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https://www.readbyqxmd.com/read/29907267/critical-care-airway-management
#1
REVIEW
Etieno U Umobong, Paul H Mayo
Critical care airway management is associated with a variety of complications, including severe oxygen desaturation, life-threatening hypotension, and death. This article reviews aspects of airway management that are relevant to intensivists and emergency medicine clinicians tasked with improving the quality of urgent endotracheal intubation in the critically ill patient.
July 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29903639/focused-transthoracic-echocardiography-curriculum-for-advanced-practice-providers-assures-good-concordance-with-intensivists-at-echocardiography
#2
Jose L Diaz-Gomez, Ami A Grek, Carla P Venegas-Borsellino, Andreea C Chirila, Angela M Builes, Robert A Ratzlaff
OBJECTIVE: To describe a focused transthoracic echocardiography (FoTE) curriculum for advanced practice providers (APPs) for echocardiography-driven diagnosis of shock in critically ill patients. METHODS: Twelve APPs in 4 intensive care units at an academic medical center received didactic sessions on FoTE, including 1-on-1 proctorship with a registered cardiac sonographer. For a period of 6 months the trainees performed individual studies, then they performed FoTE examinations on critically ill patients; their diagnoses were compared with those of experienced intensivists for the same patients...
June 11, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29902555/inter-rater-agreement-of-intensivists-evaluating-the-goal-concordance-of-preference-sensitive-icu-interventions
#3
Alison E Turnbull, Sarina K Sahetya, Elizabeth Colantuoni, Josephine Kweku, Roozbeh Nikooie, J Randall Curtis
CONTEXT: Goal-concordant care has been identified as an important outcome of advance care planning and shared decision-making initiatives. However validated methods for measuring goal-concordance are needed. OBJECTIVES: To estimate the inter-rater reliability of senior critical care fellows rating the goal-concordance of preference-sensitive interventions performed in intensive care units (ICUs) while considering patient-specific circumstances as described in a previously-proposed methodology...
June 11, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29895296/thrombocytopenia-in-the-icu-disseminated-intravascular-coagulation-and-thrombotic-microangiopathies-what-intensivists-need-to-know
#4
EDITORIAL
Jean-Louis Vincent, Pedro Castro, Beverley J Hunt, Achim Jörres, Manuel Praga, Jose Rojas-Suarez, Eizo Watanabe
No abstract text is available yet for this article.
June 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29894253/on-foreign-soil-anaesthetists-at-the-surgical-multidisciplinary-team-meeting
#5
David Timbrell, Pradeep Prabhu
Decision making through multidisciplinary teams offers an opportunity to improve perioperative care for high-risk surgical patients. While multidisciplinary team decision making is commonplace in the NHS, involvement of perioperative physicians including anaesthetists and intensivists in this process is not well established. This article presents an exemplar of anaesthetic and intensivist involvement in a joint perioperative upper gastrointestinal cancer multidisciplinary team meeting at the Royal Surrey County Hospital in Guildford, UK...
June 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29890556/-management-of-clostridium-difficile-infections-at-german-intensive-care-units-results-from-a-survey-among-intensivists
#6
Jan Bruensing, Lukas Buendgens, Christoph Jochum, Ulf Herbers, Ali Canbay, Georg Braun, Christian Trautwein, Wolfgang Huber, Alexander Koch, Frank Tacke
BACKGROUND:  Clostridium difficile associated colitis is a frequent cause of nosocomial diarrhea at the intensive care unit (ICU) and is associated with poor prognosis in critically ill patients. Few studies have evaluated the efficacy of treatment options or adherence to guideline recommendations of Clostridium difficile infections at the ICU. METHODS:  Therefore, on behalf of the Gastroenterology Intensive Care Medicine working group of the DGVS, we have conducted an online-based survey among leading intensivists in Germany...
June 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29887705/outcome-of-pancreaticoduodenectomy-at-low-volume-centre-in-tier-ii-city-of-india
#7
Kumar Vinchurkar, Vishwanath M Pattanshetti, Manoj Togale, Santosh Hazare, Varadraj Gokak
Currently, pancreaticoduodenectomy (PD) is considered a common and feasibly performed surgery for periampullary tumours, but it is still a high-risk surgical procedure with potential morbidity and mortality rates. Previously, it was emphasised for the need of high-volume centres to perform specialised surgery such as PD. The authors have made an attempt to know the relation between low-volume centre and outcomes of PD. The study was conducted in a Tier-II city referral hospital located in Karnataka, India. A total of 37 patients with suspected periampullary neoplasms underwent surgical exploration with curative intent over a period of 4 years, i...
June 2018: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29878608/analysis-of-the-level-of-clinical-skills-of-physician-assistants-tested-with-simulated-intensive-care-patients
#8
Anneke J A H van Vught, Geert T W J van den Brink, Murielle G E C Hilkens, Jos A H van Oers
RATIONALE, AIMS, AND OBJECTIVES: Since adequate staffing in intensive care units (ICUs) is an increasing problem worldwide, we investigated whether physician assistants (PAs) are able to substitute medical residents (MR) in ICUs with at least the same quality of clinical skills. In this study, we analysed the level of clinical skills of PAs in direct comparison with those who traditionally performed these tasks, ie, MR with 6 to 24 months of work experience in the ICU. METHOD: Physician assistants and MRs in the ICUs were observed on their clinical skills by means of a simulated ICU comprising 2 scenarios on a human patient simulator with typical ICU cases...
June 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29877876/critical-care-echocardiography-and-outcomes-in-the-critically-ill
#9
Karan Singh, Paul Mayo
PURPOSE OF REVIEW: Critical care echocardiography offers a comprehensive assessment of cardiac anatomy and function performed by the intensivist at point of care. This has resulted in widespread use of critical care echocardiography in ICUs leading to the question if this increased usage has resulted in improved patient outcomes. RECENT FINDINGS: Recent studies have evaluated the role of critical care echocardiography in the ICU with an emphasis on establishing accurate diagnosis and measurement of haemodynamic variables...
June 4, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29877873/terrorist-attacks-in-paris-managing-mass-casualties-in-a-remote-trauma-center
#10
Florent Femy, Arnaud Follin, Philippe Juvin, Anne-Laure Feral-Pierssens
OBJECTIVE: On 13 November 2015, Paris was the target of multiple terrorist attacks responsible for a massive influx of casualties in emergency departments (EDs). Because of the activation of a local crisis plan and the arrival of extra staff, our capacities increased markedly. Our aim was to analyze whether our center, in this challenging context, efficiently managed this massive influx of patients. PATIENTS AND METHODS: We carried out a monocentric retrospective study...
June 5, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29875062/-glass-ceiling-for-women-in-academic-medicine-in-france
#11
C Rosso, A Leger, O Steichen
OBJECTIVE: To determine whether career development in academic medicine is more difficult for women than for men, and, if any, the nature and level of barriers to this progression. METHODS: Extraction of full-time medical staff in a Parisian hospital group, through the SIGAPS platform; an online questionnaire survey of career choices and barriers experienced by full-time male and female physicians. The study population comprises 181 hospital practitioners and 141 academic physicians (49 associate professors and 92 full professors)...
June 3, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29868526/commentary-echocardiographic-evaluation-of-pulmonary-pressures-and-right-ventricular-function-after-pediatric-cardiac-surgery-a-simple-approach-for-the-intensivist
#12
COMMENT
Stefan Kurath-Koller, Sabrina Schweintzger, Martin Köestenberger
No abstract text is available yet for this article.
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29845940/an-alternative-icu-staffing-model-implementation-of-the-non-physician-provider
#13
H G Kreeftenberg, J T Aarts, A de Bie, A J G H Bindels, A N Roos, P H J van der Voort
INTRODUCTION: Literature in Europe regarding implementation of nurse practitioners or physician assistants in the intensive care unit (ICU) is lacking, while some available studies indicate that this concept can improve the quality of care and overcome physician shortages on ICUs. The aim of this study is to provide insight on how a Dutch ICU implemented non-physician providers (NPP), besides residents, and what this staffing model adds to the care on the ICU. METHODS: This paper defines the training course and job description of NPPs on a Dutch ICU...
May 2018: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29808412/point-of-care-ultrasonography-in-brazilian-intensive-care-units-a-national-survey
#14
José Augusto Santos Pellegrini, Ricardo Luiz Cordioli, Ana Cristina Burigo Grumann, Patrícia Klarmann Ziegelmann, Leandro Utino Taniguchi
BACKGROUND: Point-of-care ultrasonography (POCUS) has recently become a useful tool that intensivists are incorporating into clinical practice. However, the incorporation of ultrasonography in critical care in developing countries is not straightforward. METHODS: Our objective was to investigate current practice and education regarding POCUS among Brazilian intensivists. A national survey was administered to Brazilian intensivists using an electronic questionnaire...
April 20, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29796066/the-ultrasound-neck-imaging-for-tracheostomy-study-a-study-prompting-ultrasound-screening-prior-to-percutaneous-tracheostomy-procedures-to-improve-patient-outcomes
#15
James Rees, Yumna Haroon, Christopher Hogan, Shibaji Saha, Sharam Derekshani
Introduction: Percutaneous tracheostomy procedures are commonplace in intensive care units worldwide. Haemorrhagic complications, though potentially fatal, are thought to be under-reported. Ultrasonography use has not established itself in these procedures. This study assesses the prevalence and characteristics of pre-tracheal blood vessels, to aid intensivists on potential procedural hazards. Method: A retrospective, observational study was performed in the UK...
May 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29792461/teamwork-in-the-intensive-care-unit
#16
Jennifer N Ervin, Jeremy M Kahn, Taya R Cohen, Laurie R Weingart
Intensive care units (ICUs) provide care to the most severely ill hospitalized patients. Although ICUs increasingly rely on interprofessional teams to provide critical care, little about actual teamwork in this context is well understood. The ICU team is typically comprised of physicians or intensivists, clinical pharmacists, respiratory therapists, dieticians, bedside nurses, clinical psychologists, and clinicians-in-training. ICU teams are distinguished from other health care teams in that they are low in temporal stability, which can impede important team dynamics...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29788796/off-hours-admissions-and-mortality-in-picu-without-24-hour-onsite-intensivist-coverage
#17
Farah Chedly Thabet, Faisal Ahmed alHaffaf, Iheb Mohamed Bougmiza, Hend Ali Bafaqih, May Said Chehab, Sulaiman Abdulkareem alMohaimeed
OBJECTIVE: To evaluate whether the off-hours admission has any effect on risk-adjusted mortality and length of stay for nonelective patients admitted to a pediatric intensive care unit (PICU) without 24-hour in-house intensivist coverage. DESIGN: Prospective cohort study. SETTING: A 34-bed tertiary PICU. PATIENTS: All consecutive nonelective patients aged 0 to 14 years admitted from January 2012 to June 2015. MEASUREMENTS AND MAIN RESULTS: A total of 1254 patients were nonelectively admitted to the PICU...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29787412/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-in-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#18
Xiang Si, Hailin Xu, Zimeng Liu, Jianfeng Wu, Daiyin Cao, Juan Chen, Minying Chen, Yongjun Liu, Xiangdong Guan
BACKGROUND: We performed a systematic review and meta-analysis of studies investigating the diagnostic accuracy of respiratory variation in inferior vena cava diameter (ΔIVC) for predicting fluid responsiveness in patients receiving mechanical ventilation. METHODS: MEDLINE, EMBASE, the Cochrane Library, and Web of Science were screened from inception to February 2017. The meta-analysis assessed the pooled sensitivity, specificity, diagnostic odds ratio, and area under the receiver operating characteristic curve...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29780789/a-fundamentals-train-the-trainer-approach-to-building-pediatric-critical-care-expertise-in-the-developing-world
#19
Sheri S Crow, Beth A Ballinger, Mariela Rivera, David Tsibadze, Nino Gakhokidze, Nino Zavrashvili, Matthew J Ritter, Grace M Arteaga
Pediatric Fundamental Critical Care Support (PFCCS) is an educational tool for training non-intensivists, nurses, and critical care practitioners in diverse health-care settings to deal with the acute deterioration of pediatric patients. Our objective was to evaluate the PFCCS course as a tool for developing a uniform, reproducible, and sustainable model for educating local health-care workers in the optimal management of critically ill children in the Republic of Georgia. Over a period of 18 months and four visits to the country, we worked with Georgian pediatric critical care leadership to complete the following tasks: (1) survey health-care needs within the Republic of Georgia, (2) present representative PFCCS lectures and simulation scenarios to evaluate interest and obtain "buy-in" from key stakeholders throughout the Georgian educational infrastructure, and (3) identify PFCCS instructor candidates...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29762403/look-homeward-intensivist
#20
Kyan C Safavi, Edward A Bittner
No abstract text is available yet for this article.
June 2018: Critical Care Medicine
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