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Emergency protocols

Danieli Parreira da Silva Stalisz da Paixão, Josemar Batista, Eliane Cristina Sanches Maziero, Francine Taporosky Alpendre, Marly Ryoko Amaya, Elaine Drehmer de Almeida Cruz
OBJECTIVE: To investigate compliance of national patient safety protocols in Emergency Care Units (UPA) of the Paraná State. METHOD: From April until September 2016, the exploratory stage of the action research was conducted on stratified sampling with 377 patients of eight units, with use of verification instrument of basic safety actions. RESULTS: The absence of systematic identification of patients, fall risk assessment and signaling and development of pressure injuries were evidenced...
2018: Revista Brasileira de Enfermagem
Natalia Lorenzo, Irene Mendez, Mikel Taibo, Gianfranco Martinis, Sara Badia, Guillermo Reyes, Rio Aguilar
BACKGROUND: Atrial fibrillation frequently affects patients with valvular heart disease. Ablation of atrial fibrillation during valvular surgery is an alternative for restoring sinus rhythm. OBJECTIVES: This study aimed to evaluate mid-term results of successful atrial fibrillation surgical ablation during valvular heart disease surgery, to explore left atrium post-ablation mechanics and to identify predictors of recurrence. METHODS: Fifty-three consecutive candidates were included...
March 19, 2018: Arquivos Brasileiros de Cardiologia
Muhammad Imran Din, Aneela Rani
The green fabrication of nanoparticles (NPs) by using plants as reducing and capping agents involves energy efficient, less toxic, safer and simpler pathways. These pathways have been related to the rational use of numerous substances in fabrication of NPs and synthetic strategies, which have been mainly discussed in this article. The subject matter of this review is to discuss how a chemist can follow the green chemistry principles in terms of selection of substances and protocols used for NPs fabrication...
March 21, 2018: Critical Reviews in Analytical Chemistry
David M Cline, Susan Silva, Caroline E Freiermuth, Victoria Thornton, Paula Tanabe
Introduction: Use of alternative venues to manage uncomplicated vaso-occlusive crisis (VOC), such as a day hospital (DH) or ED observation unit, for patients with sickle cell anemia, may significantly reduce admission rates, which may subsequently reduce 30-day readmission rates. Methods: In the context of a two-institution quality improvement project to implement best practices for management of patients with sickle cell disease (SCD) VOC, we prospectively compared acute care encounters for utilization of 1) emergency department (ED); 2) ED observation unit; 3) DH, and 4) hospital admission, of two different patient cohorts with SCD presenting to our two study sites...
March 2018: Western Journal of Emergency Medicine
Susann J Jarhult, Melissa L Howell, Isabelle Barnaure-Nachbar, Yuchiao Chang, Benjamin A White, Mary Amatangelo, David F Brown, Aneesh B Singhal, Lee H Schwamm, Scott B Silverman, Joshua N Goldstein
Introduction: Our goal was to assess whether use of a standardized clinical protocol improves efficiency for patients who present to the emergency department (ED) with symptoms of transient ischemic attack (TIA). Methods: We performed a structured, retrospective, cohort study at a large, urban, tertiary care academic center. In July 2012 this hospital implemented a standardized protocol for patients with suspected TIA. The protocol selected high-risk patients for admission and low/intermediate-risk patients to an ED observation unit for workup...
March 2018: Western Journal of Emergency Medicine
Jean-Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L'Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard, François Ravat, Sébastien Vergez, Julien Amour, Max Guillot
Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
Dawn Perez, Kath Peters, Lesley Wilkes, Gillian Murphy
BACKGROUND: Physical restraints (PRs) are commonly used in intensive care units (ICUs) worldwide for the prevention of treatment interference. While PRs are fundamentally used to maintain patient safety, they can negatively impact the experiences of patients and their families and cause moral and ethical dilemmas for ICU nurses. OBJECTIVES: The aim of this integrative review was to explore the current literature on the use of PR in intensive care. METHODS: This article used an integrative review framework to explore the current literature available on the experiences of PR in ICU...
March 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Pedro Teixeira Castro, Ana Paula Pinho Matos, Osvaldo Luiz Aranda, Edson Marchiori, Haimon Diniz Lopes Alves, Alessandra Silveira Machado, Ricardo Tadeu Lopes, Heron Werner, Edward Araujo Júnior
OBJECTIVE: The aim of this study was to provide a three-dimensional (3D) microscopic reconstruction of morphological modifications of the fallopian tube (FT) following surgical sterilization (including tuboperitoneal fistula) and ectopic pregnancy (EP) using confocal microtomography (micro-CT). METHODS: Six specimens of FT from elective and emergency surgeries were selected: three remnants of the FT (RFT) from surgical sterilization, including one presenting tuboperitoneal fistula, and three FTs with EP...
March 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
Caroline Lenette, Jessica R Botfield, Katherine Boydell, Bridget Haire, Christy E Newman, Anthony B Zwi
Visual research methods like photography and digital storytelling are increasingly used in health and social sciences research as participatory approaches that benefit participants, researchers, and audiences. Visual methods involve a number of additional ethical considerations such as using identifiable content and ownership of creative outputs. As such, ethics committees should use different assessment frameworks to consider research protocols with visual methods. Here, we outline the limitations of ethics committees in assessing projects with a visual focus and highlight the sparse knowledge on how researchers respond when they encounter ethical challenges in the practice of visual research...
March 19, 2018: Journal of Bioethical Inquiry
Dejan Reljic, Felix Wittmann, Joachim E Fischer
PURPOSE: High-intensity interval training (HIIT) is emerging as an effective and time-efficient exercise strategy for health promotion. However, most HIIT studies are conducted in laboratory settings and evidence regarding the efficacy of time-efficient "low-volume" HIIT is based mainly on demanding "all-out" protocols. Thus, the aim of this pilot study was to assess the feasibility and efficacy of two low-volume (≤ 30 min time-effort/week), non-all-out HIIT protocols, performed 2 ×/week over 8 weeks in a community-based fitness centre...
March 19, 2018: European Journal of Applied Physiology
Ahmad M Radaideh, Ziad A Audat, Abdullah A Saleh
BACKGROUND Fractures of the talus are uncommon injuries that usually involve the talar neck, rather than the talar body. This report is of a rare case of combined left talar neck fracture and adjacent joint dislocation with an ipsilateral bimalleolar ankle fracture. CASE REPORT A 37-year-old man presented with an injury to his left foot following a motor vehicle accident. When he presented to the hospital emergency department, his left foot and ankle were swollen, the overlying skin was intact but badly contused, and there was no neurovascular deficit...
March 20, 2018: American Journal of Case Reports
Richard Sola, Valerie A Waddell, Shawn D St Peter, Pablo Aguayo, David Juang
INTRODUCTION: Non-accidental trauma (NAT) has significant societal and health care implications. Standardized care has been shown to improve outcomes. The purpose of our study was to survey trauma centers and elucidate the continued variable management of NAT. METHODS: After institutional review board approval, an email survey was sent to Level 1 and 2 ACS verified trauma centers along with general and pediatric surgery training programs. Trauma hospital characteristics and NAT management were analyzed...
March 10, 2018: Injury
Patrick G Robinson, Iain R Murray, Christopher C West, Ewan B Goudie, Li Y Yong, Timothy O White, Robert F LaPrade
BACKGROUND: Mesenchymal stem cells (MSCs) are increasingly being used in the treatment of a wide variety of sports-related conditions. Despite this enthusiasm, the biological properties of MSCs and their effects on musculoskeletal tissue healing remain poorly understood. MSC-based strategies encompass cell populations with heterogeneous phenotypes isolated from multiple tissues and using different methods. Therefore, comprehensive reporting of the source, preparation methods, and characteristics of MSC strategies is essential to enable interpretation of results...
March 1, 2018: American Journal of Sports Medicine
Ashley C McGinity, Caroline S Zhu, Leslie Greebon, Elly Xenakis, Elizabeth Waltman, Eric Epley, Danielle Cobb, Rachelle Jonas, Susannah E Nicholson, Brian J Eastridge, Ronald M Stewart, Donald H Jenkins
The mortality from hemorrhage in trauma patients remains high. Early balanced resuscitation improves survival. These truths, balanced with the availability of local resources and our goals for positive regional impact, were the foundation for the development of our pre-hospital whole blood initiative-using low titer cold stored O RhD positive whole blood (LTOWB). The main concern with use of RhD positive blood is the potential development of isoimmunization in RhD negative patients. We used our retrospective massive transfusion protocol (MTP) data to analyze the anticipated risk of this change in practice...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Minna M Wieck, Aaron J Cunningham, Brandon Behrens, Erika T Ohm, Bryan G Maxwell, Nicholas A Hamilton, M Christopher Adams, Frederick J Cole, Mubeen A Jafri
BACKGROUND: Expediting evaluation and intervention for severely injured patients has remained a mainstay of advanced trauma care. One technique, direct to operating room (DOR) resuscitation, for selective adult patients has demonstrated decreased mortality. We sought to investigate the application of this protocol in children. METHODS: All DOR pediatric patients from 2009-2016 at a pediatric Level I Trauma Center were identified. DOR criteria included penetrating injury, chest injuries, amputations, significant blood loss, cardiopulmonary resuscitation, and surgeon discretion...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Chao Tian, Wei Zhang, Van Phuc Nguyen, Xueding Wang, Yannis M Paulus
Photoacoustic ocular imaging is an emerging ophthalmic imaging technology that can noninvasively visualize ocular tissue by converting light energy into sound waves and is currently under intensive investigation. However, most reported work to date is focused on the imaging of the posterior segment of the eyes of small animals, such as rats and mice, which poses challenges for clinical human translation due to small eyeball sizes. This manuscript describes a novel photoacoustic microscopy (PAM) and optical coherence tomography (OCT) dual-modality system for posterior segment imaging of the eyes of larger animals, such as rabbits...
February 8, 2018: Journal of Visualized Experiments: JoVE
Ariel Finkielsztein, Lorraine Mascarenhas, Veronika Butin-Israeli, Ronen Sumagin
Polymorphonuclear neutrophil-derived microparticles (PMN)-MPs) are lipid bilayer, spherical microvesicles with sizes ranging from 50-1,000 nm in diameter. MPs are a newly evolving, important part of cell-to-cell communication and signaling machinery. Because of their size and the nature of their release, until recently MP existence was overlooked. However, with improved technology and analytical methods their function in health and disease is now emerging. The protocols presented here are aimed at isolating and characterizing PMN-MPs by flow cytometry and immunoblotting...
March 2, 2018: Journal of Visualized Experiments: JoVE
Arash Ahmadivand, Burak Gerislioglu, Asahi Tomitaka, Pandiaraj Manickam, Ajeet Kaushik, Shekhar Bhansali, Madhavan Nair, Nezih Pala
Engineered terahertz (THz) plasmonic metamaterials have emerged as promising platforms for quick infection diagnosis, cost-effective and real-time pharmacology applications owing to their non-destructive and harmless interaction with biological tissues in both in vivo and in vitro assays. As a recent member of THz metamaterials family, toroidal metamaterials have been demonstrated to be supporting high-quality sharp resonance modes. Here we introduce a THz metasensor based on a plasmonic surface consisting of metamolecules that support ultra-narrow toroidal resonances excited by the incident radiation and demonstrate detection of an ultralow concertation targeted biomarker...
February 1, 2018: Biomedical Optics Express
Chang Xu
Detection of somatic mutations holds great potential in cancer treatment and has been a very active research field in the past few years, especially since the breakthrough of the next-generation sequencing technology. A collection of variant calling pipelines have been developed with different underlying models, filters, input data requirements, and targeted applications. This review aims to enumerate these unique features of the state-of-the-art variant callers, in the hope to provide a practical guide for selecting the appropriate pipeline for specific applications...
2018: Computational and Structural Biotechnology Journal
Melissa Rochon, Julian We Jarman, Joseph Gabriel, Lisa Butcher, Carlos Morais, Martin Still, Ishtiaq Ahmed, Mario Petrou, Richard Trimlett, Anthony DeSouza, Rashmi Yadav, Shahzad G Raja
Background: Previously, we reported that the Brompton Harefield Infection Score (BHIS) accurately predicts surgical site infection (SSI) after coronary artery bypass grafting (CABG). The BHIS was developed using two-centre data and stratifies SSI risk into three groups based on female gender, diabetes or HbA1c > 7.5%, body mass index ≥ 35, left ventricular ejection fraction < 45% and emergency surgery. The purpose of this study was to prospectively evaluate BHIS internally as well as externally...
March 2018: Journal of Infection Prevention
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