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Chest Guidelines

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https://www.readbyqxmd.com/read/28328689/adult-chest-pain-in-the-pediatric-emergency-department-treatment-and-timeliness-from-door-in-to-door-out
#1
Jeffrey H Sacks, Peter B Flueckiger, Philip R Spandorfer, William T Mahle, Brian E Costello
OBJECTIVES: The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. METHODS: Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#2
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323084/integration-of-in-hospital-cardiac-arrest-contextual-curriculum-into-a-basic-life-support-course-a-randomized-controlled-simulation-study
#3
Elizabeth A Hunt, Jordan M Duval-Arnould, Nnenna O Chime, Kareen Jones, Michael Rosen, Merona Hollingsworth, Deborah Aksamit, Marida Twilley, Cheryl Camacho, Daniel P Nogee, Julianna Jung, Kristen Nelson-McMillan, Nicole Shilkofski, Julianne S Perretta
OBJECTIVE: To compare resuscitation performance on simulated in-hospital cardiac arrests after traditional American Heart Association (AHA) Healthcare Provider Basic Life Support course (TradBLS) versus revised course including in-hospital skills (HospBLS). DESIGN: Prospective, randomized, controlled curriculum evaluation. SETTING: Johns Hopkins Medicine Simulation Center. SUBJECTS: One hundred twenty-two first year medical students divided into fifty-nine teams...
March 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28320636/the-significance-of-equivocal-exercise-treadmill-ecg-for-intermediate-risk-chest-pain-assessment-insight-from-coronary-ct-angiography-data
#4
Gary T E Lau, Henry Wei, Jo Wickham, Andrew C Y To
BACKGROUND: Exercise treadmill test (ETT) is commonly the first-line investigation in troponin-negative chest pain patients. Inconclusive results are common and often lead to repeated functional testings. Coronary computed tomographic angiography (CCTA) has excellent negative predictive value for coronary artery disease detection and may play an important role in their diagnostic workup. We aim to analyse ETT and CCTA findings to understand their modern roles in intermediate risk chest pain population with inconclusive ETT...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28320069/usefulness-of-laboratory-and-radiological-investigations-in-the-management-of-supraventricular-tachycardia
#5
Aadith Ashok, Miguel Cabalag, David McD Taylor
OBJECTIVE: Although ED patients presenting with supraventricular tachycardia (SVT) are commonly investigated, the value of these investigations has been questioned. We aimed to determine the frequency and utility of investigations in patients with SVT. METHODS: We undertook an explicit retrospective medical record audit of patients with SVT who presented to a single ED (January 2004 to June 2014). Data on demographics, presenting complaints, investigations and outcomes were extracted...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28319321/unrecognized-coronary-vasospasm-in-patients-referred-for-percutaneous-coronary-intervention-intracoronary-nitroglycerin-the-forgotten-stepchild-of-cardiovascular-guidelines
#6
Alec Vishnevsky, Howard M Julien, David L Fischman, Paul Walinsky, J David Ogilby, Nicholas J Ruggiero, Babu Jasti, Michael P Savage
OBJECTIVE: The goal of this study was to demonstrate the importance of intracoronary nitroglycerin (IC NTG) administration during diagnostic coronary angiography and prior to percutaneous coronary intervention (PCI). BACKGROUND: PCI has been a mainstay treatment for patients with symptomatic coronary artery disease. While current guidelines emphasize the importance of periprocedural antithrombotic medications, they fail to mention the use of nitroglycerin prior to PCI...
March 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28317171/combination-of-change-in-hematological-parameters-with-exercise-stress-test-to-predict-coronary-artery-disease
#7
Ahmet Korkmaz, Abdulkadir Yıldız, Pınar Türker Duyuler, Serkan Duyuler, Samet Yılmaz, Funda Basyigit, Ozgul Ucar Elalmis, Umit Guray, Mehmet Ileri
OBJECTIVE: Treadmill exercise stress testing for identifying patients with a higher likelihood of coronary artery disease (CAD) before elective coronary angiography is recommended in the current guidelines. In this study, we aimed to evaluate the changes in the hematological parameters before and after exercise stress test in relation with the presence of CAD. METHODS: A total of 113 patients with chest pain who underwent treadmill exercise testing and coronary angiography were included in this study...
March 20, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28297341/assessment-of-monte-carlo-algorithm-for-compliance-with-rtog-0915-dosimetric-criteria-in-peripheral-lung-cancer-patients-treated-with-stereotactic-body-radiotherapy
#8
Damodar Pokhrel, Sumit Sood, Rajeev Badkul, Hongyu Jiang, Christopher McClinton, Christopher Lominska, Parvesh Kumar, Fen Wang
The purpose of the study was to evaluate Monte Carlo-generated dose distributions with the X-ray Voxel Monte Carlo (XVMC) algorithm in the treatment of peripheral lung cancer patients using stereotactic body radiotherapy (SBRT) with non-protocol dose-volume normalization and to assess plan outcomes utilizing RTOG 0915 dosimetric compliance criteria. The Radiation Therapy Oncology Group (RTOG) protocols for non-small cell lung cancer (NSCLC) currently require radiation dose to be calculated using tissue density heterogeneity corrections...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28295894/cost-effectiveness-analysis-appraisal-and-application-an-emergency-medicine-perspective
#9
Michael D April, Brian P Murray
Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policy-makers have any formal training in CEA methodology...
March 10, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28293721/post-whipple-imaging-in-patients-with-pancreatic-ductal-adenocarcinoma-association-with-overall-survival-a-multivariate-analysis
#10
Azadeh Elmi, Janet Murphy, Sandeep Hedgire, Shaunagh McDermott, Seyed-Mahdi Abtahi, Elkan Halpern, Carlos Fernandez-Del Castillo, Mukesh Harisinghani
PURPOSE: To compare the survival outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) who had regular imaging surveillance with those who had clinical follow-up after Whipple. METHOD: We identified 229 patients, who underwent Whipple for resection of PDAC from 2005 to 2011, and had regular postoperative clinical follow-up at our hospital. Patients were retrospectively selected for two follow-up groups: imaging surveillance (IS) defined as routine imaging at scheduled intervals, vs...
March 14, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#11
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289559/comparison-of-3d-laser-based-photonic-scans-and-manual-anthropometric-measurements-of-body-size-and-shape-in-a-validation-study-of-123-young-swiss-men
#12
Nikola Koepke, Marcel Zwahlen, Jonathan C Wells, Nicole Bender, Maciej Henneberg, Frank J Rühli, Kaspar Staub
BACKGROUND: Manual anthropometric measurements are time-consuming and challenging to perform within acceptable intra- and inter-individual error margins in large studies. Three-dimensional (3D) laser body scanners provide a fast and precise alternative: within a few seconds the system produces a 3D image of the body topography and calculates some 150 standardised body size measurements. OBJECTIVE: The aim was to enhance the small number of existing validation studies and compare scan and manual techniques based on five selected measurements...
2017: PeerJ
https://www.readbyqxmd.com/read/28286827/doing-pre-operative-investigations-in-emergency-department-a-clinical-audit
#13
Muhammad Salman Rafiq, Maria Rafiq, Muhammad Imran Rafiq, Seema Gul Salman, Sania Hafeez
INTRODUCTION: Pre-operative investigations for emergency surgical patients differ between centers. Following established guidelines can reduce unnecessary investigation, cost of treatment and hospital stay. The present audit was carried out to evaluate the condition of doing pre-operative investigations for three common surgical emergencies compared to National Institute for Health and Care Excellence (NICE) guidelines and local criteria. METHODS: A retrospective clinical audit of acute-appendicitis, abscess and hernia patients admitted to the emergency department was carried out over a one-year period from July 2014 to July 2015...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28282762/a-comparison-between-the-two-methods-of-chest-compression-in-infant-and-neonatal-resuscitation-a-review-according-to-2010-cpr-guidelines
#14
Alexandros Douvanas, Christina Koulouglioti, Maria Kalafati
AIM: The quality of chest compression (CC) delivered during neonatal and infant cardiopulmonary resuscitation (CPR) is identified as the most important factor to achieve the increase of survival rate without major neurological deficit to the patients. The objective of the study was to systematically review all the available studies that have compared the two different techniques of hand placement on infants and neonatal resuscitation, from 2010 to 2015 and to highlight which method is more effective...
March 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28275481/the-influence-of-chest-tube-size-and-position-in-primary-spontaneous-pneumothorax
#15
Sara S Riber, Lars P S Riber, Winnie H Olesen, Peter B Licht
BACKGROUND: Optimal chest tube position in the pleural cavity is largely unexplored for the treatment of primary spontaneous pneumothorax (PSP). We investigated whether type, size and position of chest tubes influenced duration of treatment for PSP. METHODS: A retrospective follow-up study of all patients admitted with PSP over a 5-year period. Traumatic, iatrogenic and secondary pneumothoraxes were excluded. Gender, age, smoking habits, type and size of chest tube used (pigtail catheter or surgical chest tube) were recorded from the patients' charts...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28272336/development-of-portable-digital-radiography-system-with-a-device-for-monitoring-x-ray-source-detector-angle-and-its-application-in-chest-imaging
#16
Tae-Hoon Kim, Dong-Woon Heo, Chang-Won Jeong, Jong-Hyun Ryu, Hong Young Jun, Seung-Jun Han, Taeuk Ha, Kwon-Ha Yoon
This study developed a device measuring the X-ray source-detector angle (SDA) and evaluated the imaging performance for diagnosing chest images. The SDA device consisted of Arduino, an accelerometer and gyro sensor, and a Bluetooth module. The SDA values were compared with the values of a digital angle meter. The performance of the portable digital radiography (PDR) was evaluated using the signal-to-noise (SNR), contrast-to-noise ratio (CNR), spatial resolution, distortion and entrance surface dose (ESD). According to different angle degrees, five anatomical landmarks were assessed using a five-point scale...
March 7, 2017: Sensors
https://www.readbyqxmd.com/read/28270248/the-resuscitative-and-pharmacokinetic-effects-of-humeral-intraosseous-vasopressin-in-a-swine-model-of-ventricular-fibrillation
#17
James M Burgert, Arthur D Johnson, Jose Garcia-Blanco, Lawrence V Fulton, Michael J Loughren
Introduction The American Heart Association (AHA; Dallas, Texas USA) and European Resuscitation Council (Niel, Belgium) cardiac arrest (CA) guidelines recommend the intraosseous (IO) route when intravenous (IV) access cannot be obtained. Vasopressin has been used as an alternative to epinephrine to treat ventricular fibrillation (VF). Hypothesis/Problem Limited data exist on the pharmacokinetics and resuscitative effects of vasopressin administered by the humeral IO (HIO) route for treatment of VF. The purpose of this study was to evaluate the effects of HIO and IV vasopressin, on the occurrence, odds, and time of return of spontaneous circulation (ROSC) and pharmacokinetic measures in a swine model of VF...
March 8, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28269574/development-of-a-diagnostic-feedback-device-to-assess-neonatal-cardiopulmonary-resuscitation-chest-compression-performance
#18
Debbie Lloyd, Dawie van den Heever, Kiran Dellimore, Johan Smith
Neonatal cardiopulmonary resuscitation (NCPR) is an important intervention to save the lives of newborns who suffer from cardiac and respiratory arrest. Despite its importance there is a dearth of NCPR research and no commercially available feedback device suitable for use during NCPR. The aim of this study is to develop a diagnostic feedback device in the form of a patch placed on the infant's chest. The diagnostic feedback patch measures both the compression depth and force during NCPR, while giving audio-visual feedback according to current NCPR guidelines...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28262338/differences-in-presentation-management-and-outcomes-in-women-and-men-presenting-to-an-emergency-department-with-possible-cardiac-chest-pain
#19
Lorcan Ruane, Jaimi H Greenslade, William Parsonage, Tracey Hawkins, Christopher Hammett, Carolyn Sp Lam, Thomas Knowlman, Shaela Doig, Louise Cullen
BACKGROUND: Research suggests that female patients with acute coronary syndrome (ACS) experience delays in emergency department (ED) management and are less likely to receive guideline-based treatments and referrals for follow-up testing. Women are often found to have poorer clinical outcomes in comparison to men. This study aimed to assess current sex differences in the presentation, management and outcomes of patients with undifferentiated chest pain presenting to a tertiary ED. METHODS: Data were analysed from two prospective studies conducted at a single Australian site between 2007 and 2014...
February 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28261908/acute-coronary-syndrome-screening-and-diagnostic-practice-variation
#20
Maame Yaa A B Maya Yiadom, Xulei Liu, Conor M McWade, Dandan Liu, Alan B Storrow
BACKGROUND: In the absence of the existing acute coronary syndrome guidelines directing the clinical practice implementation of ED screening and diagnosis, there is variable screening and diagnostic clinical practice across ED facilities. This practice diversity may be warranted. Understanding the variability may identify opportunities for more consistent practice. METHODS: This is a cross-sectional clinical practice epidemiology study with the emergency department (ED) as the unit of analysis characterizing variability in the acute coronary syndrome (ACS) evaluation across 62 diverse EDs...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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