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checklist rapid sequence

T Ott, I Schmidtmann, T Limbach, P F Gottschling, H Buggenhagen, S Kurz, G Pestel
BACKGROUND: Simulation-based training (SBT) has developed into an established method of medical training. Studies focusing on the education of medical students have used simulation as an evaluation tool for defined skills. A small number of studies provide evidence that SBT improves medical students' skills in the clinical setting. Moreover, they were strictly limited to a few areas, such as the diagnosis of heart murmurs or the correct application of cricoid pressure. Other studies could not prove adequate transferability from the skills gained in SBT to the patient site...
September 27, 2016: Der Anaesthesist
Christoph Endrullat, Jörn Glökler, Philipp Franke, Marcus Frohme
DNA sequencing continues to evolve quickly even after > 30 years. Many new platforms suddenly appeared and former established systems have vanished in almost the same manner. Since establishment of next-generation sequencing devices, this progress gains momentum due to the continually growing demand for higher throughput, lower costs and better quality of data. In consequence of this rapid development, standardized procedures and data formats as well as comprehensive quality management considerations are still scarce...
September 2016: Applied & Translational Genomics
Steven Grant, Faisal Khan, Gerben Keijzers, Mark Shirran, Leo Marneros
OBJECTIVE: To describe a simple protocol for ventilator-assisted preoxygenation (VAPOX) prior to rapid sequence intubation in the ED using a Hamilton T1 ventilator in an effort to further reduce the incidence of transient and critical hypoxaemia. METHODS: Ventilator-assisted preoxygenation includes the following steps; preparation for rapid sequence intubation as per institutional protocols, including departmental checklists. Hamilton T1 ventilator is setup in non-invasive spontaneous/timed mode with settings as described...
February 2016: Emergency Medicine Australasia: EMA
Julian Wijesuriya, Jonathan Brand
Airway management, particularly in non-theatre settings, is an area of anaesthesia and critical care associated with significant risk of morbidity & mortality, as highlighted during the 4th National Audit Project of the Royal College of Anaesthetists (NAP4). A survey of junior anaesthetists at our hospital highlighted a lack of confidence and perceived lack of safety in emergency airway management, especially in non-theatre settings. We developed and implemented a multifaceted airway package designed to improve the safety of remote site airway management...
2014: BMJ Quality Improvement Reports
Steven J Mack, Robert P Milius, Benjamin D Gifford, Jürgen Sauter, Jan Hofmann, Kazutoyo Osoegawa, James Robinson, Mathijs Groeneweg, Gregory S Turenchalk, Alex Adai, Cherie Holcomb, Erik H Rozemuller, Maarten T Penning, Michael L Heuer, Chunlin Wang, Marc L Salit, Alexander H Schmidt, Peter R Parham, Carlheinz Müller, Tim Hague, Gottfried Fischer, Marcelo Fernandez-Viňa, Jill A Hollenbach, Paul J Norman, Martin Maiers
The development of next-generation sequencing (NGS) technologies for HLA and KIR genotyping is rapidly advancing knowledge of genetic variation of these highly polymorphic loci. NGS genotyping is poised to replace older methods for clinical use, but standard methods for reporting and exchanging these new, high quality genotype data are needed. The Immunogenomic NGS Consortium, a broad collaboration of histocompatibility and immunogenetics clinicians, researchers, instrument manufacturers and software developers, has developed the Minimum Information for Reporting Immunogenomic NGS Genotyping (MIRING) reporting guidelines...
December 2015: Human Immunology
Benjamin T Kerrey, Matthew R Mittiga, Andrea S Rinderknecht, Kartik R Varadarajan, Jenna R Dyas, Gary Lee Geis, Joseph W Luria, Mary E Frey, Tamara E Jablonski, Srikant B Iyer
OBJECTIVES: Rapid sequence intubation (RSI) is the standard for definitive airway management in emergency medicine. In a video-based study of RSI in a paediatric emergency department (ED), we reported a high degree of process variation and frequent adverse effects, including oxyhaemoglobin desaturation (SpO2<90%). This report describes a multidisciplinary initiative to improve the performance and safety of RSI in a paediatric ED. METHODS: We conducted a local improvement initiative in a high-volume academic paediatric ED...
November 2015: BMJ Quality & Safety
Lars Mommers, Sean Keogh
Prehospital emergency medical services often operate in the most challenging and austere environments. Checklist use for complex tasks in these circumstances is useful but must make task completion simpler, faster and more effective. The SPEEDBOMB checklist for Prehospital Rapid Sequence Induction (PRSI) management rapidly addresses critical steps in the RSI process, is designed to improve checklist compliance and patient safety, and is adaptable for local circumstances.
April 2015: Emergency Medicine Australasia: EMA
Endale Gebreegziabher Gebremedhn, Desta Mesele, Derso Aemero, Ehtemariam Alemu
BACKGROUND: Rapid sequence induction and intubation (RSII) is an emergency airway management technique for patients with a risk of pulmonary aspiration. It involves preoxygenation, administration of predetermined doses of induction and paralytic drugs, avoidance of mask ventilation, and laryngoscopy followed by tracheal intubation and keeping cricoid pressure applied till endotracheal tube cuff be inflated. Oxygen desaturation has been seen during RSII. We assessed the incidence of oxygen desaturation during RSII...
2014: World Journal of Emergency Medicine
Endale G Gebremedhn, Kefale D Gebeyehu, Hintsawit A Ayana, Keder E Oumer, Hulgize N Ayalew
BACKGROUND: Rapid sequence induction and intubation (RSII) is a medical procedure involving a prompt induction of general anesthesia by using cricoid pressure that prevents regurgitation of gastric contents. The factors affecting RSII are prophylaxis for aspiration, preoxygenation, drug and equipment preparation for RSII, ventilation after induction till intubation and patient condition. We sometimes saw difficulties with the practice of this technique in our hospital operation theatres...
2014: World Journal of Emergency Medicine
Peter Brendon Sherren, Stephen Tricklebank, Guy Glover
INTRODUCTION: Rapid sequence induction (RSI) of critically ill patients outside of theatres is associated with a higher risk of hypoxia, cardiovascular collapse and death. In the prehospital and military environments, there is an increasing awareness of the benefits of standardised practice and checklists. METHODS: We conducted a non-systematic review of literature pertaining to key components of RSI preparation and management. A standard operating procedure (SOP) for in-hospital RSI was developed based on this and experience from large teaching hospital anaesthesia and critical care departments...
2014: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
J J Pandit, J Andrade, D G Bogod, J M Hitchman, W R Jonker, N Lucas, J H Mackay, A F Nimmo, K O'Connor, E P O'Sullivan, R G Paul, J H M G Palmer, F Plaat, J J Radcliffe, M R J Sury, H E Torevell, M Wang, J Hainsworth, T M Cook
We present the main findings of the 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia (AAGA). Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19,600 anaesthetics (95% confidence interval 1:16,700-23,450). However, there was considerable variation across subtypes of techniques or subspecialities...
October 2014: British Journal of Anaesthesia
J J Pandit, J Andrade, D G Bogod, J M Hitchman, W R Jonker, N Lucas, J H Mackay, A F Nimmo, K O'Connor, E P O'Sullivan, R G Paul, J H MacG Palmer, F Plaat, J J Radcliffe, M R J Sury, H E Torevell, M Wang, J Hainsworth, T M Cook
We present the main findings of the 5th National Audit Project on accidental awareness during general anaesthesia. Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19 600 anaesthetics (95% CI 1:16 700-23 450). However, there was considerable variation across subtypes of techniques or subspecialties. The incidence with neuromuscular blockade was ~1:8200 (1:7030-9700), and without it was ~1:135 900 (1:78 600-299 000)...
October 2014: Anaesthesia
Nazneen Aziz, Qin Zhao, Lynn Bry, Denise K Driscoll, Birgit Funke, Jane S Gibson, Wayne W Grody, Madhuri R Hegde, Gerald A Hoeltge, Debra G B Leonard, Jason D Merker, Rakesh Nagarajan, Linda A Palicki, Ryan S Robetorye, Iris Schrijver, Karen E Weck, Karl V Voelkerding
CONTEXT: The higher throughput and lower per-base cost of next-generation sequencing (NGS) as compared to Sanger sequencing has led to its rapid adoption in clinical testing. The number of laboratories offering NGS-based tests has also grown considerably in the past few years, despite the fact that specific Clinical Laboratory Improvement Amendments of 1988/College of American Pathologists (CAP) laboratory standards had not yet been developed to regulate this technology. OBJECTIVE: To develop a checklist for clinical testing using NGS technology that sets standards for the analytic wet bench process and for bioinformatics or "dry bench" analyses...
April 2015: Archives of Pathology & Laboratory Medicine
P Fernandes, A Cleland, D Bainbridge, P M Jones, M W A Chu, B Kiaii
All transcatheter aortic valve implantation (TAVI) cases are done in our hybrid operating room with a multidisciplinary team and a primed cardiopulmonary bypass (CPB) circuit on pump stand-by. We decided that we would resuscitate all patients undergoing a TAVI procedure via a transfemoral, transapical or transaortic approach, if required. Perfusion plays an essential role in providing rescue CPB for patient salvage when catastrophic complications occur. To coordinate the multidisciplinary effort, we have developed a written safety checklist that assigns a pre-determined role for team members for the rapid sequence initiation of CPB...
January 2015: Perfusion
Julie Considine, Judy Currey
AIMS AND OBJECTIVES: To argue that if all nurses were to adopt the primary survey approach (assessment of airway, breathing, circulation and disability) as the first element of patient assessment, they would be more focused on active detection of clinical deterioration rather than passive collection of patient data. BACKGROUND: Nurses are the professional group that carry the highest level of responsibility for patient assessment, accurate data collection and interpretation...
January 2015: Journal of Clinical Nursing
Mark J Conroy, Gregory S Weingart, Jestin N Carlson
BACKGROUND: Checklists have successfully been used in intensive care units (ICUs) to improve metrics of critical care. Proper peri-intubation care including use of appropriate induction agents and postintubation sedation is crucial when performing endotracheal intubation (ETI) on critically ill patients, especially in the emergency department (ED). We sought to evaluate the impact of checklists on peri-intubation care in ED trauma patients. METHODS: We performed a retrospective review of all trauma patients intubated in the ED of an urban, level 1 academic center from November 2010 to October 2012...
June 2014: American Journal of Emergency Medicine
J-J Wilson, K-W Sing, M R A Halim, R Ramli, R Hashim, M Sofian-Azirun
Bats are important flagship species for biodiversity research; however, diversity in Southeast Asia is considerably underestimated in the current checklists and field guides. Incorporation of DNA barcoding into surveys has revealed numerous species-level taxa overlooked by conventional methods. Inclusion of these taxa in inventories provides a more informative record of diversity, but is problematic as these species lack formal description. We investigated how frequently documented, but undescribed, bat taxa are encountered in Peninsular Malaysia...
2014: Genetics and Molecular Research: GMR
Eric A Youngstrom, Melissa McKeown Jenkins, Amanda Jensen-Doss, Jennifer Kogos Youngstrom
Evidence-based assessment of pediatric bipolar disorder has advanced rapidly in the last two decades, moving from isolated clinical case descriptions to what is now a portfolio of techniques that include checklists from multiple informants, semi-structured diagnostic interviews and severity ratings, and technologies that allow daily tracking of mood and energy over the course of treatment. This review critically appraises (a) the need for evidence-based assessment of bipolar disorder as a common component of clinical practice, (b) triggers that warrant assessment of bipolar, (c) when best to deploy different techniques over the course of diagnosis and treatment, and (d) promising new developments in assessment...
2012: Israel Journal of Psychiatry and related Sciences
David C Hardie, T Ryan Gregory, Paul D N Hebert
The study of genome size variation is important from a number of practical and theoretical perspectives. For example, the long-standing "C-value enigma" relating to the more than 200,000-fold range in eukaryotic genome sizes is best studied from a broad comparative standpoint. Genome size data are also required in detailed analyses of genome structure and evolution. The choice of future genome sequencing projects will be dependent on knowledge regarding the sizes of genomes to be sequenced, and so on. To date, genome size data have been acquired primarily by Feulgen microdensitometry or flow cytometry...
June 2002: Journal of Histochemistry and Cytochemistry: Official Journal of the Histochemistry Society
F Adnet, S W Borron, M A Finot, C Lapandry, F J Baud
OBJECTIVE: To determine whether the initial Glasgow Coma Scale (GCS) score is predictive of intubation difficulty in out-of-hospital airway management of poisoned patients. METHODS: A prospective, observational study was performed in a toxicological intensive care unit of a university hospital and in a physician-based out-of-hospital care system. Subjects included consecutive poisoned patients intubated during their airway management by out-of-hospital medical teams before hospitalization...
February 1998: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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