV) beneath which the left ventricle (LV) is at its maximum diameter. Identifying 'personalized' P_max.LV on computed tomography (CT), we derived and validated rules to estimate P_max.LV using posteroanterior chest radiography (chest_PA). METHODS: A retrospective, cross-sectional study was performed with non-cardiac arrest (CA) adults who underwent chest_PA and CT within 1h (derivation:validation = 3:2)...
May 7, 2018: Resuscitation
https://www.readbyqxmd.com/read/29743764/definition-of-terms-used-in-limitation-of-treatment-and-providing-palliative-care-at-the-end-of-life-the-indian-council-of-medical-research-commission-report
#10
Naveen Salins, Roop Gursahani, Roli Mathur, Shivakumar Iyer, Stanley Macaden, Nagesh Simha, Raj Kumar Mani, M R Rajagopal
Background: Indian hospitals, in general, lack policies on the limitation of inappropriate life-sustaining interventions at the end of life. To facilitate discussion, preparation of guidelines and framing of laws, terminologies relating to the treatment limitation, and providing palliative care at the end-of-life care (EOLC) need to be defined and brought up to date. Methodology: This consensus document on terminologies and definitions of terminologies was prepared under the aegis of the Indian Council of Medical Research...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29739857/how-ventilation-is-delivered-during-cardiopulmonary-resuscitation-an-international-survey
#11
Ricardo Luiz Cordioli, Laurent Brochard, Laurent Suppan, Aissam Lyazidi, François Templier, Abdo Khoury, Stephane Delisle, Dominique Savary, Jean-Christophe Richard
BACKGROUND: Recommendations regarding ventilation during cardiopulmonary resuscitation (CPR) are based on a low level of scientific evidence. We hypothesized that practices about ventilation during CPR might be heterogeneous and may differ worldwide. To address this question, we surveyed physicians from several countries on their practices during CPR. METHODS: We used a Web-based opinion survey. Links to the survey were sent by e-mail newsletters and displayed on the Web sites of medical societies involved in CPR practice from December 2013 to March 2014...
May 8, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29737261/coronary-catheterization-laboratory-role-for-post-resuscitation-care-without-st-elevation-myocardial-infarction
#12
Kris Kumar, Kapildeo Lotun
Out of hospital cardiac arrest management of patients with non-ST myocardial infarction per current American Heart Association and European Resuscitation Council guidelines leave the decision in regard to early angiography up to the physician operators. Guidelines are clear on the positive impact of early intervention on survival and improvement on left ventricular function in patients presenting with cardiac arrest and ST elevation myocardial infarction on electrocardiogram. This review aims to analyze the data that current guidelines are based upon in regards to out of hospital cardiac arrest with electrocardiogram findings of non-ST elevation myocardial infarction as well as other clinical trials that support early angiography and reperfusion strategies as well as future studies that are in trial to study the role of the coronary catheterization laboratory in cardiac arrest...
May 7, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29737260/targeted-temperature-management-review-of-literature-and-guidelines-a-cardiologist-s-perspective
#13
Taimoor Hashim, Ranjith Shetty
Out of hospital cardiac arrest (OHCA) remains not an uncommon occurrence in USA and rest of the world. However, the survival to discharge following an episode of OHCA in adults is still very disappointing at around 10%. Several areas of improvement including education of general public in early Cardio Pulmonary resuscitation (CPR) by bystander, chest compression first, and improvement of Emergency Medical response time have had a positive effect in outcomes and survival but much still needs to be done. Recently new data has emerged with regards to post resuscitation care and mild induced hypothermia (now preferably called; targeted temperature management {TTM}) and several advances have been made...
May 7, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29730774/in-flight-cardiac-arrest-and-in-flight-cardiopulmonary-resuscitation-during-commercial-air-travel-consensus-statement-and-supplementary-treatment-guideline-from-the-german-society-of-aerospace-medicine-dglrm
#14
Jochen Hinkelbein, Lennert Böhm, Stefan Braunecker, Harald V Genzwürker, Steffen Kalina, Fabrizio Cirillo, Matthieu Komorowski, Andreas Hohn, Jörg Siedenburg, Michael Bernhard, Ilse Janicke, Christoph Adler, Stefanie Jansen, Eckard Glaser, Pawel Krawczyk, Mirko Miesen, Janusz Andres, Edoardo De Robertis, Christopher Neuhaus
By the end of the year 2016, approximately 3 billion people worldwide travelled by commercial air transport. Between 1 out of 14,000 and 1 out of 50,000 passengers will experience acute medical problems/emergencies during a flight (i.e., in-flight medical emergency). Cardiac arrest accounts for 0.3% of all in-flight medical emergencies. So far, no specific guideline exists for the management and treatment of in-flight cardiac arrest (IFCA). A task force with clinical and investigational expertise in aviation, aviation medicine, and emergency medicine was created to develop a consensus based on scientific evidence and compiled a guideline for the management and treatment of in-flight cardiac arrests...
May 5, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29728116/implications-for-paediatric-shock-management-in-resource-limited-settings-a-perspective-from-the-feast-trial
#15
Kirsty Anne Houston, Elizabeth C George, Kathryn Maitland
BACKGROUND: Although the African "Fluid Expansion as Supportive therapy" (FEAST) trial showed fluid resuscitation was harmful in children with severe febrile illness managed in resource-limited hospitals, the most recent evidence reviewed World Health Organization (WHO) guidelines continue to recommend fluid boluses in children with shock according to WHO criteria "WHO shock", arguing that the numbers included in the FEAST trial were too small to provide reasonable certainty...
May 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29713000/effects-of-inhaled-nitric-oxide-on-outcome-after-prolonged-cardiac-arrest-in-mild-therapeutic-hypothermia-treated-rats
#16
Anne Brücken, Christian Bleilevens, Philipp Berger, Kay Nolte, Nadine T Gaisa, Rolf Rossaint, Gernot Marx, Matthias Derwall, Michael Fries
Guidelines endorse targeted temperature management to reduce neurological sequelae and mortality after cardiac arrest (CA). Additional therapeutic approaches are lacking. Inhaled nitric oxide (iNO) given post systemic ischemia/reperfusion injury improves outcomes. Attenuated inflammation by iNO might be crucial in brain protection. iNO augmented mild therapeutic hypothermia (MTH) may improve outcome after CA exceeding the effect of MTH alone. Following ten minutes of CA and three minutes of cardiopulmonary resuscitation, 20 male Sprague-Dawley rats were randomized to receive MTH at 33 °C for 6hrs or MTH + 20ppm iNO for 5hrs; one group served as normothermic control...
April 30, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29706236/ilcor-scientific-knowledge-gaps-and-clinical-research-priorities-for-cardiopulmonary-resuscitation-and-emergency-cardiovascular-care-a-consensus-statement
#17
Monica E Kleinman, Gavin D Perkins, Farhan Bhanji, John E Billi, Janet E Bray, Clifton W Callaway, Allan de Caen, Judith C Finn, Mary Fran Hazinski, Swee Han Lim, Ian Maconochie, Vinay Nadkarni, Robert W Neumar, Nikolaos Nikolaou, Jerry P Nolan, Amelia Reis, Alfredo F Sierra, Eunice M Singletary, Jasmeet Soar, David Stanton, Andrew Travers, Michelle Welsford, David Zideman
Despite significant advances in the field of resuscitation science, important knowledge gaps persist. Current guidelines for resuscitation are based on the International Liaison Committee on Resuscitation 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, which includes treatment recommendations supported by the available evidence. The writing group developed this consensus statement with the goal of focusing future research by addressing the knowledge gaps identified during and after the 2015 International Liaison Committee on Resuscitation evidence evaluation process...
April 25, 2018: Resuscitation
https://www.readbyqxmd.com/read/29700123/ilcor-scientific-knowledge-gaps-and-clinical-research-priorities-for-cardiopulmonary-resuscitation-and-emergency-cardiovascular-care-a-consensus-statement
#18
REVIEW
Monica E Kleinman, Gavin D Perkins, Farhan Bhanji, John E Billi, Janet E Bray, Clifton W Callaway, Allan de Caen, Judith C Finn, Mary Fran Hazinski, Swee Han Lim, Ian Maconochie, Vinay Nadkarni, Robert W Neumar, Nikolaos Nikolaou, Jerry P Nolan, Amelia Reis, Alfredo F Sierra, Eunice M Singletary, Jasmeet Soar, David Stanton, Andrew Travers, Michelle Welsford, David Zideman
Despite significant advances in the field of resuscitation science, important knowledge gaps persist. Current guidelines for resuscitation are based on the International Liaison Committee on Resuscitation 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, which includes treatment recommendations supported by the available evidence. The writing group developed this consensus statement with the goal of focusing future research by addressing the knowledge gaps identified during and after the 2015 International Liaison Committee on Resuscitation evidence evaluation process...
April 26, 2018: Circulation
https://www.readbyqxmd.com/read/29693940/the-peas-protocol-an-airway-ultrasound-technique
#19
Akihiro Suzuki
In the past ultrasound identification of the airway structure was rather difficult However, recent advancement of the high frequency linear type transducer allows us to visualize airway structure easily. Accordingly, now we have difficult airway society guideline 2015. resuscitation guideline 2015, and Australia and New Zealand Intensive Care Society guidelines for percutaneous dilatational tracheostomy which recommend use of ultrasound in airway management Airway ultrasound is an emerging technique for all physicians, and the author introduces perioperative evaluation of the airway via sonography, the PEAS protocol...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29689353/comparison-of-optimal-point-on-the-sternum-for-chest-compression-between-obese-and-normal-weight-individuals-with-respect-to-body-mass-index-using-computer-tomography-a-retrospective-study
#20
Juncheol Lee, Jaehoon Oh, Tae Ho Lim, Hyunggoo Kang, Jung Hwan Park, Soon Young Song, Ga Hye Shin, Yeongtak Song
BACKGROUND: Abdominal fatty tissue deposition in obese individuals could alter the proper hand position for chest compression during cardiopulmonary resuscitation, similar to that in pregnant women. This study aimed to identify the difference in body mass index between obese and normal weight individuals by measuring the optimal point of maximal left ventricular diameter (OPLV ), using computed tomography (CT). METHODS: We performed a retrospective analysis of chest CT scans between January 2012 and August 2016 and measured the sternal length and OPLV and estimated the ratio of OPLV to that individual sternal length...
April 21, 2018: Resuscitation
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